‘Timed up and go' test and BMD measurement for fracture prediction

January 01, 0001

‘Timed up and go' test and BMD measurement for fracture prediction

Two major factors associated with skeletal fracture in older persons are intrinsic bone strength and risk of falling. 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. The study participants were 1126 women (mean age at baseline, 75.0 years) living in Perth, Western Australia. Assessments included TUG test at baseline and dual-energy x-ray absorptiometry total hip areal BMD measurement at year 1. Incident clinical osteoporotic fracture over 10 years was confirmed by radiographic records. Complete incident hip fracture data were obtained from a hospital morbidity database.

They found: "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). 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 HR, 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). 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."

The authors concluded: "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."

The combination of slow TUG test and low BMD can explain more than half of hip fractures.

For the full abstract, click here.

Arch Intern Med 171(18):1655-1661, 10 October 2011 © 2011 to the American Medical Association
‘Timed Up and Go' Test and Bone Mineral Density Measurement for Fracture Prediction. Kun Zhu, Amanda Devine, Joshua R. Lewis, Satvinder S. Dhaliwal, Richard L. Prince. Correspondence to Dr. Zhu: kzhu@meddent.uwa.edu.au

Category: M. Musculoskeletal. Keywords: hip fracture, nonvertebral fracture, timed up and go test, bone mineral density, BMD, elderly, women, cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 25 October 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.