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29 May 2008

Impact of clinical, psychological, and social factors on decreased Tinetti test score in community-living elderly subjects: a prospective study with two-year follow-up

Patrick ManckoundiaABCD, Frederique ThomasACFG, Severine BuatoisCD, Louis GuizeCEF, Bertrand JegoCEF, Jean-Pierre AquinoEF, Athanase BenetosBCEF

Med Sci Monit 2008; 14(6): CR316-322 :: ID: 859035

Abstract

Background
Balance and gait are essential to maintain physical autonomy, particularly in elderly people. Thus the detection of risk factors of balance and gait impairment appears necessary in order to prevent falls and dependency. The objective of this study was to analyze the impact of demographic, social, clinical, psychological, and biological parameters on the decline in balance and gait assessed by the Tinetti test (TT) after a two-year follow-up.
Material and Method
This prospective study was conducted among community-living, young elderly volunteers in the centre "Investigations Preventives et Cliniques" and "Observatoire De l'Age" (Paris, France). Three hundred and forty-four participants aged 63.5 on average were enrolled and performed the TT twice, once at inclusion and again two years later. After the two-year follow-up, two groups were constituted according to whether or not there was a decrease in the TT score: the "TT no-deterioration" group comprised subjects with a decrease of less than two points and the "TT deterioration" group comprised those with a decrease of two points or more. Selected demographic, social, clinical, psychological, and biological parameters for the two groups were then compared.
Results
Statistical analysis showed that female sex, advanced age, high body mass index, osteoarticular pain, and a high level of anxiety all have a negative impact on TT score.
Conclusions
Knowledge of predictive factors of the onset or worsening of balance and gait disorders could allow clinicians to detect young elderly people who should benefit from a specific prevention program.

Keywords: Risk Factors, Residence Characteristics, Regression Analysis, Questionnaires, Prospective Studies, postural balance, Follow-Up Studies, Socioeconomic Factors, Demography, Aging - psychology, Aged, 80 and over

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750