Clinical Interventions in Aging (Jul 2023)
Association Between Timed Up-and-Go Test and Future Changes in the Frailty Status in a Longitudinal Study of Japanese Community-Dwelling Older Adults
Abstract
Yosuke Wada,1,2 Kensaku Shojima,1 Kayoko Tamaki,1 Takara Mori,1,3 Hiroshi Kusunoki,1,4 Masaaki Onishi,5 Shotaro Tsuji,5,6 Ryota Matsuzawa,7 Koutatsu Nagai,7 Kyoko Sano,8 Kana Hashimoto,9 Masashi Goto,10 Yasuyuki Nagasawa,1 Ken Shinmura1,10 1Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan; 2Roppou Clinic, Toyooka, Hyogo, Japan; 3Amagasaki Medical COOP Honden Clinic, Amagasaki, Hyogo, Japan; 4Department of Internal Medicine, Osaka Dental University, Hirakata, Japan; 5Department of Orthopedic Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan; 6Department of Orthopedic Surgery, Tatsuno City Hospital, Tatsuno, Japan; 7Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, Japan; 8Takarazuka Rehabilitation Hospital, Takarazuka, Japan; 9School of Pharmacy, Hyogo Medical University, Kobe, Japan; 10Department of General Medicine and Community Health Science, Hyogo Medical University, Sasayama Medical Center, Tambasasayama, JapanCorrespondence: Ken Shinmura, Department of General Internal Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan, Tel +81-798-45-6865, Fax +81-798-45-6977, Email [email protected]: This study aimed to evaluate the relationship between timed up-and-go (TUG) test time and changes in frailty status in a longitudinal cohort study of rural Japanese older adults.Patients and Methods: This prospective cohort study included 545 community-dwelling older adults. Initial and 2-year follow-up surveys were conducted. We compared the number of the Japanese version of the Cardiovascular Health Study components during the follow-up period and classified the participants into three groups: the favorable change, unchanged as prefrail, and unfavorable change groups. Associations between changes in frailty status and TUG time in the first survey were examined. The predictive ability of the TUG test was determined using the receiver operating characteristic (ROC) curve.Results: The favorable change group comprised 315 individuals (57.8%), the unchanged as prefrail group 105 (19.2%), and the unfavorable change group 125 (22.9%). TUG time was associated with the favorable and unfavorable changes after adjustment for covariates (OR 0.79, 95% CI 0.68– 0.92, P=0.001 and OR 1.27, 95% CI 1.09– 1.49, P=0.002). The ROC curve of TUG time as a predictor of unfavorable changes showed an area under the curve of 0.59. A cut-off point of TUG was calculated as 6.3 s with 49.6% sensitivity and 66.0% specificity.Conclusion: TUG time in the first survey was significantly associated with changes in frailty status 2 years later. However, its predictive value as a stand-alone test is limited and has the potential to predict future changes in the frailty status in older adults in combination with other tests.Keywords: frailty, cardiovascular health study, older adults, physical function, timed up-and-go test