I’m seeing more older adults with mild cognitive impairment who “pass” a Timed Up and Go yet still report a fall within 3 months, and their families are understandably anxious. Are you adding gait speed and orthostatic vitals to the annual wellness visit to catch risk earlier, and has it changed your PT referrals or home safety outcomes?
I’ve started adding 10-meter gait speed and 1- and 3-minute orthostatics at AWV; if gait speed is <0.8 m/s or they drop >=20/10 with symptoms, I auto-trigger PT plus a home OT safety visit and do a quick med deprescribing review. For the “pass TUG but still fall” crowd, TUG’s a decent smoke alarm but gait speed catches the smoldering — STEADI has a simple workflow you can drop into the visit: STEADI - Older Adult Fall Prevention | STEADI - Older Adult Fall Prevention | CDC. If time is tight, the 4-Stage Balance Test is a 30-second add-.
Quick tweak that’s helped me: I add a TUG-cog (months backward) and if it’s >4 sec slower than their standard TUG or they make >2 errors, I trigger PT plus an OT home visit; in our MCI group it’s flagged risk that a “pass” TUG and normal orthostatics missed. @julieV1975 have you found TUG-cog shifts referrals more than adding vitals?