Functional Evaluation Tests as Prognostic Factors of Falls in Elderly Patients

Abstract

Objective: Analysis of risk factors for falls through a detailed geriatric evaluation is essential. The aim of the present study was to analyze prognostic factors for falls in elderly patients in Spain. Materials and Methods: a) Initial phase (n=247): transverse observational study. Inclusion criteria: patients >80 years old living alone and/or with a relative of similar age; b) Final phase (n=90): prospective cohort study of the previously enrolled patients. Variables analyzed included demographics; clinical characteristics and results of timed up and go (TUG) (mobility assessment) and Lobo (cognitive assessment) tests; Lawton-Brody Instrumental Activities of Daily Living scale and Barthel index (basic activities). Results: Falls were significantly associated with changes in Lobo and Barthel test results during both phases. No association was found between falls and comorbidities, number or type of treatment received and analytical variables studied. No statistical difference was observed in TUG test between fallers and non-fallers in the initial phase. A significant deterioration was observed in Lobo, Lawton-Brody, Barthel and TUG evaluation tests during the 4-year in between-period; male gender and a lower score in Lobo test were independent variables related to mortality. In the final phase, a TUG cut-off value of 25 seconds (sensitivity=0.52; specificity=0.75), that differentiated fallers from non-fallers, was established. Conclusion: Tests that evaluate cognitive ability and functional activities are predictors of falls in the elderly. The use of Lobo test to define the cognitive state of elderly patients may contribute to predict their vital prognoses.