Cross-sectional assessment of the Tinetti performance-oriented mobility tool for screening physical frailty syndrome in older adults.

Abstract

Background: Physical-functional fitness (PFF) assessments have become crucial tools for identifying physical frailty syndrome (PFS) in older adults, helping guide preventive and interventional strategies.

Purpose: This study aimed to evaluate the predictive value of performance-based PFF tests for detecting PFS among community-dwelling older adults in Tehran, Iran. Additionally, it sought to compare PFF variables between PFS groups to assess the applicability of these tests as practical screening tools in clinical and community settings.

Methods: Data were collected from 161 participants (91 males, 56.5%; 70 females, 43.5%), including sociodemographic, anthropometric, medical history, PFF, and PFS assessments.

Results: Frail participants exhibited significantly lower scores in various PFF tests, including the Tinetti balance, walking, and total score components, physical activity levels (PAL), mean hand grip strength (MGS), 30-s arm curl (30 s-AC), 30 s-chair stand (30 s-CS), Standing Stork Balance (SSB), and back stretch (BST) tests (p < 0.001). Frail individuals also had lower levels of education, shorter stature, and higher BMI compared to non-frail/pre-frail participants, highlighting broader vulnerabilities. Logistic regression analyses showed that all PFF tests, including Tinetti balance and walking components, MGS, 30 s-AC, 30 s-CS, were significant protective factors against FS. However, ROC curve analysis revealed optimal cutoff points for PFS identification, with PAL and MGS demonstrating the highest sensitivity and specificity for predicting PFS. The all components of Tinetti scale also proved to be strong predictors of FS.

Conclusion: Our findings demonstrate that, regardless of age, sex, education level, stature, and fall incidence, PFF assessments remain critical for identifying older adults at risk for PFS. The study highlights the predictive strength of key variables, such as PAL, MGS, and the Tinetti-POMA components, offering novel insights into the role of these tests in improving PFS screening accuracy. These results underscore the importance of integrating PFF assessments into routine clinical and community-based health evaluations, enabling early detection and timely interventions to promote healthier aging trajectories.