Abstract
Objectives
The “timed up and go” (TUG) test is a simple and widely used test of overall functional
mobility. There is a paucity of TUG normative data among Asian individuals who differ
in habitual gait speed and fall risk from Western population. The objectives of this
study were to determine TUG reference values and optimum cutoffs predicting prevalent
and incident disability for community-dwelling adults.
Design
One cross-sectional (Study 1–Yishun Study) and one longitudinal (Study 2–Singapore
Longitudinal Aging Study) study in Singapore.
Setting and Participants
Study 1 comprised 538 nondisabled, community-dwelling adults aged between 21 and 90 years.
Study 2 comprised 1356 community-dwelling older adults aged ≥55 years followed for
3 years.
Methods
Study 1 collected TUG reference values and assessed physiological fall risk (PFR)
using the Physiological Profile Assessment (PPA). Study 2 assessed association of
TUG with disability with the Barthel Index and the Lawton scale at baseline and follow-up.
Results
From Study 1, mean TUG time for individuals aged 60 to 74 years was 9.80 seconds,
shorter than values reported for Westerners of 12.30 seconds. It was significantly
associated with high PFR [odds ratio (OR) 1.14, 95% confidence interval (CI) 1.03–1.27],
74.0% agreement, Cohen's kappa = 0.314 (95% CI 0.238–0.390); area under the curve = 0.85
(95% CI 0.80–0.90). A TUG cutoff of 10.2 seconds discriminated high PFR from low PFR
with 84.4% sensitivity and 72.6% specificity. In Study 2, the threshold for observing
significantly increased risk of disability was ≥9.45 seconds for prevalent disability
(OR 2.98, 95% CI 1.41–6.78), functional decline (OR 2.68, 95% CI 1.33–5.80), and incidental
disability (OR 2.25, 95% CI 1.08–4.97).
Conclusions and Implications
TUG reference values and cutoff predicting disability for community-dwelling older
adults in Singapore are consistent with Asian data and lower than for Western individuals.
TUG could be used to guide development and evaluation of risk screening of adverse
health outcomes across the life span in Singapore.
Keywords
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Article info
Publication history
Published online: April 02, 2021
Footnotes
P. L. C. and N. X. T. contributed equally to this work.
The authors declare no conflicts of interest.
This research was supported as part of a core funding from the Ministry of Health of Singapore, Singapore to GERI.
Identification
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© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
