Timed “Up & Go” Dual-Task Tests: Age- and Sex-Specific Reference Values and Test–Retest Reliability in Cognitively Healthy Controls

Abstract

Objective To establish reference values for the Uppsala-Dalarna Dementia and Gait (UDDGait) Timed “Up & Go” dual-task (TUGdt) test variables in cognitively healthy adults and to assess these variables’ test–retest reliability. Methods For reference values, 166 participants were recruited with approximately equal numbers and proportions of women and men in the age groups 50 to 59, 60 to 69, 70 to 79, and 80+ (mean age = 70 years, age range = 50–91 years, 51% women). For reliability testing, 43 individuals (mean age = 69 years, age range = 50–89 years, 51% women) were recruited. Two dual-task tests were carried out: TUGdt naming animals and TUGdt months backward, representing 8 test variables: time scores, costs (the relative difference between single- and dual-task time scores), “number of animals”, “number of months”, “animals/10 s”, and “months/10 s”. Reference ranges for the variables were established by quantile regression in age- and sex-specific groups. For reliability, ICCs, standard error of measurement, minimal detectable change, and Bland–Altman plots were used. Results Reference values for the TUGdt test variables are presented for the 2.5th and 97.5th percentile. The reliability of TUGdt time scores was excellent (ICCs between 0.85 and 0.86). “Number of animals” and “animals/10 s” as well as “months/10 s” showed fair to good levels of reliability (ICCs between 0.45 and 0.58), whereas the reliability for both cost measures and “number of months” was poor (ICCs between 0.34 and 0.39). Conclusions Normative reference values, potentially useful for clinical and research purposes, were presented in 4 age- and sex-specific groups from 50 years and above. Reliability for the test variables varied between poor and excellent, the lower estimates partly explained by some variables being the ratio of 2 other variables. In UDDGait, TUGdt tests are intended for diagnostic and predictive purposes, for which these tests are promising and require further investigations. Impact We present normative reference values and test–retest reliability results for the UDDGait TUGdt test variables. These results should be useful for both clinical and research purposes.

Dual-tasking interference is exacerbated outdoors: A pilot study

“…This implies that a longer task may provide additional opportunities for individuals to be affected by the distractions of outdoor environments, making more errors in dual-tasking conditions. It should be noted that previous research showed fair to excellent test-retest reliability for time and gait speed when completing dual-task TUG tests, however; poor to good test-rest reliability for DCTs were reported (34,35). This may occur due to an increase in systematic errors when the difference between the single and dual-task conditions is calculated to measure the DTCs (36).…”

Adaptation and reliability of tests of functional mobility and muscle strength using telehealth for older people with dementia

“…No studies with TUG-DT among older people with dementia were found in our search. The only relevant literature was the study of Åhman et al, 10 which also used naming of animals during performance of the dual task to assess the test-retest reliability of the TUG-DT in healthy older people through face-toface assessments and reported good reliability (ICC = 0.86). 10 These findings are in line with the results obtained in the present study, in which the reliability of the TUG-DT was considered excellent (ICC = 1.00) when comparing real-time assessment and subsequent review of its recording, as well as in the comparison between examiners.…”

“…The only relevant literature was the study of Åhman et al, 10 which also used naming of animals during performance of the dual task to assess the test-retest reliability of the TUG-DT in healthy older people through face-toface assessments and reported good reliability (ICC = 0.86). 10 These findings are in line with the results obtained in the present study, in which the reliability of the TUG-DT was considered excellent (ICC = 1.00) when comparing real-time assessment and subsequent review of its recording, as well as in the comparison between examiners. The difference in the results can perhaps be explained by methodological differences, as the assessment was only conducted once in the present study (in real time) and was compared asynchronously.…”

“…Prior to engaging older people in a telehealth-based physical exercise program, it is important to investigate whether the tools to determine the effect of the intervention are reliable when performed remotely. Ways to assess human functioning include using functional mobility and muscle strength measures, such as the Short Physical Performance Battery (SPPB), 7 the Timed Up and Go (TUG) test, 8,9 the TUG Dual Task (TUG-DT), 10,11 and the 30-Second Sit to Stand Test (SST30s). [12][13][14][15] Some physical tests have demonstrated good psychometric properties when performed remotely via telehealth, but research into this aspect has been limited.…”

Extracted step parameters during the Timed Up and Go test discriminate between groups with different levels of cognitive ability - A cross-sectional study.

“…Data collection for all participants was carried out by a trained physiotherapist and followed the procedure that has been described in more detail elsewhere [24,25]. Demographic data were collected through selfreports from the participants and, if he/she so wished, also from a relative.…”