## 4 Discussion  
The aim of this study was to develop a predictive model combining the TUG test with intrinsic and extrinsic fall risk factors to predict future falls among community-dwelling Portuguese adults aged 50 years and older. Given the need for fall risk screening tools to be brief, efficient, robust, and practical, this study also aimed to identify risk factors that can be easily self-reported during fall risk screenings carried out in public spaces. The TUG test is strongly associated with measurements of dynamic balance, mobility, and lower extremity muscle strength [28], encompassing basic motor tasks essential for independent living, such as standing up from and sitting down on a chair, walking briskly, and changing direction while walking [4, 29]. Our choice of the TUG test as a predictor of fall risk is related to the fact that this test is recommended by respected organizations, such as the Center for Disease Control and Prevention (CDC) [35], the American Geriatric Society, and the British Geriatric Society [7], as a routine screening tool to assess gait and balance in fall risk assessments. Figure 1: **(A–H)** Predictive Receiver Operating Characteristic (ROC) curves for Fall and Non-Fall subjects. (**A–C**) TUG duration for 50–60 years, 60–70 years, and 70 or older, respectively; (**D–F**) Logistic Regression models for 50–60 years, 60–70 years, and 70 or older, respectively; (**G**) TUG duration for 50 or older; (**H**) Regression models for 50 or older. TUG = Timed Up and Go test. This recommendation is based on the minimum testing requirements in terms of time, space, and material resources, as well as its ease of integration into regular clinical practice [3]. Although the TUG test is increasingly recognized as a significant predictor of falls [22,27], several studies emphasize that it should not be used as a standalone tool for identifying individuals at high risk of falling [30,31]. In fact, the ROC curve analysis showed that the TUG test did not present significant discriminatory capacity when analysing the general sample (AUC = 54.7%), improving this capacity when we combine the TUG with intrinsic and extrinsic risk factors (AUC = 67.1%). In our analysis, we reached the same conclusion when evaluating the ability of the TUG test to predict falls during the 12-month follow-up period. Similar results were obtained when we analysed the groups aged 60-70 years and 70 or more years, which improved the results from 56.8% to 75.4% and 43.4% to 70.8%, respectively. The group that had the best results was 50-60 years old but this group still managed to improve when combining the TUG test with risk factors, going from AUC = 77.7% to AUC = 82.5%. The National Institute for Health and Care Excellence (NICE) [2], alongside recent literature [3,4], advocates for a multifactorial approach to fall risk assessment and prevention. This approach encompasses factors such as HoF, self-assessment of functional ability, FoF, medication usage, home hazards, and comprehensive evaluations of gait, balance, mobility, and muscle strength. Holistic strategies incorporating these elements enable more accurate and effective fall prevention and management in older adults [3,4,22]. In our study, we distinguished between falls with an intrinsic precipitating cause (gender, HoF, FoF, UpExt) and those triggered by an extrinsic circumstance (assisted mobility, presence of stairs at home, ingestion of benzodiazepines, antidepressants and antihypertensive, polypharmacy). Distinguishing between extrinsic and intrinsic factors can enhance our understanding of falls among community-dwelling individuals, enabling healthcare professionals to develop more targeted and effective prevention strategies, as demonstrated by [PERSON] et al. [10]. According to these authors, distinguishing those factors is relevant because institutionalized older adults tend to fall due to intrinsic precipitating factors, whereas community-dwelling older adults are more likely to fall due to extrinsic factors.