Timed Up-and-Go as a predictor of fracture risk: a systematic review and meta-analysis in a population of over 1.6 million people.

OBJECTIVES

This systematic review aimed to synthesize evidence from prospective cohort studies assessing the Timed Up-and-Go (TUG) test as association of fracture risk in older people, and to quantify the association through meta-analysis using hazard ratios (HR).

METHODS

Two authors independently conducted systematic searches in PubMed/MEDLINE, Scopus, Web of Science, CINAHL Complete, and the Psychology and Behavioral Sciences Collection. MEDLINE was accessed through PubMed and was therefore not treated as a separate database. The Psychology and Behavioral Sciences Collection was included because it may capture studies addressing behavioral, psychological, and functional factors relevant to fracture risk. Eligible cohort studies were those that examined the association between slower TUG performance, reflected by longer completion time in seconds, and all-cause fractures in older people. HR estimates with 95% confidence intervals (CI) were pooled using random-effects meta-analysis after assessment of between-study heterogeneity.

RESULTS

Two authors independently extracted the data. Six studies with 1,639,397 participants. A low TUG score was associated with hip fractures from all causes (HR = 1.64; 95% CI = 1.20-2.22), as well as with overall fractures (femur, spine lumbar, pelvis, forearm and proximal humerus; HR = 1.38; 95% CI = 1.05-1.80). However, a modest but statistically significant association was observed for vertebral fractures (HR = 1.11; 95% CI = 1.03-1.20).

CONCLUSION

Poor performance on the TUG test is associated with hip fractures and overall fractures in older people.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251244709, identifier PROSPERO (CRD420251244709).