Age-associated declines in complex walking task performance: the Walking InCHIANTI toolkit

Abstract

Objectives: To describe a set of complex walking tasks (CWTs) that can be used to evaluate mobility and to characterize age- and sex-specific performance on these tests.

Design: A population-based study of persons living in the Chianti geographic area (Tuscany, Italy).

Setting: Community.

Participants: One thousand two hundred twenty-seven persons (aged 20-95) selected from the city registries of Greve and Bagno a Ripoli (Tuscany, Italy).

Measurements: Gait velocity (m/s) was measured during 13 walking tests (Walking InCHIANTI Toolkit (WIT)) used to examine walking ability under a range of conditions and distances. Other measures included performance on the Short Physical Performance Battery and self-reported health and functional status, including disability in activities of daily living.

Results: Age-associated differences on the WIT were reflected in the number of older adults unable to complete CWTs and a decrease in gait velocity. For all tasks, decrements in walking speed with increasing age were significantly larger at aged 65 and older. Performance on CWTs was highly variable and could not be explained by usual gait speed measured under low-challenge conditions alone.

Conclusion: CWTs may provide important insight into mobility function, particularly in persons with normal or near-normal usual gait speed. Further research is needed to elucidate the specific physiological mechanisms that contribute to declining performance on CWT with increasing age.

Figure 1

A comparison of percentage of nonperformers by task and age.

Figure 2

A comparison of the variation in percentage decline in gait speed from reference walk according to task and age. For each task, box plots are presented by age with the top plot data from those aged 85 and older, followed by 75–84, 65–74, and the lowest box plot < 65. Within the box plots, the median is shown as a vertical line, the ends of the box identify the 25th and 75th percentiles, and the horizontal line marks the 5th and 95th percentiles.

Figure 3

Scatterplot showing gait speed (m/s) in three walking tasks (A = 7-m usual pace; B = 7-m fast pace, obstacles; C = 7-m usual pace, walk and talk) as a function of age. Also shown are LOWESS smoothing curves for men (black lines) and women (gray lines).

Figure 4

The relationship between usual gait speed (measured under low-challenge conditions) and speed on the walk-and-talk test, for men (gray circles) and women (black squares) aged 20 to 95. Data from nonperformers (excluded or unable for safety and medical reasons) are plotted as 0.