The Timed Up and Go (TUG) test, in which individuals are timed when rising from a chair, walking 3 m, and turning to return to sit on the chair, is a commonly used method of assessing functional mobility among older adults in geriatric clinics to evaluate physical performance. However, less attention has been paid to the role of risk factors for falling, which in addition to bone mass are important determinants of the occurrence of most appendicular skeletal fracture. Since the development of dual-energy x-ray absorptiometry (DXA) measurement of areal bone mineral density (BMD) in the 1980s, great progress has been made in our understanding of the important role of bone structure in resistance to fracture. For nonvertebral fracture and hip fracture, the population-attributable risks of slow TUG test performance with normal hip BMD were 19.3% and 32.3%, of normal TUG test performance with low hip BMD were 31.3% and 50.3%, and of both slow TUG test performance and low hip BMD were 30.1% and 55.9%, respectively.Ĭonclusion 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.įracture represents a major public health problem and is a leading cause of morbidity, mortality, and hospitalization among older persons. Relative to risks among participants having normal TUG test performance and normal BMD, risks of nonvertebral fracture and hip fracture were significantly higher among participants who had slow TUG test performance and normal hip BMD (nonvertebral fracture hazard ratio, 1.84 hip fracture HR, 2.48) or both slow TUG test performance and low hip BMD (nonvertebral fracture HR, 2.51 hip fracture HR, 4.68). Results One-third (32.7%) of participants had slow TUG test performance (>10.2 seconds), and 54.2% of participants had low hip areal BMD (T-score of less than −1). Complete incident hip fracture data were obtained from a hospital morbidity database. Incident clinical osteoporotic fracture over 10 years was confirmed by radiographic records. Assessments included TUG test at baseline and dual-energy x-ray absorptiometry total hip areal BMD measurement at year 1. Methods The study participants were 1126 women (mean age at baseline, 75.0 years) living in Perth, Western Australia. This study examined the role of Timed Up and Go (TUG) test performance, a validated predictor of falling, and hip areal bone mineral density (BMD), a validated predictor of bone strength in fracture prediction in a 10-year longitudinal study. Shared Decision Making and Communicationīackground Two major factors associated with skeletal fracture in older persons are intrinsic bone strength and risk of falling.Scientific Discovery and the Future of Medicine.
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