Comparison of fragility score in older women assessed with radiofrequency echographic multispectrometry (REMS) and time-up-and-go test performance

Introduction: Fragility and mobility are key indicators of health in older adults. The time-up-and-go (TUG) test is widely used to assess functional mobility, while radiofrequency echographic multispectrometry (REMS) provides a non-invasive method to evaluate fragility scores (FS), bone mineral density (BMD), and T-scores of the spine and hip (1,2). Despite the widespread use of these tools, the relationship between TUG performance and fragility in older women remains underexplored. This study aimed to compare FS across different groups based on TUG test performance.

Methods: We assessed fragility scores, BMD, and T-scores of the spine in 86 women aged≥60 years (yrs.) using REMS. Body mass index (BMI) and TUG times were also measured. For the TUG test, participants were instructed to stand up from a chair, walk three meters, turn around, return to the chair, and sit down. The time taken to complete the task was recorded in seconds (s). Based on TUG performance, participants were categorized into four groups: TUG<10 s, TUG=11–20 s, TUG=21–29 s, and TUG≥30 s. We then compared FS between these groups according to TUG test performance.

Results: The mean age of participants was 70±7 yrs. (range: 60–88 yrs.). The mean BMI was 29.6±5.6 kg/m² (range: 17.3–47.5 kg/m²). The mean BMD was 0.810±0.117 g/cm² (range: 0.585–1.258 g/cm²) and the mean T-score was -1.3±1.1 standard deviation (SD), (range: -4.1 SD to 1.9 SD). Of the participants, 59 women (68.6%) had a TUG time<10 s with a mean FS of 38.9±11.9. Twelve women (13.9%) had a TUG time between 11 and 20 s with a mean FS of 56.4±18.4. Nine women (10.5%) had a TUG time between 21 and 29 s with a mean FS of 54.3±19.4. Six women (7%) had a TUG time≥30 s and had the highest mean FS of 77.7±6.3, compared to the other groups. FS differed significantly across the groups based on TUG performance (p<0.001).

Discussion: This study demonstrated a significant association between TUG test performance and FS in older women. Slower TUG times were associated with higher FS, indicating greater frailty. These findings suggest that the TUG test may serve as a useful tool for identifying individuals at higher risk of fragility and related health complications in this population.

Keywords: time-up-and-go test, fragility score, REMS

Korrespondenzadresse: Nikola Kirilov, Department of Orthopedics and Traumatology, University Hospital “Dr. Georgi Stranski, Medical univer, Bul. Ruse 89, 5803 Pleven, България, E-Mail: [e-mail]

Publication History

Article published online:
21 March 2025

• Literature

• 1 Pisani P, Conversano F. et al. (2023). Fragility Score: a REMS-based indicator for the prediction of incident fragility fractures at 5 years. Aging clinical and experimental research.
• 2 Zheleva Z., Kirilova E., Popov I. (2019). Self-assessment tool for the risk of osteoporosis in postmenopausal women. Science & Technologies 9 (01) 111-5