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Usual gait speed independently predicts mortality in very old people: a population-based study.
J Am Med Dir Assoc. 2013 Jul; 14(7):529.e1-6.JA

Abstract

OBJECTIVES

In older people, usual gait speed has been shown to independently predict mortality; however, less is known about whether usual gait speed is as informative in very old populations, in which prevalence of multimorbidity and disability is high. The aim of this study was to investigate if usual gait speed can independently predict all-cause mortality in very old people, and whether the prediction is influenced by dementia disorder, dependency in activities of daily living (ADL), or use of walking aids in the gait speed test.

DESIGN

Prospective cohort study.

SETTING

Population-based study in northern Sweden and Finland (the Umeå 85+/GERDA Study).

PARTICIPANTS

A total of 772 participants with a mean age of 89.6 years, 70% women, 33% with dementia disorders, 54% with ADL dependency, and 39% living in residential care facilities.

MEASUREMENTS

Usual gait speed assessed over 2.4 meters and mortality followed-up for 5 years.

RESULTS

The mean ± SD gait speed was 0.52 ± 0.21 m/s for the 620 (80%) participants able to complete the gait speed test. Cox proportional hazard regression analyses adjusted for potential confounders were performed. Compared with the fastest gait speed group (≥ 0.64 m/s), the hazard ratio for mortality was for the following groups: unable = 2.27 (P < .001), ≤ 0.36 m/s = 1.97 (P = .001), 0.37 to 0.49 m/s = 1.99 (P < .001), 0.50 to 0.63 m/s = 1.11 (P = .604). No interaction effects were found between gait speed and age, sex, dementia disorder, dependency in ADLs, or use of walking aids.

CONCLUSION

Among people aged 85 or older, including people dependent in ADLs and with dementia disorders, usual gait speed was an independent predictor of 5-year all-cause mortality. Inability to complete the gait test or gait speeds slower than 0.5 m/s appears to be associated with higher mortality risk. Gait speed might be a useful clinical indicator of health status among very old people.

Authors+Show Affiliations

Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden. annika.toots@germed.umu.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23706405

Citation

Toots, Annika, et al. "Usual Gait Speed Independently Predicts Mortality in Very Old People: a Population-based Study." Journal of the American Medical Directors Association, vol. 14, no. 7, 2013, pp. 529.e1-6.
Toots A, Rosendahl E, Lundin-Olsson L, et al. Usual gait speed independently predicts mortality in very old people: a population-based study. J Am Med Dir Assoc. 2013;14(7):529.e1-6.
Toots, A., Rosendahl, E., Lundin-Olsson, L., Nordström, P., Gustafson, Y., & Littbrand, H. (2013). Usual gait speed independently predicts mortality in very old people: a population-based study. Journal of the American Medical Directors Association, 14(7), e1-6. https://doi.org/10.1016/j.jamda.2013.04.006
Toots A, et al. Usual Gait Speed Independently Predicts Mortality in Very Old People: a Population-based Study. J Am Med Dir Assoc. 2013;14(7):529.e1-6. PubMed PMID: 23706405.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Usual gait speed independently predicts mortality in very old people: a population-based study. AU - Toots,Annika, AU - Rosendahl,Erik, AU - Lundin-Olsson,Lillemor, AU - Nordström,Peter, AU - Gustafson,Yngve, AU - Littbrand,Håkan, Y1 - 2013/05/23/ PY - 2013/03/28/received PY - 2013/04/17/accepted PY - 2013/5/28/entrez PY - 2013/5/28/pubmed PY - 2013/11/6/medline SP - 529.e1 EP - 6 JF - Journal of the American Medical Directors Association JO - J Am Med Dir Assoc VL - 14 IS - 7 N2 - OBJECTIVES: In older people, usual gait speed has been shown to independently predict mortality; however, less is known about whether usual gait speed is as informative in very old populations, in which prevalence of multimorbidity and disability is high. The aim of this study was to investigate if usual gait speed can independently predict all-cause mortality in very old people, and whether the prediction is influenced by dementia disorder, dependency in activities of daily living (ADL), or use of walking aids in the gait speed test. DESIGN: Prospective cohort study. SETTING: Population-based study in northern Sweden and Finland (the Umeå 85+/GERDA Study). PARTICIPANTS: A total of 772 participants with a mean age of 89.6 years, 70% women, 33% with dementia disorders, 54% with ADL dependency, and 39% living in residential care facilities. MEASUREMENTS: Usual gait speed assessed over 2.4 meters and mortality followed-up for 5 years. RESULTS: The mean ± SD gait speed was 0.52 ± 0.21 m/s for the 620 (80%) participants able to complete the gait speed test. Cox proportional hazard regression analyses adjusted for potential confounders were performed. Compared with the fastest gait speed group (≥ 0.64 m/s), the hazard ratio for mortality was for the following groups: unable = 2.27 (P < .001), ≤ 0.36 m/s = 1.97 (P = .001), 0.37 to 0.49 m/s = 1.99 (P < .001), 0.50 to 0.63 m/s = 1.11 (P = .604). No interaction effects were found between gait speed and age, sex, dementia disorder, dependency in ADLs, or use of walking aids. CONCLUSION: Among people aged 85 or older, including people dependent in ADLs and with dementia disorders, usual gait speed was an independent predictor of 5-year all-cause mortality. Inability to complete the gait test or gait speeds slower than 0.5 m/s appears to be associated with higher mortality risk. Gait speed might be a useful clinical indicator of health status among very old people. SN - 1538-9375 UR - https://www.unboundmedicine.com/medline/citation/23706405/Usual_gait_speed_independently_predicts_mortality_in_very_old_people:_a_population_based_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1525-8610(13)00231-4 DB - PRIME DP - Unbound Medicine ER -