Balance perception as a potential tool for screening imbalance in the Timed Up and Go test among cognitively impaired older adults
DOI:
https://doi.org/10.1590/1980-0037.2025v27e87710Keywords:
Aged, Cognitive Dysfunction, Mass Screening, Postural Balance, Self ReportAbstract
Imbalance is a common complaint in cognitively impaired older adults. It is unknown whether cognitive impairment (CI) affects the validity and interpretability of balance perception in this population when standing up and walking. Investigate the validity of imbalance perception to screen performance limitations in the task proposed in the Timed Up and Go (TUG) test in older adults with CI. Cross-sectional study with data on older people assessed in 2019-2020 at a specialized geriatric care service. Participants were 136 older adults with CI identified by the Mini-Mental State Examination (MMSE). They were questioned about imbalance perception (test index) and submitted to the TUG test (reference standard; cutoff point>20 seconds). The answers given were confirmed with the caregiver. Sensitivity (SE), specificity (SP) and the positive (VPP) and negative predictive values (VPN) were estimated, and the agreement percentage was calculated (Cohen’s Kappa test). Of the 136 individuals studied, 60.3% reported imbalance in the TUG and 25.3% exhibited it during the test. Validity estimates showed high sensitivity and NPV values (SE=85.7%, SP=48.5%, PPV=36.6%, NPV=90.7%). Agreement between the two tools in the overall sample was 58.1%. Despite the low agreement between instruments, perceived imbalance showed low false-negative percentages, indicating that it could be a potential tool for screening limitations in the TUG, favoring the identification of individuals at risk of imbalance among older adults with CI.
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