Matteo Cesari1,2, Stephen B. Kritchevsky1,2, B. Penninx1,2, Barbara J. Nicklas1,2, Eleanor M. Simonsick1,2, Anne B. Newman1,2, Frances A. Tylavsky1,2, Jennifer S. Brach1,2, Suzanne Satterfield1,2, Douglas C. Bauer1,2, Marjolein Visser1,2, Susan M. Rubin1,2, Tamara B. Harris1,2, Marco Pahor1,2
1Departments of
¶Medicine#Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania**Department of Preventive Medicine, University of Tennessee, Memphis, Tennessee††Department of Medicine, University of California at San Francisco, San Francisco, California‡‡Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland.
2From the
*Department of Aging and Geriatric Research, College of Medicine, Institute on Aging, University of Florida, Gainesville, Florida†Sticht Center on Aging, Wake Forest University School of Medicine, Winston Salem, North Carolina‡Department of Psychiatry§Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, the Netherlands∥Intramural Research Program, National Institute on Aging, Baltimore, Maryland
Tóm tắt
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.
