Streamlining assessment and intervention in a falls clinic using the Timed Up and Go Test and Physiological Profile Assessments.

Abstract:

BACKGROUND:The Timed Up and Go Test (TUGT) has been recommended as a simple screening tool to identify those at risk of falling. However, subsequent detailed assessment is required to identify underlying falls risk factors to provide direction for optimal targeted intervention strategies. METHODS:110 consecutive falls clinic patients underwent the TUGT, the Abbreviated Mental Test and the Physiological Profile Assessment (PPA), a validated tool for quantifying risk of falling based on a combination of physiological measures-contrast sensitivity, knee extension strength, proprioception, reaction time and postural sway. Regression analysis was used to determine how well the TUGT and presence of cognitive impairment could identify patients at high risk of falls as defined by the PPA. RESULTS:TUGT and cognitive status were found to be independent and significant predictors of PPA scores. These variables accounted for 21% of the variance in PPA scores (multiple R=0.47, P<0.001). The standardised beta weights were 0.403 for TUGT and 0.236 for cognitive status. A receiver-operator curve (ROC) indicated that 15 seconds in the TUGT was the optimal cut-point for identifying those with a high risk of falling: 70% of the total sample. CONCLUSIONS:The TUGT and a simple test of cognition can be used to streamline referrals in a high-risk population, allowing for more efficient use of available resources in clinical practice. A subsequent PPA provides quantification of risk and direction for tailored intervention.

journal_name

Age Ageing

journal_title

Age and ageing

authors

Whitney JC,Lord SR,Close JC

doi

10.1093/ageing/afi178

subject

Has Abstract

pub_date

2005-11-01 00:00:00

pages

567-71

issue

6

eissn

0002-0729

issn

1468-2834

pii

34/6/567

journal_volume

34

pub_type

杂志文章
  • A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomised controlled trial (RCT).

    abstract:OBJECTIVE:to evaluate the effectiveness of a multifactorial intervention on incidence of falls in psychogeriatric nursing home patients. DESIGN:cluster-randomised controlled 12-month trial. SETTING:psychogeriatric wards in 12 nursing homes in The Netherlands. PARTICIPANTS:psychogeriatric nursing home patients (n = 5...

    journal_title:Age and ageing

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/ageing/afn297

    authors: Neyens JC,Dijcks BP,Twisk J,Schols JM,van Haastregt JC,van den Heuvel WJ,de Witte LP

    更新日期:2009-03-01 00:00:00

  • Refeeding syndrome.

    abstract:CASE REPORT:An elderly woman with poor nutritional intake developed profound hypophosphataemia and hypokalaemia following the institution of nasogastric feeding. DISCUSSION:Refeeding syndrome is well recognized in certain undernourished groups of patients, but may not be so well known to physicians looking after elder...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/31.1.65

    authors: Mallet M

    更新日期:2002-01-01 00:00:00

  • Estimated societal costs of stroke in the UK based on a discrete event simulation.

    abstract:BACKGROUND:there are around 100,000 new stroke cases and over a million people living with its consequences annually in the UK. This has large impacts on health and social care, unpaid carers and lost productivity. We aimed to estimate associated costs. METHODS:we estimated 2014/2015 annual mean cost per person and ag...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afz162

    authors: Patel A,Berdunov V,Quayyum Z,King D,Knapp M,Wittenberg R

    更新日期:2020-02-27 00:00:00

  • Use of antipsychotics among nonagenarian residents in long-term institutional care in Finland.

    abstract:BACKGROUND:There is a paucity of information about the use of antipsychotic medication in long-term care, especially among the oldest-old residents. OBJECTIVE:To analyse the factors associated with the use of antipsychotic medication among nonagenarian residents in long-term institutional care. DESIGN:A retrospective...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afl065

    authors: Alanen HM,Finne-Soveri H,Noro A,Leinonen E

    更新日期:2006-09-01 00:00:00

  • Shared genetic influence on frailty and chronic widespread pain: a study from TwinsUK.

    abstract:Introduction:frailty is an increased vulnerability to adverse health outcomes, across multiple physiological systems, with both environmental and genetic drivers. The two most commonly used measures are Rockwood's frailty index (FI) and Fried's frailty phenotype (FP). Material and methods:the present study included 36...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afx122

    authors: Livshits G,Ni Lochlainn M,Malkin I,Bowyer R,Verdi S,Steves CJ,Williams FMK

    更新日期:2018-01-01 00:00:00

  • Fixing the broken image of care homes, could a 'care home innovation centre' be the answer?

