Association Between Timed Up-and-Go Test and Future Changes in the Frailty Status in a Longitudinal Study of Japanese Community-Dwelling Older Adults

Figures & data

Table 1 Changes in the Frailty Status Based on Changes in the Number of J-CHS Components

Number of positive J-CHS components	At the first survey	0 (n=247)						1 (n=202)
	At the second survey	0	1	2		3		0	1	2	3		4
	(n)	(169)	(65)	(10)		(3)		(78)	(89)	(27)	(7)		(1)
Subgroups based on changes in the frailty status		FCG	UCG	UCG		UCG		FCG	UPG	UCG	UCG		UCG
Number of positive J-CHS components	At the first survey	2 (n=77)						3 (n=16)				4 (n=3)
	At the second survey	0	1	2	3		5	0	1	2	3	1	2
	(n)	(20)	(35)	(16)	(5)		(1)	(4)	(2)	(4)	(6)	(2)	(1)
Subgroups based on changes in the frailty status		FCG	FCG	UPG	UCG		UCG	FCG	FCG	FCG	UCG	FCG	FCG

Abbreviations: J-CHS, Japanese version of Cardiovascular Health Study; FCG, favorable change group; UPG, unchanged as prefrail group; UCG, unfavorable change group.

Table 2 Baseline Characteristics of the Study Participants

	Total n=545	FCG n=315	UPG n=105	UCG n=125	P-value
Age, y	72 (68–76)	71 (68~75)	72 (67~77)	74 (71~78)^a,b	<0.001
Female	357 (65.5)	210 (66.7)	66 (62.9)	81 (64.8)	0.764
BMI, kg/m^2	22.7±2.9	22.5±2.8	23.1±2.8	22.9±3.2	0.049
SBP, mmHg	138±17	138±18	140±17	136±16	0.169
DBP, mmHg	80±10	80±10	81±10	79±11	0.128
Comorbidities
Number, median	1 (1–2)	1 (1–2)	1 (1–2)	1 (1–2)	0.137
Hypertension	241 (44)	136 (43)	56 (53)	49 (39)	0.085
Diabetes mellitus	60 (11)	26 (8)	12 (11)	22 (18)	0.032
Dyslipidemia	125 (23)	74 (23)	25 (24)	26 (21)	0.440
CKD	21 (4)	10 (3)	6 (6)	5 (4)	0.527
CVD	41 (8)	15 (5)	11 (10)	15 (12)	0.017
Stroke	7 (1)	3 (1)	2 (2)	2 (2)	0.716
RA and collagen disease	6 (1)	4 (1)	0 (0)	2 (2)	0.265
History of cancer	44 (8)	28 (9)	8 (8)	8 (6)	0.667
MMSE	29 (27–30)	29 (27–30)	29 (27–30)	29 (27–30)	0.536
GDS-15 (%)*	12	9	18	15	0.033
Exercise habit	356 (65)	214 (68)	41 (39)	101 (81)	<0.001
Smoking habit					0.927
Never	392 (72)	226 (72)	78 (74)	88 (70)
Past	133 (24)	78 (25)	24 (23)	31 (25)
Current	20 (4)	11 (3)	3 (3)	6 (5)
Alcohol consumption					0.675
0 g/day	289 (53)	159 (50)	58 (55)	72 (58)
≦ 20 g/day	172 (32)	104 (33)	33 (31)	35 (28)
> 20 g/day	84 (15)	52 (17)	14 (13)	18 (14)
MNA-SF	14 (12~14)	14 (12~14)	14 (12~14)	14 (13~14)	0.925
Gait speed, m/s	1.5±0.2	1.5±0.2	1.5±0.2	1.5±0.3^a	0.016
Handgrip strength
Total, kg	28.3±10.6	29.1±12.4	28.0±7.9	26.5±7.3^a	0.009
Male, kg	35.6±6.4	36.5±6.2	35.3±6.7	34.0±6.2	0.056
Female, kg	23.9±4.1	24.6±3.9	23.7±4.6	22.4±3.8^a	<0.001
TUG time, sec	6.2±1.5	5.9±1.2	6.4±1.7^a	6.6±1.7^a	<0.001
Components of J-CHS frailty criteria
Weight loss	59/54	48/1	8/11	3/42	<0.001
Weakness	9/46	9/1	0/13	0/32	<0.001
Exhaustion	44/60	36/1	6/14	2/45	<0.001
Slowness	8/17	5/0	3/3	0/14	<0.001
Low activity	123/31	86/0	29/5	8/26	<0.001

