Performances on the Timed Up and Go Test and subtasks between fallers and non-fallers in older adults with cognitive impairment

Juliana Hotta Ansai; Larissa Pires de Andrade; Theresa Helissa Nakagawa; José Rubens Rebelatto

doi:10.1590/0004-282X20180055

Arquivos de Neuro-Psiquiatria, Table of Contents

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2018; 76(06): 381-386
DOI: 10.1590/0004-282X20180055

ARTICLE

Performances on the Timed Up and Go Test and subtasks between fallers and non-fallers in older adults with cognitive impairment

Performances no teste Timed Up and Go e subtarefas em idosos com comprometimento cognitivo, caidores e não caidores

Juliana Hotta Ansai

¹Universidade Federal do Mato Grosso do Sul; Departamento de Fisioterapia, Instituto Integrado de Saúde, Campo Grande MS, Brasil;

,

Larissa Pires de Andrade

²Universidade Federal de São Carlos, Departamento de Fisioterapia, São Carlos SP, Brasil;

,

Theresa Helissa Nakagawa

³Centro Universitário do Norte, Departamento de Fisioterapia, Manaus AM, Brasil.

,

José Rubens Rebelatto

²Universidade Federal de São Carlos, Departamento de Fisioterapia, São Carlos SP, Brasil;

› Author Affiliations

Abstract

ABSTRACT

This work aimed to compare performances on the Timed Up and Go (TUG) test and its subtasks between faller and non-faller older adults with mild cognitive impairment (MCI) and mild Alzheimer’s disease (AD). A prospective study was conducted, with 38 older adults with MCI and 37 with mild AD. Participants underwent an assessment at baseline (the TUG and its subtasks using the Qualisys ProReflex system) and the monitoring of falls at the six-month follow up. After six months, 52.6% participants with MCI and 51.3% with AD fell. In accordance with specific subtasks, total performance on the TUG distinguished fallers from non-fallers with AD, fallers from non-fallers with MCI and non-fallers with MCI from non-fallers with AD. Although no other difference was found in total performances, non-fallers with MCI and fallers with AD differed on the walking forward, turn and turn-to-sit subtasks; and fallers with MCI and non-fallers with AD differed on the turn-to-sit subtask.

RESUMO

O objetivo deste trabalho foi comparar o desempenho do Timed up and go test (TUG) e suas subtarefas entre idosos caidores e não caidores com comprometimento cognitivo leve (CCL) e doença de Alzheimer (DA) leve. Um estudo prospectivo foi conduzido, com 38 idosos com CCL e 37 com DA leve. Foi realizada uma avaliação inicial (TUG e subtarefas por meio do sistema Qualisys Pro Reflex) e um monitoramento de quedas por 6 meses. Após 6 meses, 52.6% pessoas com CCL e 51.3% com DA caíram. Em concordância com subtarefas específicas, a performance total do TUG distinguiu caidores de não caidores com DA, caidores de não caidores com CCL e não caidores com CCL de não caidores com DA. Embora nenhuma outra diferença foi encontrada na performance total do TUG, não caidores com CCL e caidores com DA apresentaram diferenças nas performances das subtarefas marcha ida, retornar e virar-se para sentar; e caidores com CCL e não caidores com DA diferiram na subtarefa virar-se para sentar.

