Sains Malaysiana 47(11)(2018): 2769–2776

http://dx.doi.org/10.17576/jsm-2018-4711-19

 

Discriminative and Predictive Ability of Physical Performance Measures in Identifying Fall Risk among Older Adults

(Keupayaan Ramalan dan Diskriminasi Ujian Prestasi Fizikal bagi Mengenal Pasti Risiko Jatuh dalam Kalangan Warga Emas di Malaysia)

ZUNAIDAH ABU SAMAH¹, DEVINDER KAUR AJIT SINGH^2*, RESSHAYA ROOBINI MURUKESU², SUZANA SHAHAR³, NOR AZLIN MOHD NORDIN², MOHD AZAHADI OMAR⁴ & CHIN AI-VYRN⁵

 

¹Department of Medical Rehabilitation Services, UKM Medical Centre, Jalan Yaa’cob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Federal Territory, Malaysia

 

²Physiotherapy Programme, Centre for Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, 50300 Kuala Lumpur, Federal Territory, Malaysia

 

³Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, 50300 Kuala Lumpur, Federal Territory, Malaysia

 

⁴Centre for Burden of Disease Research, Institute for Public Health, Ministry of Health, Jalan Bangsar, Federal Hill, 50590 Kuala Lumpur, Federal Territory, Malaysia

 

⁵Ageing and Age-Associated Disorders Research Group, Division of Geriatric Medicine, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

 

Diserahkan: 27 Mac 2018/Diterima: 6 Julai 2018

 

ABSTRACT

Falls are a public health concern among older adults. There is a need to take significant measures such as screening for the risk of a fall as a means of prevention and management. A cross-sectional study was conducted to determine discriminative and predictive ability of physical performance measures in identifying the risk of fall among Malaysian community dwelling older adults. Three hundred twenty-five Malaysian community dwelling older adults aged 60 years and above (67.67+ 5.5 years) participated in this study. This study was a part of a larger longitudinal study ‘LRGS TUA’. Physiological Profile Assessment (PPA), a comprehensive tool for quantifying risk of fall was used as a standard measure of comparison to 6 Meter Gait Speed (GS), Timed Up and Go (TUG) and Walking While Talking (WWT) tests to establish discriminative and predictive ability. Participants recorded incidence of falls in a ‘falls diary’ over a span of six months. To determine the optimum cut off scores of the test identified to classify fall risk, receiver operator curves (ROC) were used and its sensitivity and specificity were calculated. A significant mean difference between fallers and non-fallers was demonstrated only with TUG test (p<0.05). TUG test cut off score in discriminating older adults at risk of fall was established at eight seconds, with a sensitivity and specificity of 83.95% and 32.4%, respectively, in this study. Eighty-four percent older adults who experienced a fall in our study were identified to be at risk of fall when screened using this TUG cut off score. Our study results suggested TUG test to be an optimal screening tool for risk of fall among community dwelling older adults.

 

Keywords: Aging; community dwelling; falls; geriatrics; risk assessment

 

 

 

ABSTRAK

Masalah jatuh adalah salah satu kemelut kesihatan awam dalam kalangan warga emas. Langkah pencegahan seperti pemeriksaan risiko jatuh diperlukan untuk menangani masalah ini. Tujuan kajian kami adalah untuk menentukan kesahan ramalan dan diskriminasi ujian prestasi fizikal dalam mengenal pasti risiko jatuh dalam kalangan warga emas yang tinggal di komuniti. Sejumlah 325 warga emas Malaysia dalam komuniti yang berusia 60 tahun ke atas (min umur dan piawaian sisihan: 67.67+ 5.5 tahun) telah direkrut melalui persampelan rawak bagi menyertai kajian hirisan lintang ini. Kajian ini adalah sebahagian daripada kajian longitud ‘LRGS TUA’. Penilaian profil psikologi (PPA), ujian komprehensif untuk mengesan risiko jatuh telah digunakan sebagai pengukur piawai berbanding ujian kelajuan pergerakan 6 meter (GS), masa bangun dan pergi (TUG) dan berjalan sambil bercakap (WWT) untuk menentukan keupayaan diskriminasi dan kesahan ramalan. Para peserta mencatatkan insiden jatuh dalam ‘diari jatuh’ sepanjang tempoh 6 bulan. Bagi menentukan titik penggal yang optimum bagi ujian yang dikenal pasti untuk mengelaskan risiko jatuh, lengkung pengoperasi penerima (ROC) telah digunakan dan nilai kesensitifan dan kekhususan telah dikira. Ujian TUG dikenal pasti sebagai ujian prestasi fizikal yang mampu menunjukkan perbezaan yang signifikan antara warga emas yang pernah mengalami insiden jatuh dan yang tidak (p<0.05). Skor titik potong ujian TUG dalam mendiskriminasi warga emas yang berisiko jatuh adalah lapan saat dengan kesensitifan dan kekhususan sebanyak 83.95% dan 32.4%. Berdasarkan skor titik potong ujian TUG ini, didapati bahawa 84% warga emas dalam kajian ini yang telah mengalami insiden jatuh dikesan sebagai mempunyai risiko jatuh. Keputusan kajian kami mencadangkan Ujian TUG sebagai ujian saringan yang paling sesuai untuk menyaring risiko jatuh dalam kalangan warga emas dalam komuniti.

 

Kata kunci: Dalam komuniti; geriatrik; insiden jatuh; penilaian risiko; warga emas

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*Pengarang untuk surat-menyurat; email: devinder@ukm.edu.my