Isometric Strength Measures are Superior to the Timed Up and Go Test for Fall Prediction in Older Adults: Results from a Prospective Cohort Study

Figures & data

Table 1 Baseline Characteristics of Study Participants

Variable	All (n=24)	Fallers (n=12)	Non-Fallers (n=12)	p-value
Gender (n, % female)	19 (79%)	9 (75%)	10 (83%)	0.615
Age (years)	88 ± 7	91 ± 8	86 ± 6	0.055
Body mass index (kg·m^−2)	24.4 ± 3.2	23.3 ± 3.5	25.5 ± 2.6	0.083
Katz ADL score [max = 6]	5.7 ± 0.7	5.5 ± 0.9	5.8 ± 0.4	0.259
MOCA score [max = 30]	20.9 ± 5.5	18.5 ± 5.7	22.8 ± 2.4	0.033
Handgrip strength (kg)	20.9 ± 5.6	17.7 ± 4.9	24.2 ± 4.3	0.002
Hip flexion strength (kg)	15.5 ± 5.2	14.3 ± 3.8	16.8 ± 6.2	0.248
Knee extension strength (kg)	13.2 ± 4.4	10.8 ± 3.4	15.6 ± 4.2	0.006
TUG-standard (s)	12.1 ± 7.5	15.2 ± 8.3	8.9 ± 5.1	0.038
TUG-cognitive (s)	14.9 ± 15.7	20.0 ± 20.7	9.7 ± 5.4	0.110
TUG-motor (s)	12.7 ± 5.6	15.0 ± 4.6	10.5± 5.6	0.049

Notes: Values expressed as mean ± SD (unless otherwise stated). The p-values refer to the differences between fallers and non-fallers. Significant p-values are highlighted in bold.

Abbreviations: ADL, activities of daily living; BMI, body mass index; MOCA, Montreal cognitive assessment; TUG, timed up and go.

Table 2 Associations Between Baseline Physical Performance Test Results and the Risk of Falling During the One-Year Follow-Up

Test	Crude OR (95% CI)	Adjusted OR (95% CI)*
Handgrip strength (kg)	0.73 (0.56, 0.94) p = 0.017	0.74 (0.55, 1.01) p = 0.056
Hip flexion strength (kg)	0.90 (0.74, 1.08) p = 0.251	0.91 (0.74, 1.13) p = 0.392
Knee extension strength (kg)	0.74 (0.57, 0.95) p = 0.016	0.77 (0.58, 1.02) p = 0.070
TUG-standard (s)	1.23 (0.99, 1.52) p = 0.057	1.19 (0.94, 1.51) p = 0.141
TUG-cognitive (s)	1.19 (0.99, 1.43) p = 0.060	1.16 (0.92, 1.45) p = 0.210
TUG-motor (s)	1.19 (0.99, 1.44) p = 0.066	1.18 (0.93, 1.50) p = 0.166

Notes: Data are shown as odds ratio (OR), 95% confidence intervals (CI) and p-values. Significant p-values are highlighted in bold. *Adjusted for gender, age, body mass index, and previous history of falls.

Table 3 Differences in Physical Performance Tests Between Fallers and Non-Fallers During the One-Year Follow-Up

Test	Crude Difference (95% CI)	Adjusted Difference (95% CI)*
Handgrip strength (kg)	−7.01 (−10.72, −3.31) p = 0.001	−5.74 (−10.41, −1.08) p = 0.019
Hip flexion strength (kg)	−4.22 (−8.00, −0.43) p = 0.031	−2.72 (−6.98, 1.54) p = 0.196
Knee extension strength (kg)	−7.11 (−11.00, −3.22) p = 0.001	−4.92 (−9.62, −0.21) p = 0.042
TUG-standard (s)	9.23 (1.63, 16.82) p = 0.020	7.23 (−0.71, 15.16) p = 0.072
TUG-cognitive (s)	13.30 (2.93, 23.66) p = 0.014	9.62 (−1.43, 20.67) p = 0.084
TUG-motor (s)	8.53 (1.73, 15.32) p = 0.016	4.56 (−2.92, 12.03) p = 0.216

Notes: Data (estimate [95% confidence intervals] and p-value) represent the difference between groups (ie, fallers vs non-fallers) during the follow-up. Significant p-values are highlighted in bold. *Adjusted for gender, age, body mass index, and previous history of falls.

Figure 1 Functional mobility (A–C) and isometric strength (D–F) results in fallers and non-fallers during the one-year follow-up. Multiple imputation was performed to create the figures, as there were missing data (<25%) at some time points. The crude difference (diff, expressed along with 95% confidence intervals [CI]) corresponds to the average difference between groups, and was computed using linear mixed model analysis with no data imputation. Significant differences between groups were found for all tests.