Notes: Date represent mean ± SD or median (IQR) or n (%) or improved/worsened. *Percentage of individuals showing ≧ 5 points. ^aP<0.05 compared with the favorable change group. ^bP<0.05 compared with the unchanged as prefrail group.

Abbreviations: FCG, favorable change group; UPG, unchanged as prefrail group; UCG, unfavorable change group; IQR, interquartile range; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; CKD, chronic kidney disease; CVD, cardiovascular disease; RA, rheumatoid arthritis; MMSE, Mini-mental state examination; GDS, Geriatric depression scale; MNA-SF, Mini nutritional assessment-short form; TUG, timed up-and-go test; SD, standard deviation.

Table 3 Logistic Regression Analysis Regarding Factors Contributing to Changes in the Frailty Status

(1) Factors contributing the favorable change group (FCG) in the frailty status
	FCG vs the Others
	Model 1 (n=545)			Model 2 (n=542^d)
	OR (95% CI)		P-value	OR (95% CI)	P-value
TUG	0.79 (0.68–0.91)		0.001	0.79 (0.67–0.92)	0.001
Age	0.98 (0.95–1.01)		0.219	0.98 (0.95–1.01)	0.233
Sex^a	0.88 (0.60–1.27)		0.488	0.89 (0.61–1.32)	0.571
Frailty status^b				1.03 (0.83–1.28)	0.793
BMI				0.97 (0.91–1.02)	0.278
Number of comorbidities				0.86 (0.73–1.02)	0.089
MMSE score				0.98 (0.89–1.08)	0.727
Depression^c				0.54 (0.31–0.93)	0.025
(2) Association between TUG and the unchanged as prefrail group (UPG) in the frailty status
	UPG vs the Others
	Crude Model (n=545)
	OR (95% CI)		P-value
TUG	1.11 (0.97–1.27)		0.141
(3) Factors contributing the unfavorable change group (UCG) in the frailty status
		UCG vs the Others
		Model 1 (n=545)		Model 2 (n=542^d)
		OR (95% CI)	P-value	OR (95% CI)		P-value
TUG		1.16 (1.01–1.33)	0.042	1.27 (1.09–1.49)		0.002
Age		1.05 (1.01–1.09)	0.013	1.05 (1.01–1.09)		0.022
Sex^a		0.97 (0.63–1.50)	0.909	0.95 (0.60–1.50)		0.812
Frailty status^b				0.49 (0.36–0.66)		<0.001
BMI				1.03 (0.95–1.10)		0.513
Number of comorbidities				1.14 (0.94–1.39)		0.194
MMSE score				1.04 (0.93–1.17)		0.487
Depression^c				1.80 (0.97–3.34)		0.068

Notes: (1) Dependent variable is favorable change group or the other groups. (2) Dependent variable is unchanged as prefrail group or the other groups. (3) Dependent variable is unfavorable change group or the other groups. Model 1: adjusted for age and sex. Model 2: adjusted for model 1+ frailty status, BMI, number of comorbidities, MMSE score, and depression. ^aMale vs female, ^bThe number of J-CHS components in the first survey, ^cGDS score ≧ 5 points vs 0–4 points, ^dExclude cases with missing covariates data (BMI and MMSE).

Abbreviations: OD, odds ratio; CI, confidence interval.

Figure 1 Receiver operating characteristic curve of TUG test time as a predictor of unfavorable change. Area under the curve=0.59.