The predictive value of gait speed and maximum step length for falling in community-dwelling older persons

Background: Circulating osteoprogenitor (COP) cells are a surrogate of the bone marrow mesenchymal stem cells with high levels observed in osteoporosis and the initial stages of fracture healing. Conversely, a low percentage of COP cells (%COP) is strongly associated with frailty and disability. However, it is unknown whether %COP is associated with sarcopenia, a musculoskeletal disease closely related to frailty. Objectives: This study sought to determine the associations between %COP and sarcopenia defined using the Sarcopenia Definitions and Outcomes Consortium (SDOC) criteria. Methods: Data from a random sample of 73 community-dwelling older persons enrolled in the Nepean Osteoporosis and Frailty study (median age 74 years; 60% female) were analyzed. %COP was quantified by flow cytometry using selective gating of CD45/osteocalcin (OCN) + cells. Sarcopenia was defined using handgrip strength and gait speed with cut points as per the SDOC criteria. Linear regression was used for analysis. Results: Sarcopenia was identified in 19% of participants, all of whom were frail. After adjusting for age, sex, and interleukin 6, sarcopenic participants had 36% lower %COP (95% confidence interval [CI] −56%, −6%, p = 0.024). Both grip strength and gait speed showed associations with %COP (p = 0.065 and 0.002, respectively); however, after adjusting for age and frailty, only gait speed remained associated with %COP (0.1 m/s increase in gait velocity was associated with a 5% increase in %COP cells (95% CI 0%, 10%, p = 0.052). Conclusions: High levels of %COP are associated with better muscle function. Future longitudinal studies are required to elucidate the clinical utility of %COP as a potential biomarker or disease stratifier for sarcopenia.

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Safety, Feasibility, and Reliability of the Maximal Step Length, Gait Speed, and Chair Test Measured by Seniors Themselves: The Senior Step Study

Journal of Aging and Physical Activity ◽

10.1123/japa.2013-0231 ◽

2015 ◽

Vol 23 (3) ◽

pp. 438-443 ◽

Cited By ~ 6

Author(s):

Kim T.J. Bongers ◽

Yvonne Schoon ◽

Maartje J. Graauwmans ◽

Marlies E. Hoogsteen-Ossewaarde ◽

Marcel G.M. Olde Rikkert

Keyword(s):

Older Adults ◽

Gait Speed ◽

Fall Risk ◽

Intraclass Correlation ◽

Step Length ◽

Community Dwelling ◽

Self Management ◽

Training Effect ◽

Community Dwelling Older Adults ◽

At Home

Self-management of mobility and fall risk might be possible if older adults could use a simple and safe self-test to measure their own mobility, balance, and fall risk at home. The aim of this study was to determine the safety, feasibility, and intraindividual reliability of the maximal step length (MSL), gait speed (GS), and chair test (CT) as potential self-tests for assessing mobility and fall risk. Fifty-six community-dwelling older adults performed MSL, GS, and CT at home once a week during a four-week period, wherein the feasibility, test-retest reliability, coefficients of variation, and linear mixed models with random effects of these three self-tests were determined. Forty-nine subjects (mean age 76.1 years [SD: 4.0], 19 females [42%]) completed the study without adverse effects. Compared with the other self-tests, MSL gave the most often (77.6%) valid measurement results and had the best intraclass correlation coefficients (0.95 [95% confidence interval: 0.91−0.97]). MSL and GS gave no significant training effect, whereas CT did show a significant training effect (p < .01). Community-dwelling older adults can perform MSL safely, correctly, and reliably, and GS safely and reliably. Further research is needed to study the responsiveness and beneficial effects of these self-tests on self-management of mobility and fall risk.

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Reliability of two gait speed tests of different timed phases and equal non-timed phases in community-dwelling older persons

Medwave ◽

10.5867/medwave.2019.03.7611 ◽

2019 ◽

Vol 19 (03) ◽

pp. e7611-e7611 ◽

Cited By ~ 1

Author(s):

Lincoyán Fernández-Huerta ◽

Karen Córdova-León

Keyword(s):

Gait Speed ◽

Older Persons ◽

Community Dwelling

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The Predictive Value of Combined Hypoalbuminemia and Hypocholesterolemia in High Functioning Community-Dwelling Older Persons: MacArthur Studies of Successful Aging

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.1999.tb07230.x ◽

1999 ◽

Vol 47 (4) ◽

pp. 402-406 ◽

Cited By ~ 77

Author(s):

David B. Reuben ◽

Joachim H. Ix ◽

Gail A. Greendale ◽

Teresa E. Seeman

Keyword(s):