    abstract::The UK has many excellent care homes that provide high-quality care for their residents; however, across the care home sector, there is a significant need for improvement. Even though the majority of care homes receive a rating of 'good' from regulators, still significant numbers are identified as requiring 'improveme...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afw154

    authors: Hockley J,Harrison JK,Watson J,Randall M,Murray S

    更新日期:2017-03-01 00:00:00

  • Sports injuries in elderly athletes: a three-year prospective, controlled study.

    abstract::A 3-year prospective, controlled study of sports injuries in elderly athletes (over 60 years of age) treated at an outpatient sports clinic was carried out in order to determine the number, profile, and specific features of these injuries compared with those of young athletes (between 21 and 25 years). During the stud...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/18.4.263

    authors: Kannus P,Niittymäki S,Järvinen M,Lehto M

    更新日期:1989-07-01 00:00:00

  • Oxybutynin chloride for geriatric urinary dysfunction: a double-blind placebo-controlled study.

    abstract::Twenty-four incontinent elderly institutionalized subjects with detrusor instability participated in a double-blind placebo-controlled trial of oxybutynin chloride. Patients were randomly assigned to oral oxybutynin 5 mg or placebo twice daily. Administration continued for 8 days; a 6-day washout period was followed b...

    journal_title:Age and ageing

    pub_type: 临床试验,杂志文章,随机对照试验,评审

    doi:10.1093/ageing/18.3.195

    authors: Zorzitto ML,Holliday PJ,Jewett MA,Herschorn S,Fernie GR

    更新日期:1989-05-01 00:00:00

  • The Short FES-I: a shortened version of the falls efficacy scale-international to assess fear of falling.

    abstract:BACKGROUND:the 16-item Falls Efficacy Scale-International (FES-I) has been shown to have excellent reliability and construct validity. However, for practical and clinical purposes, a shortened version of the FES-I would be useful. OBJECTIVE:to develop and validate a shortened version of FES-I while preserving good psy...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afm157

    authors: Kempen GI,Yardley L,van Haastregt JC,Zijlstra GA,Beyer N,Hauer K,Todd C

    更新日期:2008-01-01 00:00:00

  • A re-validation of the Rivermead ADL scale for elderly patients with stroke.

    abstract::The Rivermead ADL scale was developed for assessing activities of daily living in stroke patients but was not validated for elderly subjects. This study was designed to validate the scale for patients aged over 64 years. A series of 150 stroke patients was assessed on the scale, of whom 103 were aged over 64 years. Th...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/19.1.19

    authors: Lincoln NB,Edmans JA

    更新日期:1990-01-01 00:00:00

  • Where are we in perioperative medicine for older surgical patients? A UK survey of geriatric medicine delivered services in surgery.

    abstract:INTRODUCTION:national reports have highlighted deficiencies in care provided to older surgical patients and suggested a role for innovative, collaborative, inter-specialty models of care. The extent of geriatrician-led perioperative services in the UK (excluding orthogeriatric services) has not previously been describe...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afu084

    authors: Partridge JS,Collingridge G,Gordon AL,Martin FC,Harari D,Dhesi JK

    更新日期:2014-09-01 00:00:00

  • Defining 'recovery' for delirium research: a systematic review.

    abstract:BACKGROUND:Delirium is a common neuropsychiatric disorder. The natural course is of an acute, fluctuating and often transient condition; however, accumulating evidence suggests that delirium can be associated with incomplete recovery. Despite a growing body of research, a lack of clarity exists regarding definition and...

    journal_title:Age and ageing

    pub_type: 杂志文章,评审

    doi:10.1093/ageing/afu152

    authors: Adamis D,Devaney A,Shanahan E,McCarthy G,Meagher D

    更新日期:2015-03-01 00:00:00

  • Spindle cell sarcoma: a rare cause of a large abdominal mass.

    abstract::A 73-year-old man presented with a huge intra-abdominal mass. Initially a gastrointestinal stromal tumour (GIST) was diagnosed, but his tumour was subsequently classified as a spindle cell sarcoma. Difficulties in the classification of rare intra-abdominal tumours are discussed. ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afi002

    authors: Bills V,Iqbal R,Haqqani M,Clague JE

    更新日期:2005-01-01 00:00:00

  • Much more medicine for the oldest old: trends in UK electronic clinical records.

