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. 2021 Apr;12(2):274-297.
doi: 10.1002/jcsm.12667. Epub 2021 Feb 16.

How gait influences frailty models and health-related outcomes in clinical-based and population-based studies: a systematic review

Ilaria Bortone  1 , Rodolfo Sardone  1 , Luisa Lampignano  1 , Fabio Castellana  1 , Roberta Zupo  1 , Madia Lozupone  1   2 , Biagio Moretti  3 , Gianluigi Giannelli  4 , Francesco Panza  1   2
Affiliations

How gait influences frailty models and health-related outcomes in clinical-based and population-based studies: a systematic review

Ilaria Bortone et al. J Cachexia Sarcopenia Muscle. 2021 Apr.

Abstract

Aging is often associated with a decline in physical function that eventually leads to loss of autonomy in activities of daily living (ADL). Walking is a very common ADL, important for main determinants of quality of life in older age, and it requires the integration of many physiological systems. Gait speed has been described as the 'sixth vital sign' because it is a core indicator of health and function in aging and disease. We reviewed original studies up to June 2020 that assessed frailty in both longitudinal and cross-sectional observational studies, paying particular attention to how gait is measured in older population and how the gait parameter adopted may influence the estimated frailty models and the health-related outcomes of the various studies (i.e. clinical, cognitive, physical, and nutritional outcomes). Eighty-five studies met the search strategy and were included in the present systematic review. According to the frailty tools, more than 60% of the studies used the physical phenotype model proposed by Fried and colleagues, while one-third referred to multi-domain indexes or models and only 5% referred to other single-domain frailty models (social or cognitive). The great heterogeneity observed in gait measurements and protocols limited the possibility to directly compare the results of the studies and it could represent an important issue causing variability in the different outcome measures in both clinical-and population-based settings. Gait appeared to be an indicator of health and function also in frail older adults, and different gait parameters appeared to predict adverse health-related outcomes in clinical, cognitive, and physical domains and, to a lesser extent, in nutritional domain. Gait has the potential to elucidate the common basic mechanisms of cognitive and motor decline. Advances in technology may extend the validity of gait in different clinical settings also in frail older adults, and technology-based assessment should be encouraged. Combining various gait parameters may enhance frailty prediction and classification of different frailty phenotypes.

Keywords: Aging; Cognition; Diet; Gait analysis; Health status; Physical performance.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Health‐related outcomes extracted and grouped according to the nature of the measure (clinical, cognitive, physical, and nutritional) in relation to gait.
Figure 2
Figure 2
PRISMA 2009 flow diagram of retrieved and selected studies.
Figure 3
Figure 3
Distribution of included studies in relation to frailty models (and related domains) in relation to the selected gait parameters and protocols.
Figure 4
Figure 4
Distribution of included studies in relation to the health‐related outcomes investigated and the gait parameters adopted.
See this image and copyright information in PMC

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