aged - Alzheimer’s disease - accidental falls - cognitive disfunction

idoso - doença de Alzheimer - acidentes por quedas - disfunção cognitiva

Full Text

References

References
1 Bergland A. Jørgensen L, Emaus N, Strand BH. Mobility as a predictor of all-cause mortality in older men and women: 11.8 year follow-up in the Tromsø study. BMC Health Serv Res. 2017;17(1):22. https://doi.org/10.1186/s12913-016-1950-0
2 Alexandre TS, Meira DM, Rico NC, Mizuta SK. Accuracy of Timed Up and Go Test for screening risk of falls among community-dwelling elderly. Rev Bras Fisioter. 2012 Sep-Oct;16(5):381-8. https://doi.org/10.1590/S1413-35552012005000041
3 Mirelman A, Weiss A, Buchman AS, Bennett DA, Giladi N, Hausdorff JM. Association between performance on Timed Up and Go subtasks and mild cognitive impairment: further insights into the links between cognitive and motor function. J Am Geriatr Soc. 2014 Apr;62(4):673-8. https://doi.org/10.1111/jgs.12734
4 Ansai JH, Andrade LP, Rossi PG, Takahashi AC, Vale FA, Rebelatto JR. Gait, dual task and history of falls in elderly with preserved cognition, mild cognitive impairment, and mild Alzheimer’s disease. Braz J Phys Ther. 2017 Mar - Apr;21(2):144-51. https://doi.org/10.1016/j.bjpt.2017.03.010
5 Gillain S, Warzee E, Lekeu F, Wojtasik V, Maquet D, Croisier JL et al. The value of instrumental gait analysis in elderly healthy, MCI or Alzheimer’s disease subjects and a comparison with other clinical tests used in single and dual-task conditions. Ann Phys Rehabil Med. 2009 Jul;52(6):453-74. https://doi.org/10.1016/j.rehab.2008.10.004
6 Taylor ME, Delbaere K, Mikolaizak AS, Lord SR, Close JC. Gait parameter risk factors for falls under simple and dual task conditions in cognitively impaired older people. Gait Posture. 2013 Jan;37(1):126-30. https://doi.org/10.1016/j.gaitpost.2012.06.024
7 Allan LM, Ballard CG, Rowan EN, Kenny RA. Incidence and prediction of falls in dementia: a prospective study in older people. PLoS One. 2009;4(5):e5521. https://doi.org/10.1371/journal.pone.0005521
8 Zakaria NA, Kuwae Y, Tamura T, Minato K, Kanaya S. Quantitative analysis of fall risk using TUG test. Comput Methods Biomech Biomed Engin. 2015;18(4):426-37. https://doi.org/10.1080/10255842.2013.805211
9 Montaño MB, Ramos LR. Validity of the Portuguese version of Clinical Dementia Rating. Rev Saúde Pública 2005;39(6):1-5. https://doi.org/10.1590/S0034-89102005000600007
10 American Psychiatric Association. Diagnostic and Statistical manual of mental disorders. 4th ed. Washington: American Psychiatric Association; 2000.
11 Lustosa LP, Pereira DS, Dias RC, Britto RR, Parentoni NA, Pereira LS. Translation and cultural adaptation of the Minnesota Leisure Time Activities Questionnaire in community-dwelling older people. Geriatr Gerontol. 2011;5(2):57-65.
12 Ansai JH, Andrade LP, Nakagawa TH, Vale FA, Caetano MJ, Lord SR et al. Cognitive correlates of Timed up and go subtasks in older people with preserved cognition, mild cognitive impairment and Alzheimer’s disease. Am J Phys Med Rehabil. 2017 Oct;96(10):700-5. https://doi.org/10.1097/PHM.20180055201800550722
13 Higashi Y, Yamakoshi K, Fujimoto T, Sekine M, Tamura T. Quantitative evaluation of movement using the timed up-and-go test. IEEE Eng Med Biol Mag. 2008;27(4):38-46. https://doi.org/10.1109/MEMB.2008.919494
14 Galán-Mercant A, Cuesta-Vargas AI. Differences in trunk accelerometry between frail and non-frail elderly persons in functional tasks. BMC Res Notes. 2014 Feb;7(1):100. https://doi.org/10.1186/1756-0500-7-100
15 The prevention of falls in later life. A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly. Dan Med Bull. 1987 Apr;34(4 Suppl 4):1-24. P
16 Taylor ME, Delbaere K, Lord SR, Mikolaizak AS, Brodaty H, Close JC. Neuropsychological, physical, and functional mobility measures associated with falls in cognitively impaired older adults. J Gerontol A Biol Sci Med Sci. 2014 Aug;69(8):987-95. https://doi.org/10.1093/gerona/glt166
17 Pettersson AF, Olsson E, Wahlund LO. Effect of divided attention on gait in subjects with and without cognitive impairment. J Geriatr Psychiatry Neurol. 2007 Mar;20(1):58-62. https://doi.org/10.1177/0891988706293528
18 Borges SM, Radanovic M, Forlenza OV. Functional mobility in a divided attention task in older adults with cognitive impairment. J Mot Behav. 2015;47(5):378-85. https://doi.org/10.1080/00222895.2014.998331
19 Maquet D, Lekeu F, Warzee E, Gillain S, Wojtasik V, Salmon E et al. Gait analysis in elderly adult patients with mild cognitive impairment and patients with mild Alzheimer’s disease: simple versus dual task: a preliminary report. Clin Physiol Funct Imaging. 2010 Jan;30(1):51-6. https://doi.org/10.1111/j.1475-097X.2009.00903.x
20 Allali G, Launay CP, Blumen HM, Callisaya ML, De Cock AM, Kressig RW et al.; Biomathics Consortium. Falls, Cognitive Impairment, and Gait Performance: Results From the GOOD Initiative. J Am Med Dir Assoc. 2017 Apr;18(4):335-40. https://doi.org/10.1016/j.jamda.2016.10.008
21 Donoghue OA, Horgan NF, Savva GM, Cronin H, O’Regan C, Kenny RA. Association between timed up-and-go and memory, executive function, and processing speed. J Am Geriatr Soc. 2012 Sep;60(9):1681-6. https://doi.org/10.1111/j.1532-5415.2012.04120.x
22 Doi T, Shimada H, Makizako H, Tsutsumimoto K, Uemura K, Anan Y et al. Cognitive function and gait speed under normal and dual-task walking among older adults with mild cognitive impairment. BMC Neurol. 2014 Apr;14(1):67. https://doi.org/10.1186/1471-2377-14-67
23 Muir SW, Speechley M, Wells J, Borrie M, Gopaul K, Montero-Odasso M. Gait assessment in mild cognitive impairment and Alzheimer’s disease: the effect of dual-task challenges across the cognitive spectrum. Gait Posture. 2012 Jan;35(1):96-100. https://doi.org/10.1016/j.gaitpost.2011.08.014
24 Ansai JH, Andrade LP, Masse FA, Gonçalves J, Takahashi ACM, Vale FA et al. Risk factors for falls in older adults with mild cognitive impairment and mild Alzheimer disease. J Geriatr Phys Ther. 2017 Mar 3. https://doi.org/10.1519/JPT.20180055201800550135
25 Horikawa E, Matsui T, Arai H, Seki T, Iwasaki K, Sasaki H. Risk of falls in Alzheimer’s disease: a prospective study. Intern Med. 2005 Jul;44(7):717-21. https://doi.org/10.2169/internalmedicine.44.717
26 Mancini M, Schlueter H, El-Gohary M, Mattek N, Duncan C, Kaye J et al. Continuous monitoring of turning mobility and its association to falls and cognitive function: a pilot study. J Gerontol A Biol Sci Med Sci. 2016 Aug;71(8):1102-8. https://doi.org/10.1093/gerona/glw019