Feasibility and measurement properties of the functional reach and thetimed up and go tests in the Canadian study of health and aging

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Abstract
BACKGROUND: Physical performance measures may offer advantages overself-report in the functional assessment of older people. Estimates of thefeasibility, reliability, and construct validity of these measures inlarge, heterogeneous samples are necessary to establish their importancerelative to traditional measures of function. METHODS: Analysis of clinicaldata from Phase 2 of the Canadian Study of Health and Aging, a nation-widerepresentative survey of elderly people in Canada (N = 2,305). RESULTS:Both physical performance measures proved infeasible in many subjects(29.3% for the Timed Up and Go [TUG], 35.9% for the Functional Reach [FR]).Cognitive impairment was the most important determinant of inability tocomplete the tests. For those able to complete the tests, cognitivelyunimpaired subjects could reach farther (median 29 cm) and complete the TUGin less time (median 12 seconds) than those cognitively impaired (25 cm forFR, 15 seconds for the TUG). Test-retest reliability between the screeningand clinical administrations of the TUG was .56 for all participants(intra-class correlations), .50 for the cognitively unimpaired, and .56 forthe cognitively impaired. Construct validity was substantial, andcorrelations between performance measures and self-report activities ofdaily living (ADL) measures ranged from .40 to .70. Compared with a globalclinical measure of frailty, correlations were more modest (.38 to .60).CONCLUSIONS: The FR and the TUG were not feasible tools in this study. TheTUG showed poor test-retest reliability. Our data support the observationthat subsequent studies of measurement instruments typically reveal lowerperformance than the original reports.

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