Timed "Up & Go" Dual-Task Tests: Age- and Sex-Specific Reference Values and Test-Retest Reliability in Cognitively Healthy Controls.
Hanna B Åhman, Lars Berglund, Ylva Cedervall and 4 others
PMID 34272869WHAT IT FOUND
Timed Up & Go dual-task time scores are highly reliable, but verbal outputs and cost measures vary widely between tests.
Use time scores for consistent monitoring. Do not rely on animal naming counts to track small changes or evaluate interventions.
Key findings
01The time taken to complete the dual-task TUG tests showed excellent test-retest reliability, whereas the number of animals or months named showed only fair to poor reliability.
02A change of at least 4 animals per 10 seconds is required to distinguish a true change in performance from random variability, making this metric unsuitable for evaluating interventions.
03Cost measures, which calculate the percentage difference between single-task and dual-task performance, demonstrated poor reliability with wide limits of agreement.
STILL TO COME
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What it does not show
The reliability sample of 43 participants was smaller than the number recommended by COSMIN guidelines, although it exceeded the minimum acceptable number of 30. The reference sample was recruited from a university city and had a high proportion of individuals with university education (73%), which may limit generalizability to populations with lower educational attainment. The study was conducted with Swedish-speaking participants, and results may not directly translate to other linguistic or cultural groups. For some participants, the time interval between test and retest deviated from the planned 10 days due to practical reasons, although sensitivity analyses suggested this did not affect the results.
Declared interests
The study was funded by the Swedish Research Council, Uppsala-Örebro Regional Research Council, Alzheimer Foundation Sweden, Dementia Foundation, and Promobilia Foundation. The funders had no role in the study's design or conduct.
The easy way to misread this
Do not interpret a small change in the number of animals named during the dual-task TUG as evidence of clinical improvement or decline. The test-retest variability is high enough that a change of less than 4 animals per 10 seconds is likely due to random error rather than a true change in status.