Predictive Value ◽

Successful Aging ◽

Older Persons ◽

Community Dwelling ◽

High Functioning

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The Association between Different Levels of Alcohol Use and Gait under Single and Dual Task in Community-Dwelling Older Persons Aged 65 to 70 Years

Current Gerontology and Geriatrics Research ◽

10.1155/2016/2018507 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Laurence Seematter-Bagnoud ◽

Christophe Büla ◽

Brigitte Santos-Eggimann

Keyword(s):

Alcohol Use ◽

Dual Task ◽

Gait Speed ◽

Older Persons ◽

Heavy Drinking ◽

Community Dwelling ◽

Cross Sectional ◽

Single Task ◽

Moderate Drinking

Objectives. This study aimed to describe the cross-sectional and longitudinal association between alcohol intake and gait parameters in older persons.Methods. Community-dwelling persons aged 65–70 years (N=807). Information on health, functional status, and alcohol use was self-reported at baseline and at 3-year follow-up, whereas gait speed and stride-to-stride variability were measured while walking only (single task) and under dual tasking (counting backwards).Results. Compared to light-to-moderate drinking, heavy drinking was associated with slower gait speed in single task (adj. coeff.: −.040, 95% CI: −.0.78 to −.002,p=.035). No significant association was observed between heavy drinking and gait speed variability. Nondrinkers walked significantly slower than light-to-moderate drinkers in dual task and had significantly higher gait speed variability in both single and dual task, but these associations disappeared after adjustment for comorbidity. At follow-up, 35.2% and 34.1% of the participants walked significantly slower in single and dual task, respectively. This proportion varied a little across drinking categories.Conclusion. At baseline, heavy alcohol consumption was significantly associated with slower gait speed in single task. Selective survival of the fittest heavy drinkers probably explains why this association faded in longitudinal analyses. The trend of poorer gait performance in nondrinkers disappeared after adjustment for comorbidity, suggesting confounding by a worse health status.

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Skeletal Muscle Apoptotic Signaling Predicts Thigh Muscle Volume and Gait Speed in Community-Dwelling Older Persons: An Exploratory Study

PLoS ONE ◽

10.1371/journal.pone.0032829 ◽

2012 ◽

Vol 7 (2) ◽

pp. e32829 ◽

Cited By ~ 56

Author(s):

Emanuele Marzetti ◽

Hazel A. Lees ◽

Todd M. Manini ◽

Thomas W. Buford ◽

Juan M. Aranda ◽

...

Keyword(s):

Skeletal Muscle ◽

Gait Speed ◽

Exploratory Study ◽

Older Persons ◽

Community Dwelling ◽

Muscle Volume ◽

Thigh Muscle ◽

Apoptotic Signaling

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The effect of different test protocols and walking distances on gait speed in older persons

Aging Clinical and Experimental Research ◽

10.1007/s40520-020-01703-z ◽

2020 ◽

Author(s):

Sebastian Krumpoch ◽

Ulrich Lindemann ◽

Anja Rappl ◽

Clemens Becker ◽

Cornel C. Sieber ◽

...

Keyword(s):

Gait Speed ◽

Older Persons ◽

Community Dwelling ◽

Assessment Tools ◽

Walking Distance ◽

Test Protocol ◽

Gait Characteristics ◽

Study Results ◽

Significant Difference ◽

Usual Gait Speed

Abstract Background and aims Walking is the core physical activity of older persons. The assessment of walking capacity is increasingly important for clinical purposes and clinical research. Differences between assessment tools and protocols for short walks to obtain gait characteristics can be responsible for changes, e.g., in gait speed from 0.1 to 0.2 m/s. The purpose of this study was to generate further knowledge for the harmonization and/or standardization of short walk-test protocols for assessing gait characteristics under supervised conditions. Methods For this cross-sectional study, 150 community-dwelling older adults (mean age 80.5 ± 4.5 years) were recruited. Participants performed eight walks differing in the distance (8-versus 4-m), static versus dynamic trials and comparing different test speed instructions (usual versus maximal) on an electronic walkway. Results A meaningful significant difference in mean usual gait speed was documented comparing the 4-m dynamic and static test protocol (0.12 m/s; p = 0.001). For the same comparison over an 8-m distance (dynamic versus static) and for the comparison between usual gait speed over 4-and 8-m, the differences in gait speed were smaller, but still statistically significant (p = 0.001). Conclusions Gait speed was faster, if the test protocol did not include a static start or stop. The differences were greater for a shorter walking distance. This aspect should be considered for the comparison of study results and is particularly relevant for systematic reviews and meta-analyses.

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Fear of Falling and Walking Quality: What Your Walking Reveals

Innovation in Aging ◽

10.1093/geroni/igaa057.3374 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 919-919

Author(s):

Anisha Suri ◽

Andrea Rosso ◽

Jessie VanSwearingen ◽

Gelsy Torres-Oviedo ◽

Leslie Coffman ◽

...