    abstract:BACKGROUND:the oldest old (85+) pose complex medical challenges. Both underdiagnosis and overdiagnosis are claimed in this group. OBJECTIVE:to estimate diagnosis, prescribing and hospital admission prevalence from 2003/4 to 2011/12, to monitor trends in medicalisation. DESIGN AND SETTING:observational study of Clinic...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afu113

    authors: Melzer D,Tavakoly B,Winder RE,Masoli JA,Henley WE,Ble A,Richards SH

    更新日期:2015-01-01 00:00:00

  • Does looped nasogastric tube feeding improve nutritional delivery for patients with dysphagia after acute stroke? A randomised controlled trial.

    abstract:BACKGROUND:nasogastric tube (NGT) feeding is commonly used after stroke, but its effectiveness is limited by frequent dislodgement. OBJECTIVE:the objective of the study was to evaluate looped NGT feeding in acute stroke patients with dysphagia. METHODS:this was a randomised controlled trial of 104 patients with acute...

    journal_title:Age and ageing

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1093/ageing/afq088

    authors: Beavan J,Conroy SP,Harwood R,Gladman JR,Leonardi-Bee J,Sach T,Bowling T,Sunman W,Gaynor C

    更新日期:2010-09-01 00:00:00

  • Growth hormone secreting carcinoma of lung and hypertrophic osteoarthropathy.

    abstract::Plasma Human Growth Hormone (HGH) was raised in a patient with bronchial carcinoma and hypertrophic pulmonary osteoarthropathy before radiotherapy to the tumour. Though the soft-tissue swelling and pain of hypertrophic osteoarthropathy disappeared two to three weeks after radiotherapy to the carcinoma the HGH plasma l...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/4.2.95

    authors: Mukherjee SK

    更新日期:1975-05-01 00:00:00

  • Stroke knowledge and awareness: an integrative review of the evidence.

    abstract:BACKGROUND:the recognition of stroke symptoms by the public and activation of the emergency medical services (EMS) are the most important factors in instigating pre-hospital stroke care. Studies have suggested that poor recognition of the warning signs of stroke is the main cause of delay in accessing the EMS. METHODS...

    journal_title:Age and ageing

    pub_type: 杂志文章,评审

    doi:10.1093/ageing/afp196

    authors: Jones SP,Jenkinson AJ,Leathley MJ,Watkins CL

    更新日期:2010-01-01 00:00:00

  • Post-acute care for older people in community hospitals--a cost-effectiveness analysis within a multi-centre randomised controlled trial.

    abstract:OBJECTIVES:to compare the cost effectiveness of post-acute care for older people provided in community hospitals with general hospital care. DESIGN:cost-effectiveness study embedded within a randomised controlled trial. SETTING:seven community hospitals and five general hospitals at five centres in the midlands and n...

    journal_title:Age and ageing

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1093/ageing/afn120

    authors: O'Reilly J,Lowson K,Green J,Young JB,Forster A

    更新日期:2008-09-01 00:00:00

  • Infective discitis as an uncommon but important cause of back pain in older people.

    abstract:CASE REPORTS:two elderly patients (aged 70 and 80 years) presented with severe back pain and restriction of spinal movements. Inflammatory markers were raised and in each case computed tomography findings confirmed infective discitis. One patient improved with antibiotics but the second developed paraplegia, a recogniz...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/29.5.454

    authors: Goel V,Young JB,Patterson CJ

    更新日期:2000-09-01 00:00:00

  • The elimination half-life of benzodiazepines and fall risk: two prospective observational studies.

    abstract:BACKGROUND:the STOPP criteria advise against the use of long-acting benzodiazepines (LBs). OBJECTIVE:to study whether LBs are associated with a higher fall risk than short-acting benzodiazepines (SBs) (elimination half-life ≤ 10 h). METHODS:we used base-line data and prospective fall follow-up from the Longitudinal A...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/aft089

    authors: de Vries OJ,Peeters G,Elders P,Sonnenberg C,Muller M,Deeg DJ,Lips P

    更新日期:2013-11-01 00:00:00

  • Changes in falls prevention policies in hospital in England and Wales.

    abstract:BACKGROUND:in 2007, the National Patient Safety Agency (NPSA) published 'Slips trips and falls in hospital' and 'Using bedrails safely and effectively'. OBJECTIVES:this observational study aimed to identify changes in local policies in hospitals in England and Wales following these publications. METHOD:policies in pl...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afs063

    authors: Healey F,Treml J

    更新日期:2013-01-01 00:00:00

  • Does vitamin D stop inpatients falling? A randomised controlled trial.

