Prognostic Value of Usual Gait Speed in Well-Functioning Older PeopleâResults from the Health, Aging and Body Composition Study
ABSTRACT To define clinically relevant cutpoints for usual gait speed and to investigate their predictive value for health-related events in older persons.
Prospective cohort study.
Health, Aging and Body Composition Study.
Three thousand forty-seven well-functioning older persons (mean age 74.2).
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 (> or = 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.
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.
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.
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- "The test was timed with a digital stopwatch , and subjects were instructed to perform as many repetitions as possible during a 30-s time period. Usual gait speed (UGS) assessment was verified according to Cesari et al. (2005). Briefly, the subjects were instructed to stand with their feet behind a starting line and then to walk at their normal pace during a 6-m distance until the finish line. "
ABSTRACT: Muscle quality is an important component of the functional profile of the elderly, and previous studies have shown that both muscle quantity and quality independently contribute to muscle strength of the elderly. This study aimed to verify the association between quadriceps femoris muscle quality, analyzed by specific tension and echo intensity (EI), and rate of torque development (RTD) of the knee extensor muscles with the functional performance in elderly active women. Forty-five healthy, active elderly women (70.28 ± 6.2) volunteered to participate in this study. Quadriceps femoris muscle thickness and EI were determined by ultrasonography. Knee extension isometric peak torque and RTD were obtained from maximal isometric voluntary contraction curves. The 30-s sit-to-stand-up (30SS) test and usual gait speed (UGS) test were applied to evaluate functional performance. Rectus femoris EI presented a significant negative correlation with 30SS (r = −0.505, P < 0.01), UGS (r s = −0.347, P < 0.05), and isometric peak torque (r = −0.314, P < 0.05). The quadriceps femoris EI correlated negatively with 30SS (r = −0.493, P < 0.01) and isometric peak torque (r = −0.409, P < 0.01). The EI of the quadriceps femoris and all quadriceps muscle portions significantly correlated with RTD. RTD significantly correlated with physical performance in both functional tests (30SS = r = 0.340, P < 0.05; UGS = r s = 0.371, P < 0.05). We concluded that muscle EI may be an important predictor of functional performance and knee extensor power capacity in elderly, active women.Journal of the American Aging Association 10/2014; 36(5):9708. DOI:10.1007/s11357-014-9708-2 · 3.45 Impact Factor
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- "Moreover, it is generally accepted that morbidity and mortality risks increase significantly in those who walk slower than 1.0 m/s (Cesari et al., 2005; Studenski et al., 2003). In a recent study (Clark et al., 2013), it was suggested that maximal walking speed, which is determined by neuromuscular function, could be used in a clinical setting as an assessment of mobility. "
ABSTRACT: The objective of this study was to examine the relationships between executive functions, physical fitness and mobility in well-functioning older adults. Forty-eight well functioning older adults (70.5 +/- 5.3years old; 20 Men, 28 Women) were included in this study. Two median splits were conducted based on each individual's performance for the 10MWT and the TUG. Comparisons between groups of slower and faster individuals were made with regards to executive functions and physical fitness parameters. A correlational approach was used to assess the association between variables. Between groups comparisons revealed that faster individuals in mobility tests demonstrate better performances in measures cognitive flexibility (0.68<g<0.90). After including covariates from the medical/social domain, significant correlations were established between faster mobility tests and better cognitive flexibility (TUG: r=0.565; 10MWT: r=0.324). Between groups comparisons also revealed that faster individuals in mobility tests presented higher physical fitness levels (aerobic: 0.49<g<0.77, strength: 0.34<g<1.31). Significant correlations were found between better physical fitness and better cognitive flexibility (strength: r=-0.380; V˙O2peak: r=-0.325) even after including age, education, fat-free mass and gender as covariates. These results suggest that the TUG and the 10MWT could potentially help distinguish individuals with poor neuromuscular, aerobic and cognitive flexibility performances.Experimental gerontology 09/2013; 48(12). DOI:10.1016/j.exger.2013.08.017 · 3.53 Impact Factor
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- "After filtering variables with low correlation to gait speeds, we constructed the models using a hybrid approach. A priori predictors age, and MDS-UPDRS were selected first based on previous reports describing the relationships between gait performance, age and disease severity   . The entire MDS-UPDRS score (sum of all four subscales) was used because it includes motor and nonmotor aspects of the disease as well as activities of daily living and motor complications. "
ABSTRACT: Gait difficulties and falls are commonly reported in people with Parkinson disease (PD). Reduction in gait speed is a major characteristic of Parkinsonian gait, yet little is known about its underlying determinants, its ability to reflect an internal reservation about walking, or its relationship to falls. To study these issues, we selected age, disease severity, and nonmotor factors (i.e., depression, quality of life, balance confidence, and exercise beliefs and attitudes) to predict self-selected (SELF), fast-as-possible (FAST), and the difference (DIFF) between these walking speeds in 78 individuals with PD. We also examined gender differences in gait speeds and evaluated how gait speeds were related to a retrospective fall report. Age, disease severity, and balance confidence were strong predictors of SELF, FAST, and, to a lesser extent, DIFF. All three parameters were strongly associated with falling. DIFF was significantly greater in men compared to women and was significantly associated with male but not female fallers. The results supported the clinical utility of using a suite of gait speed parameters to provide insight into the gait difficulties and differentiating between fallers in people with PD.Parkinson's Disease 06/2013; 2013:141720. DOI:10.1155/2013/141720 · 2.10 Impact Factor