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Decline in Fast Gait Speed as a Predictor of Disability in Older Adults.
J Am Geriatr Soc. 2015 Jun; 63(6):1129-36.JA

Abstract

OBJECTIVES

To determine whether fast gait speed at study baseline and change in gait speed had independent associations with disability onset.

DESIGN

Cohort study with 11-year follow-up (1999-2010).

SETTING

Three-City Study center, Dijon, France.

PARTICIPANTS

Community-dwelling individuals aged 65 to 85 (N = 3,814, 61% female).

MEASUREMENTS

Fast gait speed (over 6 m) was assessed up to five times and disability (mobility (Rosow-Breslau scale), instrumental activities of daily living (IADLs; Lawton-Brody scale), basic activities of daily living (ADLs; Katz scale)) six times. A hierarchical disability indicator was constructed; participants were considered disabled if they reported difficulties with mobility and IADLs or with mobility, IADLs, and ADLs. The association between baseline fast gait speed and its slope of change and disability incidence was examined using joint models for longitudinal and time-to-event data.

RESULTS

Over follow-up, 628 participants (68% women) developed disability. Mean fast gait speed at baseline was 1.54 m/s, and annual decline was 0.017 m/s. The hazard ratio of disability per standard deviation (SD) (-0.22 m/s) slower baseline fast gait speed was 1.77 (95% confidence interval (CI) = 1.60-1.94) and for one-SD (-0.013 m/s) faster annual decline was 1.38 (95% CI = 1.10-1.73) when both parameters were included in a sex- and age-adjusted model. All associations remained statistically significant in multivariable models, except for slope of change when chronic conditions were added to the model; of chronic conditions, dyspnea was the main contributor.

CONCLUSION

Accelerated decline in fast gait speed was associated with disability independent of baseline fast gait speed. These results confirm the importance of measuring gait speed repeatedly in elderly adults to identify those at higher risk of disability and the need to identify determinants of decline, because they are likely to be targets for prevention and treatment to reduce disability risk.

Authors+Show Affiliations

INSERM, Centre for Research in Epidemiology and Population Health, U1018, Epidemiology of Ageing and Age-Related Diseases, Villejuif, France. UMRS 1018, University Versailles St-Quentin, Versailles, France.INSERM, Centre for Research in Epidemiology and Population Health, U1018, Epidemiology of Ageing and Age-Related Diseases, Villejuif, France. UMRS 1018, University Versailles St-Quentin, Versailles, France. Department of Epidemiology and Public Health, University College London, London, UK.INSERM, Centre for Research in Epidemiology and Population Health, U1018, Epidemiology of Ageing and Age-Related Diseases, Villejuif, France. UMRS 1018, University Versailles St-Quentin, Versailles, France.INSERM U897, Neuroepidemiology Team, Bordeaux, France. University of Bordeaux, Bordeaux, France.INSERM, Centre for Research in Epidemiology and Population Health, U1018, Epidemiology of Ageing and Age-Related Diseases, Villejuif, France. UMRS 1018, University Versailles St-Quentin, Versailles, France.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26096387

Citation

Artaud, Fanny, et al. "Decline in Fast Gait Speed as a Predictor of Disability in Older Adults." Journal of the American Geriatrics Society, vol. 63, no. 6, 2015, pp. 1129-36.
Artaud F, Singh-Manoux A, Dugravot A, et al. Decline in Fast Gait Speed as a Predictor of Disability in Older Adults. J Am Geriatr Soc. 2015;63(6):1129-36.
Artaud, F., Singh-Manoux, A., Dugravot, A., Tzourio, C., & Elbaz, A. (2015). Decline in Fast Gait Speed as a Predictor of Disability in Older Adults. Journal of the American Geriatrics Society, 63(6), 1129-36. https://doi.org/10.1111/jgs.13442
Artaud F, et al. Decline in Fast Gait Speed as a Predictor of Disability in Older Adults. J Am Geriatr Soc. 2015;63(6):1129-36. PubMed PMID: 26096387.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decline in Fast Gait Speed as a Predictor of Disability in Older Adults. AU - Artaud,Fanny, AU - Singh-Manoux,Archana, AU - Dugravot,Aline, AU - Tzourio,Christophe, AU - Elbaz,Alexis, Y1 - 2015/06/11/ PY - 2015/6/23/entrez PY - 2015/6/23/pubmed PY - 2015/9/12/medline KW - aged KW - cohort study KW - disability KW - epidemiology KW - motor decline SP - 1129 EP - 36 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 63 IS - 6 N2 - OBJECTIVES: To determine whether fast gait speed at study baseline and change in gait speed had independent associations with disability onset. DESIGN: Cohort study with 11-year follow-up (1999-2010). SETTING: Three-City Study center, Dijon, France. PARTICIPANTS: Community-dwelling individuals aged 65 to 85 (N = 3,814, 61% female). MEASUREMENTS: Fast gait speed (over 6 m) was assessed up to five times and disability (mobility (Rosow-Breslau scale), instrumental activities of daily living (IADLs; Lawton-Brody scale), basic activities of daily living (ADLs; Katz scale)) six times. A hierarchical disability indicator was constructed; participants were considered disabled if they reported difficulties with mobility and IADLs or with mobility, IADLs, and ADLs. The association between baseline fast gait speed and its slope of change and disability incidence was examined using joint models for longitudinal and time-to-event data. RESULTS: Over follow-up, 628 participants (68% women) developed disability. Mean fast gait speed at baseline was 1.54 m/s, and annual decline was 0.017 m/s. The hazard ratio of disability per standard deviation (SD) (-0.22 m/s) slower baseline fast gait speed was 1.77 (95% confidence interval (CI) = 1.60-1.94) and for one-SD (-0.013 m/s) faster annual decline was 1.38 (95% CI = 1.10-1.73) when both parameters were included in a sex- and age-adjusted model. All associations remained statistically significant in multivariable models, except for slope of change when chronic conditions were added to the model; of chronic conditions, dyspnea was the main contributor. CONCLUSION: Accelerated decline in fast gait speed was associated with disability independent of baseline fast gait speed. These results confirm the importance of measuring gait speed repeatedly in elderly adults to identify those at higher risk of disability and the need to identify determinants of decline, because they are likely to be targets for prevention and treatment to reduce disability risk. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/26096387/Decline_in_Fast_Gait_Speed_as_a_Predictor_of_Disability_in_Older_Adults_ L2 - https://doi.org/10.1111/jgs.13442 DB - PRIME DP - Unbound Medicine ER -