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Open Access 01-01-2021 | Original Article

The timed up and go test predicts fracture risk in older women independently of clinical risk factors and bone mineral density

Authors: B. A. M. Larsson, L. Johansson, H. Johansson, K. F. Axelsson, N. Harvey, L. Vandenput, P. Magnusson, E. McCloskey, E. Liu, J. A. Kanis, D. Sundh, M. Lorentzon

Published in: Osteoporosis International | Issue 1/2021

Abstract

Summary

The timed up and go (TUG) test measures physical performance and predicts falls in the elderly. In older women, TUG time predicts the risk of major osteoporotic fracture and hip fracture independently of clinical risk factors and bone mineral density, and has a substantial impact on fracture probabilities.

Introduction

The timed up and go (TUG) test measures physical performance and predicts falls in the elderly. A slow TUG has been associated with an increased fracture risk, but it is unclear whether the association is independent of clinical risk factors and bone mineral density (BMD). The aim of this study was to investigate if TUG time was associated with fracture risk independently of clinical risk factors and BMD and to determine its impact on fracture probabilities in older women.

Methods

A standardized questionnaire was used to assess information regarding clinical risk factors in the large population-based SUPERB study of 3028 older women (75–80 years). At baseline, the TUG test was performed and BMD measured with DXA. The association between TUG time and the risk of hip fracture and major osteoporotic fracture (MOF) was examined using an extension of Poisson regression.

Results

Fracture incidence increased steeply with increasing TUG time up to 12 s and subsequently started to level off. A slow TUG time was therefore defined as TUG > 12 s, a cutoff level then used in Cox models to study the association between slow TUG and fracture risk. A slow TUG time was associated with an increased risk of fracture (MOF 2.39 [1.80–3.18] and hip fracture 2.96 [1.62–5.40]). These associations were slightly attenuated but remained significant after adjustment for clinical risk factors and femoral neck BMD. Depending on BMD, the 4-year fracture probability of MOF increased by a factor of 1.5–1.9 in a 75-year-old woman with slow TUG (> 12 s).

Conclusion

The TUG time predicts the risk of MOF and hip fracture independently of clinical risk factors and BMD and has a substantial impact on fracture probabilities, indicating that inclusion of the TUG test in patient evaluation should be considered in order to improve fracture prediction in older women.

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Title: The timed up and go test predicts fracture risk in older women independently of clinical risk factors and bone mineral density
Authors: B. A. M. Larsson
L. Johansson
H. Johansson
K. F. Axelsson
N. Harvey
L. Vandenput
P. Magnusson
E. McCloskey
E. Liu
J. A. Kanis
D. Sundh
M. Lorentzon
Publication date: 01-01-2021
Publisher: Springer London
Published in: Osteoporosis International / Issue 1/2021
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-020-05681-w

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Springer Medicine

The timed up and go test predicts fracture risk in older women independently of clinical risk factors and bone mineral density

Abstract

Summary

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

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