Is timed up and go better than gait speed in predicting health, function, and falls in older adults?

Abstract

Objectives: To assess whether the Timed Up and Go (TUG) is superior to gait speed in predicting multiple geriatric outcomes.

Design: Prospective cohort study.

Setting: Medicare health maintenance organization and Veterans Affairs primary care clinics.

Participants: Adults aged 65 and older (N=457).

Measurements: Baseline gait speed and TUG were used to predict health decline according to EuroQol and Medical Outcomes Study 36-item Short Form Survey (SF-36) global health; functional decline according to National Health Interview Survey (NHIS) activities of daily living (ADLs) score and SF-36 physical function index; hospitalization; and any falls and multiple falls over 1 year.

Results: Mean age was 74, and 44% of participants were female. Odds ratios for all outcomes were equivalent for gait speed and TUG. Using area under the receiver operating characteristic curve of 0.7 or greater for acceptable predictive ability, gait speed and TUG each alone predicted decline in global health, new ADL difficulty, and falls, with no difference in predictive ability between performance measures. Neither performance measure predicted hospitalization, EuroQol decline, or physical function decline. As a continuous variable, TUG did not add predictive ability to gait speed for any outcome.

Conclusion: Gait speed predicts most geriatric outcomes, including falls, as does TUG. The time taken to complete TUG may not add to information provided by gait speed, although its qualitative elements may have other utility.