Mobility as a predictor of all-cause mortality in older men and women: 11.8\xa0year follow-up in the Troms\xf8 study

Astrid Bergland,Lone Jørgensen,Nina Emaus,Bjørn Heine Strand

doi:10.1186/s12913-016-1950-0

Abstract

BackgroundDisability in older adults is associated with loss of independence, institutionalization, and death. The aim of this study was to study the association between the Timed Up and Go (TUG) test and all-cause mortality in a population-based sample of older men and women.MethodsOur study population was home dwellers aged 65 and above, who participated in the fifth wave of the Tromsø study. This study included the TUG test and a range of lifestyle and mortality predictors. Participants were linked to the Cause of Death Registry and followed up for mortality for a maximum of 11.8 years. Cox regression was used to investigate the association between TUG and total mortality.ResultsMean TUG score was 12.6 s, and men performed better than women. The oldest participants had poorer TUG score compared to younger participants, increasing 0.25 s per year. There was a significant association between TUG and all-cause mortality, and the association was equally strong in men and women. Across the TUG-score categories, from quickest fifth to slowest fifth, the mortality increased in a step-wise fashion. Compared to the quickest fifth, the slowest fifth had hazard ratio (HR) of 1.79 (95% confidence interval (CI) 1.33, 2.42) in a model adjusted for age and gender. For each standard deviation TUG-score the increase in HR was 1.23 (95% CI 1.14, 1.33). The association between the TUG score and mortality remained significant after adjusting for self-reported health, body mass index, smoking and education.ConclusionsA significant association between the TUG score and mortality was observed in both men and women. Identifying older people with poor TUG may aid in identifying those at risk and thus targeted interventions may be applied.

Highlights

Disability in older adults is associated with loss of independence, institutionalization, and death
Timed up and go Timed Up and Go (TUG) was measured as the time it takes for the study participant to rise from a chair, walk three meters quickly but safely, turn and walk back to the chair and sit down
Across the TUG-score categories, from quickest fifth to slowest fifth, there was a tendency for increased mortality in a step-wise fashion, and especially those in the two poorest TUG performance fifths had high mortality rate; Compared to the quickest fifth, the slowest fifth had hazard ratio (HR) 1.79 (95% confidence interval 1.33, 2.42) in a model adjusted for age and gender

Summary

Introduction

Disability in older adults is associated with loss of independence, institutionalization, and death. Population aging is associated with an increase in the number of people who are disabled. This increase presents a challenge for society because elderly persons disabled in one or more domains of life are hospitalized. Maintaining independent mobility is an important goal, especially for old women who are at a greater risk for functional decline and disability than older men [17]. Longitudinal predictors of mobility decline have been documented including; increasing age [1, 28,29,30], number of morbidities [31], poor self-rated health [31], obesity [32], reduced leg strength [27, 33, 34], and psychosocial factors [31]

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