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. 2018 May;66(5):954-961.
doi: 10.1111/jgs.15331. Epub 2018 Apr 2.

Gait Speed and Mobility Disability: Revisiting Meaningful Levels in Diverse Clinical Populations

Michael E Miller  1 , Jay Magaziner  2 , Anthony P Marsh  3 , Roger A Fielding  4 , Thomas M Gill  5 , Abby C King  6 , Stephen Kritchevsky  7 , Todd Manini  8 , Mary M McDermott  9 , Rebecca Neiberg  1 , Denise Orwig  2 , Adam J Santanasto  10 , Marco Pahor  8 , Jack Guralnik  2 , W Jack Rejeski  3 ; LIFE Investigators
Affiliations

Gait Speed and Mobility Disability: Revisiting Meaningful Levels in Diverse Clinical Populations

Michael E Miller et al. J Am Geriatr Soc. 2018 May.

Abstract

Objectives: To investigate the heterogeneity of clinically meaningful levels of gait speed relative to self-reported mobility disability (SR-MD).

Design: Five longitudinal studies with older adults in different health states (onset of acute event, presence of chronic condition, sedentary, community living) were used to explore the relationship between gait speed and SR-MD.

Setting: Lifestyle Interventions and Independence for Elders Pilot (LIFE-P), LIFE, Trial of Angiotensin-Converting Enzyme Inhibition and Novel Cardiovascular Risk Factors (TRAIN), Baltimore Hip Fracture Study (BHS2), Invecchiare in Chianti (InCHIANTI).

Participants: Individuals aged 65 and older (N=3,540): sedentary, community dwelling (LIFE-P/LIFE), with hip fracture (BHS2), random population-based sample (InCHIANTI), high cardiovascular risk (TRAIN).

Measurements: Usual-pace gait speed across 3 to 4 m and SR-MD, defined as inability to walk approximately 1 block or climb 1 flight of stairs.

Results: The mean gait speed of participants without SR-MD was greater than 1.0 m/s in InCHIANTI and TRAIN, 0.79 m/s in LIFE-P/LIFE, and 0.46 m/sec in BHS2. Of individuals with SR-MD, mean gait speed was 0.08 m/s slower in LIFE-P/LIFE, 0.19 m/s slower in TRAIN, 0.22 m/s slower in BHS2, and 0.36 m/s slower in InCHIANTI. The optimal gait speed cutpoint for minimizing SR-MD misclassification rates ranged from 0.3 m/s in BHS2 to 1.0 m/s in TRAIN. In longitudinal analyses, development of SR-MD was dependent on initial gait speed and change in gait speed (p<.001).

Conclusion: The relationship between absolute levels of gait speed and SR-MD may be context specific, and there may be variations between populations. Across diverse clinical populations, clinical interpretations of how change in usual pace gait speed relates to development of SR-MD depend on where on the gait speed continuum change occurs.

Keywords: mobility disability; stair climb; usual-pace 3- to 4-m gait speed.

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Conflict of interest statement

The authors have no financial or personal conflicts.

Figures

Figure 1
Figure 1
Predicted probability of self-reported mobility disability obtained from logistic regression as a function of 3m or 4m gait speed (m/s) collected at the same visit.
Figure 2
Figure 2
Predicted probabilities of the development of (panel A), or recovery from (panel B), self-reported mobility disability obtained from logistic regression as a function of 3m or 4m gait speed (m/s) collected at the initial visit and change in gait speed (m/s) to the subsequent visit. Curves are truncated to represent the range of change in gait speed observed for each initial level of gait speed. Ninety percent of gait speed measures in BHS2 were < 0.68 m/s.
See this image and copyright information in PMC

References

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