Cevher SAVCUN DEMİRCİ, MERAL SERTEL, Elif SAKİZLİ ERDAL, SABİHA BEZGİN

Identifying a cut-off point for Timed Up and Go Test and 30-second Chair Stand Test in dual-task condition: Effects of cognitive status

A decline in mental function is a common problem associated with aging. The most commonly used tests for evaluating functional mobility, fall risk, and lower limb strength of older adults in the clinic are ‘Timed Up and Go Test’ and ‘30-second Chair Stand Test’. This study was planned to determine the cut-off point of these tests in cognitive declines. A total of 204 older adults aged 65 years and over participated in this study. To examine the cut-off points of tests for single and dual-tasks, count off by twos was added as a cognitive task. The cut-off points of tests without and with an additional task were determined as 10.54, 12.21 second, 10.5, and 8.5 stands respectively. These results are important to reveal the effects of mental declines should be taken into account when interpreting the results of clinical functional mobility assessments in older adults.

PDF

___

Deary IJ, Corley J, Gow AJ, et al. Age-associated cognitive decline. Br Med Bull. 2009;92:135-52.

Park DC, Reuter-Lorenz P. The adaptive brain: aging and neurocognitive scaffolding. Annu Rev Psychol. 2009;60:173-96.

Gleason CE, Gangnon RE, Fischer BL, et al. Increased risk for falling associated with subtle cognitive impairment: secondary analysis of a randomized clinical trial. Dement Geriatr Cogn Disord. 2009;27:557-63.

Liu-Ambrose TY, Ashe MC, Graf P, et al. Increased risk of falling in older community-dwelling women with mild cognitive impairment. Phys Ther. 2008;88:1482-91.

Hartholt KA, van Beeck EF, Polinder S, et al. Societal consequences of falls in the older population: injuries, healthcare costs, and long-term reduced quality of life. J Trauma Acute Care Surg. 2011;71:748-53.

Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35:ii37-ii41.

Beauchet O, Annweiler C, Allali G, et al. Recurrent falls and dual task-related decrease in walking speed: Is there a relationship? J Am Geriatr Soc. 2008;56:1265-9.

Hsu CL, Nagamatsu LS, Davis JC, et al. Examining the relationship between specific cognitive processes and falls risk in older adults: a systematic review. Osteoporosis int. 2012;23:2409-24.

Trombini-Souza F, de Maio Nascimento M, da Silva TFA, et al. Dual-task training with progression from variable-to fixed-priority instructions versus dual-task training with variable-priority on gait speed in community-dwelling older adults: A protocol for a randomized controlled trial. BMC Geriatr. 2020;20:1-12.

Tang PF, Yang HJ, Peng YC, Chen HY. Motor dual‐task Timed Up & Go test better identifies prefrailty individuals than single‐task Timed Up & Go test. Geriatr Gerontol Int. 2015;15(2):204-10.

Holtzer R, Burright RG, Donovick PJ. The sensitivity of dual-task performance to cognitive status in aging. J Int Neuropsychol Soc. 2004;10:230-8.

Venema DM, Hansen H, High R, et al. Minimal detectable change in dual-task cost for older adults with and without cognitive impairment. J Geriatr Phys Ther. 2019;42: 32-8.

Porciuncula FS, Rao AK, McIsaac TL. Aging-related decrements during specific phases of the dual-task Timed Up-and-Go test. Aging Clin Exp Res. 2016;28:121-30.

Herman T, Giladi N, Hausdorff JM. Properties of the ‘timed up and go’ test: more than meets the eye. Gerontology. 2011;57:203-10.

Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142-8.

Makizako H, Shimada H, Doi T, et al. Predictive cutoff values of the Five-Times Sit-to-Stand Test and the Timed “Up & Go” Test for disability incidence in older people dwelling in the community. Phys Ther. 2017;97:417-24.