Keyword(s):

Gait Speed ◽

Fall Risk ◽

Fear Of Falling ◽

Step Length ◽

Community Dwelling ◽

Support Vector ◽

Cross Sectional ◽

Time Frequency ◽

Gait Quality ◽

Walk Ratio

Abstract Fear of Falling (FOF) is common among community-dwelling older adults and is associated with increased fall-risk. In this cross-sectional study we examined the relationships between FOF and factors associated with fall-risk such as gait quality, cognition, and walking-confidence. Using baseline data from older adult participants in a randomized exercise trial (N=232; age 77±6; 65% females; 40% reported FOF), we quantified the following outcome measure for (1) gait quality: harmonic ratio (smoothness) and time-frequency spatiotemporal variables from triaxial accelerometry during 6 minute walk; gait speed, step-time CoV (variability) and walk-ratio (step-length/cadence) on an instrumented walkway; (2) cognition: Trails A and B (3) walking-confidence: Gait efficacy Scale. Mann Whitney U-tests indicated individuals without FOF had better gait quality (p<0.05): greater smoothness (2.38±.58 vs 1.14±.73), speed (1.10±.15 vs 1.04±.17 m/s) and walk-ratio (.56±.07 vs .53±.08 cm/steps/min), lower step-time CoV (3.72±1.24 vs 4.17±1.66), and greater walking-confidence (89±11 vs 79±13). A random forest classifier predicted FOF with 64% (gait only) and 70% (additional variables: cognition, walking-confidence) accuracy; Gini-index based ranking indicated gait quality (smoothness vertical (V) direction, walking speed) were consistently important variables. Linear Support Vector Machine learning yielded accuracies of 60% (only gait) and 68% (with additional measures): smoothness V, mediolateral frequency bandwidth, gait speed among top 4 ranked variables in both models, and walking-confidence in the additional measures model; smoothness-V the highest weighted coefficient (-0.52). Based on these findings, interventions targeted for gait quality and walking-confidence may be important to overcome FOF and reduce fall risks.

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THE PHENOTYPE OF FRAILTY PREDICTS DISABILITY AND MORTALITY AMONG MEXICAN COMMUNITY-DWELLING ELDERLY

Journal of Frailty & Aging ◽

10.14283/jfa.2012.18 ◽

2012 ◽

pp. 1-7

Author(s):

S. AGUILAR-NAVARRO ◽

L.M. GUTIERREZ-ROBLEDO ◽

J.M.A. GARCIA-LARA ◽

H. PAYETTE ◽

H. AMIEVA ◽

...

Keyword(s):

Latin American ◽

Predictive Value ◽

Older Persons ◽

Frailty Index ◽

Adverse Outcomes ◽

Community Dwelling ◽

Health Study ◽

Cardiovascular Health Study ◽

Iadl Disability ◽

Health Related

Background: Frailty represents a major public health priority in Western countries. Specific social and cultural factors may influence the prevalence and predictive value for negative health-related events of this syndrome. Objective: To determine the prevalence and predictive value of the phenotype of frailty among community-dwelling Mexican American older persons. Design, Setting and Participants: Two-year longitudinal study of 5,644 men and women aged 60 years and older participating in the Mexican Health and Aging Study. Measurements: The Frailty index used in the present study was a modified version of the operational definition proposed in the Cardiovascular Health Study (CHS). Frailty was defined by the presence of at least three of the four following criteria: weight loss, weakness, exhaustion, slowness, and low physical activity. The main outcomes were incident disability and mortality. Chi-square, ANOVA and multiple logistic regression analyses were used to test the prognostic value of frailty for the outcomes of interest. Results: The mean age of the study sample was 68.7 (SD 6.9) years. Thirty-seven percent of participants (n=2,102) met the definition of frailty. Frail subjects were significantly older, and more likely to be women than non-frail participants. They also presented lower education, more chronic diseases, lower income, and poorer self-reported health status. After adjusting for potential confounders, frailty was found to be a predictor of incident mobility disability (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.37-2.66), activities of daily living (ADL) disability (OR 9.33; 95%CI 3.37-25.82), and instrumental ADL (IADL) disability (OR 1.81, 95%CI 1.23-2.68). The risk of mortality among frail participants was almost three-fold higher than in non-frail ones. Conclusion: The prevalence of frailty is higher in this elderly population than what previously reported in other cohorts. The phenotype of frailty was confirmed to be a predictor for adverse health-related outcomes (including mobility, ADL, and IADL disability). Further studies in Latin American countries are needed to identify frailty and develop adapted interventions for the prevention of adverse outcomes in older persons.

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