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

BACKGROUND: Isometric strength measures and timed up and go (TUG) tests are both recognized as valuable tools for fall prediction in older adults. However, results from direct comparison of these two tests are lacking. We aimed to assess the potential of isometric strength measures and the different modalities of the TUG test to detect individuals at risk of falling. METHODS: This is a prospective cohort study including 24 community-dwelling older adults (≥65 years, 19 females, 88±7 years). Participants performed three variations of the TUG test (standard, counting and holding a full cup) and three isometric strength tests (handgrip, knee extension and hip flexion) at several time points (at baseline and every ~6 weeks) during a one-year follow-up. The association between these tests and the incidence of falls during the follow-up was assessed. RESULTS: Twelve participants out of 24 participants experienced falls during the follow-up. Fallers showed a significantly lower handgrip strength (−5.7 kg, 95% confidence interval: −10.4 to −1.1, p=0.019) and knee extension strength (−4.9 kg, −9.6 to −0.2, p=0.042) at follow-up, while no significant differences were found for any TUG variation. CONCLUSIONS: Handgrip and knee extension strength measures – particularly when assessed regularly over time – have the potential to serve as a simple and easy tool for detecting individuals at risk of falling as compared to functional mobility measures (ie, TUG test).