Prognostic Value of Usual Gait Speed in Well-Functioning Older People—Results from the Health, Aging and Body Composition Study

Authors: Cesari, Matteo¹; Kritchevsky, Stephen B.²; Penninx, Brenda W. H. J.³; Nicklas, Barbara J.²; Simonsick, Eleanor M.⁴; Newman, Anne B.⁵; Tylavsky, Frances A.⁶; Brach, Jennifer S.⁷; Satterfield, Suzanne⁸; Bauer, Douglas C.⁸; Visser, Marjolein⁹; Rubin, Susan M.⁸; Harris, Tamara B.¹⁰; Pahor, Marco¹

Source: Journal of the American Geriatrics Society, Volume 53, Number 10, October 2005 , pp. 1675-1680(6)

Publisher: Wiley-Blackwell

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Abstract:

Objectives:

To define clinically relevant cutpoints for usual gait speed and to investigate their predictive value for health-related events in older persons. Design:

Prospective cohort study. Setting:

Health, Aging and Body Composition Study. Participants:

Three thousand forty-seven well-functioning older persons (mean age 74.2). Measurements:

Usual gait speed on a 6-m course was assessed at baseline. Participants were randomly divided into two groups to identify (Sample A; n=2,031) and then validate (Sample B; n=1,016) usual gait-speed cutpoints. Rates of persistent lower extremity limitation events (mean follow-up 4.9 years) were calculated according to gait speed in Sample A. A cutpoint (defining high- (<1 m/s) and low risk (

1 m/s) groups) was identified based on persistent lower extremity limitation events. The predictive value of the identified cutpoints for major health-related events (persistent severe lower extremity limitation, death, and hospitalization) was evaluated in Sample B using Cox regression analyses. Results:

A graded response was seen between risk groups and health-related outcomes. Participants in the high-risk group had a higher risk of persistent lower extremity limitation (rate ratio (RR)=2.20, 95% confidence interval (CI)=1.76–2.74), persistent severe lower extremity limitation (RR=2.29, 95% CI=1.63–3.20), death (RR=1.64, 95% CI=1.14–2.37), and hospitalization (RR=1.48, 95% CI=1.02–2.13) than those in the low-risk group. Conclusion:

Usual gait speed of less than 1 m/s identifies persons at high risk of health-related outcomes in well-functioning older people. Provision of a clinically meaningful cutpoint for usual gait speed may facilitate its use in clinical and research settings.

Keywords: physical performance; gait speed; lower extremity limitation; death; hospitalization

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1532-5415.2005.53501.x

Affiliations: 1: Department of Aging and Geriatric Research, College of Medicine, Institute on Aging, University of Florida, Gainesville, Florida; 2: Sticht Center on Aging, Wake Forest University School of Medicine, Winston Salem, North Carolina; 3: Department of Psychiatry and 4: Intramural Research Program, National Institute on Aging, Baltimore, Maryland; Departments of 5: Medicine and 6: Department of Preventive Medicine, University of Tennessee, Memphis, Tennessee; 7: Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania; 8: Department of Medicine, University of California at San Francisco, San Francisco, California; and 9: Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, the Netherlands; 10: Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland.

Publication date: 2005-10-01

Prognostic Value of Usual Gait Speed in Well-Functioning Older People—Results from the Health, Aging and Body Composition Study

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