Occupational therapist use of the 'Timed Up and Go' test in a Memory Clinic to compare performance between cognitive diagnoses and screen for falls risk

Kristie J Harper; Vera Riley; Antonio Petta; Angela Jacques; Nicholas Spendier; Katharine Ingram

doi:10.1111/1440-1630.12617

Occupational therapist use of the 'Timed Up and Go' test in a Memory Clinic to compare performance between cognitive diagnoses and screen for falls risk

Aust Occup Ther J. 2020 Feb;67(1):13-21. doi: 10.1111/1440-1630.12617. Epub 2019 Oct 14.

Authors

Kristie J Harper¹, Vera Riley², Antonio Petta², Angela Jacques³, Nicholas Spendier², Katharine Ingram²

Affiliations

¹ Occupational Therapy Department, Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia.
² Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia.
³ Department of Research, Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia.

PMID: 31609001
DOI: 10.1111/1440-1630.12617

Abstract

Introduction: Occupational therapists assess older patients attending Memory Clinics to address multiple facets, including memory, activities of daily living function, mobility and falls risk. Identifying deficits in motor and functional abilities represents a crucial and necessary component of cognitive diagnosis. The aim of this research was to compare performance on the TUG between patients with normal (NC), mild cognitive impairment (MCI) and dementia.

Methods: A prospective single-blind single-centre cohort study was conducted in a Memory Clinic. Patients underwent comprehensive medical assessment, including the Mini Mental Status Examination (MMSE) to determine a cognitive diagnosis. The occupational therapist, blinded to any diagnosis, completed the TUG.

Results: A total of 158 patients aged 60 years and older were recruited. The average TUG was 15.4 s, which was similar between men and women (p = .87). A TUG greater than ≥14 s was significantly associated with the use of a walking aid (p ≤ .001). The TUG increased with age and a slower TUG was associated with a greater number of previous falls (p = .023). The TUG did not significantly differ between patients with dementia, MCI and NC (p = .095). However, there was a significant difference comparing patients with NC and MCI (14.3 s) to those with dementia (16.4 s) (p = .048). There was a significant weak negative correlation between the MMSE and the TUG of -0.253 (p = .003). Univariate models showed that a patient's ability to ambulate independently contributed to 33% of the variance in the TUG, whereas previous falls contributed to 4%, highlighting the importance of physical function and intervention to target this.

Conclusion: A simple TUG test should be considered for use by occupational therapists in a Memory Clinic to screen patients at risk of falling. Patients diagnosed with dementia have a significantly slower TUG. However, this tool cannot assist with the early detection of patients with MCI.

Keywords: accidental falls; cognition; memory; occupational therapy; walking.

MeSH terms

Accidental Falls / statistics & numerical data
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Cognitive Dysfunction / diagnosis*
Dementia / diagnosis*
Female
Geriatric Assessment / methods*
Humans
Male
Mental Status and Dementia Tests
Middle Aged
Occupational Therapy / methods*
Occupational Therapy / standards
Prospective Studies
Single-Blind Method