Beauchet O, Fantino B, Allali G, et al. Timed Up and Go test and risk of falls in older adults: a systematic review. J Nutr Health Aging. 2011;15:933-8.

Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exercise Sport. 1999;70:113-9.

Nakatani T, Nadamoto M, Mimura K,et al. Validation of a 30-sec chair-stand test for evaluating lower extremity muscle strength in Japanese elderly adults. JSPE. 2002;47:451-61.

Macfarlane D, Chou K, Cheng Y, et al. Validity and normative data for thirty‐second chair stand test in elderly community‐dwelling Hong Kong Chinese. Am J Hum Biol. 2006;18:418-21.

Bohannon RW. Sit-to-stand test for measuring performance of lower extremity muscles. Percept Mot Skills. 1995;80:163-6.

Csuka M, McCarty DJ. Simple method for measurement of lower extremity muscle strength. Am J Med. 1985;78:77-81.

Macrae PG, Lacourse M, Moldavon R. Physical performance measures that predict faller status in community-dwelling older adults. J Orthop Sports Phys Ther. 1992;16:123-8.

McMurdo ME, Rennie L. A controlled trial of exercise by residents of old people's homes. Age Ageing. 1993;22:11-5.

Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80:896-903.

Zia A, Kamaruzzaman SB, Tan MP. Polypharmacy and falls in older people: balancing evidence-based medicine against falls risk. Postgrad Med. 2015;127:330-7.

Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-98.

Keskinoglu P, Ucku R, Yener G, et al. Reliability and validity of revised Turkish version of Mini Mental State Examination (rMMSE‐T) in community‐dwelling educated and uneducated elderly. Int J Geriatr Psychiatry. 2009;24:1242-50.

Millor N, Lecumberri P, Gómez M, et al. An evaluation of the 30-s chair stand test in older adults: frailty detection based on kinematic parameters from a single inertial unit. J Neuroeng Rehabil. 2013;10:86.

Bischoff HA, Stähelin HB, Monsch AU, et al. Identifying a cut‐off point for normal mobility: a comparison of the timed ‘up and go’test in community‐dwelling and institutionalised elderly women. Age Ageing. 2003;32:315-20.

Telenius EW, Engedal K, Bergland A. Inter-rater reliability of the Berg Balance Scale, 30-s chair stand test and 6 m walking test, and construct validity of the Berg Balance Scale in nursing home residents with mild-to-moderate dementia. BMJ open. 2015;5:e008321.

Ross CM. Application and interpretation of functional outcome measures for testing individuals with cognitive impairment. Top Geriatr Rehabil. 2018;34:13-35.

Sturnieks DL, St. George R, Fitzpatrick RC, et al. Effects of spatial and nonspatial memory tasks on choice stepping reaction time in older people. J Gerontol A Biol Sci. 2008;63:1063-8.

Smith E, Cusack T, Blake C. The effect of a dual task on gait speed in community dwelling older adults: A systematic review and meta-analysis. Gait Posture. 2016;44:250-8.

Brauer S, Woollacott M, Shumway-Cook A. The influence of a concurrent cognitive task on the compensatory stepping response to a perturbation in balance-impaired and healthy elders. Gait Posture. 2002;15:83-93.

Liston MB, Bergmann JH, Keating N, et al. Postural prioritization is differentially altered in healthy older compared to younger adults during visual and auditory coded spatial multitasking. Gait Posture. 2014;39:198-204.

Yogev-Seligmann G, Rotem-Galili Y, Dickstein R, et al. Effects of explicit prioritization on dual task walking in patients with Parkinson's disease. Gait Posture. 2012;35:641-6.

Tombu M, Jolicoeur P. A central capacity sharing model of dual-task performance. J Exp Psychol Human. 2003;29:3.

Sertel M, Demirci CS, Erdal ES, et al. Determination of cut-off values of Tinetti Performance Oriented Mobility Assessment and Fall Risk Questionnaire in older adults individuals with cognitive impairment. Ann Med Res2019;26:204-8.