    abstract:BACKGROUND:Vitamin D deficiency is common in older people and may increase risk of falls and fracture. Hospital inpatients are at particular risk of falling. Previous studies suggest that vitamin D improves neuromuscular function and reduces falls. OBJECTIVE:To determine whether routine supplementation with vitamin D ...

    journal_title:Age and ageing

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/ageing/afm087

    authors: Burleigh E,McColl J,Potter J

    更新日期:2007-09-01 00:00:00

  • Observer variation in the clinical assessment of stroke.

    abstract::Clinical assessments have to be used in epidemiological studies in the absence of more objective means of establishing diagnosis or recording events in the natural history of disease. This requires the standardization of definition, technique and interpretation as a means of reducing observer variability in clinical e...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/5.4.233

    authors: Garraway WM,Akhtar AJ,Gore SM,Prescott RJ,Smith RG

    更新日期:1976-11-01 00:00:00

  • Prevention of NSAID gastropathy in elderly patients. An observational study in general practice and nursing homes.

    abstract:OBJECTIVES:The objectives of this study were to (i) survey the risk factors for NSAID gastropathy in outpatients (elderly patients in the community), compared to those living in old people's homes or nursing homes, (ii) study the prescription of medication prophylaxis during use of NSAIDs conform the current national g...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afm049

    authors: van Leen MW,van der Eijk I,Schols JM

    更新日期:2007-07-01 00:00:00

  • Potentially inappropriate prescribing in older residents in Irish nursing homes.

    abstract:BACKGROUND:STOPP/START was formulated to identify potentially inappropriate prescribing (PIP) and potential prescribing omissions (PPOs) in older people. The purpose of this study was to determine the prevalence of PIP and PPO in older Irish patients in residential care using STOPP/START. METHODS:data were collected p...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afs068

    authors: Ryan C,O'Mahony D,Kennedy J,Weedle P,Cottrell E,Heffernan M,O'Mahony B,Byrne S

    更新日期:2013-01-01 00:00:00

  • Using the Resident Assessment Instrument for quality enhancement in nursing homes.

    abstract:BACKGROUND:in some current policy discussions concerning long-term care, the emphasis has been almost solely on the costs of care. This dialogue must be replaced with a discussion of value, which emphasizes both the costs of care and quality of care. While the Resident Assessment Instrument (RAI) was originally designe...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/26.suppl_2.77

    authors: Phillips CD,Zimmerman D,Bernabei R,Jonsson PV

    更新日期:1997-09-01 00:00:00

  • A general population survey of rest cramps.

    abstract::Two hundred and eighteen subjects, out of 250 individuals taken from a general practice register, returned completed questionnaires giving details about rest cramps, and a further 15 were contacted by telephone. The overall prevalence of rest cramps in the survey population was 37%. The symptom was more prevalent in o...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/23.5.418

    authors: Naylor JR,Young JB

    更新日期:1994-09-01 00:00:00

  • Medication management at home: medication-related risk factors associated with poor health outcomes.

    abstract:BACKGROUND:Some patients may have medication-related risk factors only identified by home visits, but the extent to which those risk factors are associated with poor health outcomes remains unclear. OBJECTIVE:To determine the association between medication-related risk factors and poor patient health outcomes from obs...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afi202

    authors: Sorensen L,Stokes JA,Purdie DM,Woodward M,Roberts MS

    更新日期:2005-11-01 00:00:00

  • Moderate physical activity associated with a higher naïve/memory T-cell ratio in healthy old individuals: potential role of IL15.

    abstract:INTRODUCTION:ageing is accompanied by impairments in immune responses due to remodelling of the immune system (immunesenescence). Additionally, a decline in habitual physical activity has been reported in older adults. We have recently published that specific features of immunesenescence, such as thymic involution and ...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/afaa035

    authors: Bartlett DB,Duggal NA

    更新日期:2020-04-27 00:00:00

  • Dual-task effects of talking while walking on velocity and balance following a stroke.

    abstract:BACKGROUND:Therapists and nurses often use verbal instruction in the rehabilitation of mobility following stroke. This study aimed to determine whether performing a verbal cognitive task while walking adversely affected patients' balance and velocity. METHODS:There were two counterbalanced conditions: walking only and...

    journal_title:Age and ageing

    pub_type: 杂志文章

    doi:10.1093/ageing/30.4.319

    authors: Bowen A,Wenman R,Mickelborough J,Foster J,Hill E,Tallis R

    更新日期:2001-07-01 00:00:00