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Time to get up from chair indicates fracture risk

Timing how long it takes elderly patients to rise from their chairs can reliably and independently predict their risk of nonvertebral fractures, a new study reports.

The Timed Up and Go (TUG) test, which measures the time taken for a patient to rise from a chair, walk three metres and then turn around, has already been shown to predict the risk of falls.

Researchers performed the test on 1,126 elderly women (mean age 75) in Australia, and measured their bone mineral density by X-ray absorpiometry.

One-third had a slow TUG test result (more than 10.2 seconds) and 54% a low BMD. The risk of nonvertebral fracture over the next 10 years was raised by 84%, and risk of hip fracture by 2.5-fold, in those with slow TUG times and normal BMD.

For those with both slow TUG times and a low BMD, the hazard ratios were 2.51 for nonvertebral fracture and 4.68 for hip fracture, according to the study, published in the Archives of Internal Medicine last month.

Study leader Dr Kun Zhu, associate professor at the school of medicine and pharmacology at the University of Western Australia, said: ‘The TUG test is a feasible inexpensive physical performance assessment for use in clinical practice to screen patients with increased risk of fracture. She added that if validated it could be added into existing risk scores.

Dr Pam Brown, a GP in Swansea and member of the Welsh Osteoporosis Group, said: 'Most non-vertebral and hip fractures occur as a result of a fall. This study reminds us that when considering fracture risk, we must consider a range of risk  factors, including those predicting falls, such as the TUG test.'

Arch Intern Med 2011; 171:1655-661


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