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Rising Energetic Cost of Walking Predicts Gait Speed Decline With Aging.
J Gerontol A Biol Sci Med Sci. 2016 07; 71(7):947-53.JG

Abstract

BACKGROUND

Slow gait is a robust biomarker of health and a predictor of functional decline and death in older adults, yet factors contributing to the decline in gait speed with aging are not well understood. Previous research suggests that the energetic cost of walking at preferred speed is inversely associated with gait speed, but whether individuals with a rising energetic cost of walking experience a steeper rate of gait speed decline has not been investigated.

METHODS

In participants of the Baltimore Longitudinal Study of Aging, the energetic cost of overground walking at preferred speed (mL/kg/m) was assessed between 2007 and 2014 using a portable indirect calorimeter. The longitudinal association between the energetic cost of walking and usual gait speed over 6 meters (m/s) was assessed with multivariate linear regression models, and the risk of slow gait (<1.0 m/s) was analyzed using Cox proportional hazards models.

RESULTS

The study population consisted of 457 participants aged 40 and older who contributed 1,121 person-visits to the analysis. In fully adjusted models, increases in the energetic cost of walking predicted the rate of gait speed decline in those older than 65 years (β = -0.008 m/s, p < .001). Moreover, those with a higher energetic cost of walking (>0.17mL/kg/m) had a 57% greater risk of developing slow gait compared with a normal energetic cost of walking (≤0.17mL/kg/m; adjusted hazard ratio = 1.57, 95% confidence interval: 1.01-2.46).

CONCLUSIONS

These findings suggest that strategies to maintain walking efficiency hold significant implications for maintaining mobility in late life. Efforts to curb threats to walking efficiency should focus on therapies to treat gait and balance impairments, and reduce clinical disease burden.

Authors+Show Affiliations

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland. jschrac1@jhu.edu.Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland.Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland.Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural

Language

eng

PubMed ID

26850913

Citation

Schrack, Jennifer A., et al. "Rising Energetic Cost of Walking Predicts Gait Speed Decline With Aging." The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, vol. 71, no. 7, 2016, pp. 947-53.
Schrack JA, Zipunnikov V, Simonsick EM, et al. Rising Energetic Cost of Walking Predicts Gait Speed Decline With Aging. J Gerontol A Biol Sci Med Sci. 2016;71(7):947-53.
Schrack, J. A., Zipunnikov, V., Simonsick, E. M., Studenski, S., & Ferrucci, L. (2016). Rising Energetic Cost of Walking Predicts Gait Speed Decline With Aging. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 71(7), 947-53. https://doi.org/10.1093/gerona/glw002
Schrack JA, et al. Rising Energetic Cost of Walking Predicts Gait Speed Decline With Aging. J Gerontol A Biol Sci Med Sci. 2016;71(7):947-53. PubMed PMID: 26850913.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rising Energetic Cost of Walking Predicts Gait Speed Decline With Aging. AU - Schrack,Jennifer A, AU - Zipunnikov,Vadim, AU - Simonsick,Eleanor M, AU - Studenski,Stephanie, AU - Ferrucci,Luigi, Y1 - 2016/02/05/ PY - 2015/03/19/received PY - 2016/01/05/accepted PY - 2016/2/7/entrez PY - 2016/2/7/pubmed PY - 2017/8/5/medline KW - Functional performance KW - Gait KW - Metabolism KW - Physical function KW - Physiology SP - 947 EP - 53 JF - The journals of gerontology. Series A, Biological sciences and medical sciences JO - J Gerontol A Biol Sci Med Sci VL - 71 IS - 7 N2 - BACKGROUND: Slow gait is a robust biomarker of health and a predictor of functional decline and death in older adults, yet factors contributing to the decline in gait speed with aging are not well understood. Previous research suggests that the energetic cost of walking at preferred speed is inversely associated with gait speed, but whether individuals with a rising energetic cost of walking experience a steeper rate of gait speed decline has not been investigated. METHODS: In participants of the Baltimore Longitudinal Study of Aging, the energetic cost of overground walking at preferred speed (mL/kg/m) was assessed between 2007 and 2014 using a portable indirect calorimeter. The longitudinal association between the energetic cost of walking and usual gait speed over 6 meters (m/s) was assessed with multivariate linear regression models, and the risk of slow gait (<1.0 m/s) was analyzed using Cox proportional hazards models. RESULTS: The study population consisted of 457 participants aged 40 and older who contributed 1,121 person-visits to the analysis. In fully adjusted models, increases in the energetic cost of walking predicted the rate of gait speed decline in those older than 65 years (β = -0.008 m/s, p < .001). Moreover, those with a higher energetic cost of walking (>0.17mL/kg/m) had a 57% greater risk of developing slow gait compared with a normal energetic cost of walking (≤0.17mL/kg/m; adjusted hazard ratio = 1.57, 95% confidence interval: 1.01-2.46). CONCLUSIONS: These findings suggest that strategies to maintain walking efficiency hold significant implications for maintaining mobility in late life. Efforts to curb threats to walking efficiency should focus on therapies to treat gait and balance impairments, and reduce clinical disease burden. SN - 1758-535X UR - https://www.unboundmedicine.com/medline/citation/26850913/Rising_Energetic_Cost_of_Walking_Predicts_Gait_Speed_Decline_With_Aging_ L2 - https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/glw002 DB - PRIME DP - Unbound Medicine ER -