‘Timed Up and Go’ test aids fracture prediction
MedWire News: The "Timed Up and Go" (TUG) test, widely used to assess functional mobility in elderly people, can also predict the risk for nonvertebral fracture, a longitudinal study published in the Archives of Internal Medicine has found.
The researchers suggest that the TUG test - the time required to rise from a chair, walk 3 m, and return to sitting - is a simple and inexpensive way to screen patients for fracture risk in daily practice.
"Next steps should include confirming these results in other prospective cohorts and then assembling and pooling the studies relating TUG (and perhaps other simple measurements of physical performance) to fracture risk in older individuals," remarked Douglas Bauer (University of California, San Francisco, USA) in an accompanying commentary.
The study, by Kun Zhu (University of Western Australia), involved 1126 women aged 75 years, on average, at baseline. They were assessed using the TUG test at baseline and for hip bone mineral density (BMD) at 1 year and were then followed-up for 10 years.
Fracture rates during follow-up were 17.5% for nonvertebral fracture and 6.0% for clinical vertebral fracture, with 1.6% of the population suffering at least one incident fracture of each type.
Compared with patients who had a normal TUG test, patients with a slow TUG test, defined as 10.2 seconds or longer, had significantly higher rates of both nonvertebral fracture (21.2 vs 15.7%) and hip fracture (9.2 vs 5.3%), but not vertebral fracture (5.7 vs 6.1%).
Unsurprisingly, patients with low hip BMD had also significantly higher rates of all types of fractures than those with normal BMD.
Slow TUG test performance increased the population-attributable risk for nonvertebral fracture (10.3%) and hip fracture (19.7%) but not clinical spine fracture. Low hip BMD, meanwhile, increased the population-attributable risk for all fracture types, with values ranging from 23.6% to 41.0%.
The researchers conclude: "Slow TUG test performance is an independent risk factor for incident nonvertebral fracture and a feasible inexpensive physical performance assessment for use in clinical practice to screen patients with increased risk of fracture."
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By Joanna Lyford