title: Predicting falls with the cognitive timed up-and-go dual task in frail older patients.
abstract: BACKGROUND
  The cognitive timed up-and-go dual task (CogTUG) has been proposed to improve the performance of the timed up-and-go (TUG) test for predicting falls in older patients and as a screening tool for early detection of frailty. We aimed to determine whether the CogTUG score is associated with a history of falls in frail older outpatients with gait disorders.
  
  
  METHODS
  This retrospective study involved outpatients >75 years old with or without previous falls who were admitted from 2012 to 2014 to a geriatric day hospital for gait disorders. Patients took the TUG and CogTUG tests on the day of comprehensive geriatric assessment.
  
  
  RESULTS
  Among the 161 patients included (157 analyzed; mean age 84.4±6.2 years; 72% women), 84 (53.5%) had fallen in the previous year: 105 (66.9%) were considered pre-frail and 52 (33.1%) frail. As compared with non-fallers, fallers had lower Tinetti balance scores (P=0.0004) and handgrip strength (P=0.03), more lost weight (P=0.04), and they took longer to perform the TUG test (P=0.04). Fallers and non-fallers did not differ in time taken to perform the CogTUG test (30.7±11.2 vs. 28.5±10.2s, P=0.20). History of falls was associated with only weight loss (odds ratio 3.43; 95% CI 1.13-11.30, P=0.03) and handgrip strength (0.88; 0.78-0.97, P=0.02) on multivariate analysis.
  
  
  CONCLUSIONS
  Unlike TUG scores, the CogTUG score was not associated a history of falls in frail older outpatients with gait disorders. Our results underline that weight loss and low muscle strength are related to falls.
authors.affiliation: Département de Gériatrie Bichat-Beaujon-Secteur Ambulatoire de Bretonneau, APHP, 75018 Paris, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Cardon-Verbecq
authors.affiliation: Hôpital Simone-Veil, 14, rue de Saint-Prix, 95600 Eaubonne, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Loustau
authors.affiliation: Département de Gériatrie Bichat-Beaujon-Secteur Ambulatoire de Bretonneau, APHP, 75018 Paris, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Guitard
authors.affiliation: Département de Gériatrie Bichat-Beaujon-Secteur Ambulatoire de Bretonneau, APHP, 75018 Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Bonduelle
authors.affiliation: Département de Gériatrie Bichat-Beaujon-Secteur Ambulatoire de Bretonneau, APHP, 75018 Paris, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Delahaye
authors.affiliation: Département de Gériatrie Bichat-Beaujon-Secteur Ambulatoire de Bretonneau, APHP, 75018 Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Koskas
authors.affiliation: Département de Gériatrie Bichat-Beaujon-Secteur Ambulatoire de Bretonneau, APHP, 75018 Paris, France; Faculté de Médecine Denis-Diderot, 75010 Paris, France. Electronic address: agathe.raynaud-simon@aphp.fr.
authors.forename: Agathe
authors.initials: A
authors.lastname: Raynaud-Simon
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D005080:Exercise Test; D005260:Female; D016330:Frail Elderly; D000073496:Frailty / Q000175:diagnosis / Q000503:physiopathology; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D015577:Geriatric Assessment; D018737:Hand Strength; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D013647:Task Performance and Analysis
keywords: Dual task TUG; Falls; Frailty; Handgrip strength; Malnutrition; Older age; TUG