What cut-point in gait speed best discriminates community dwelling older adults with mobility complaints from those without? A pooled analysis from the Sarcopenia Definitions and Outcomes Consortium

Abstract Background Cut-points to define slow walking speed have largely been derived from expert opinion. Methods Study participants (13,589 men and 5,043 women aged ≥65years) had walking speed (m/s) measured over 4-6 meters (mean ± SD: 1.20 ± 0.27 m/s in men and 0.94 ± 0.24 m/s in women.) Mobility limitation was defined as self-reported any difficulty with walking ~1/4 mile (prevalence: 12.6% men, 26.4% women). Sex-stratified classification and regression tree (CART) models with 10-fold cross-validation identified walking speed cut-points that optimally discriminated those who reported mobility limitation from those who did not. Results Among 5,043 women, CART analysis identified two cut-points, classifying 4,144 (82.2%) with walking speed ≥0.75 m/s, which we labeled as “fast”; 478 (9.5%) as “intermediate” (walking speed ≥0.62 m/s but <0.75 m/s); and 421 (8.3%) as “slow” (walking speed <0.62 m/s). Among 13,589 men, CART analysis identified three cut-points, classifying 10,001 (73.6%) with walking speed ≥1.00 m/s (“very fast”); 2,901 (21.3%) as “fast” (walking speed ≥0.74 m/s but <1.00 m/s); 497 (3.7%) as “intermediate” (walking speed ≥0.57 m/s but <0.74 m/s); and 190 (1.4%) as “slow” (walking speed <0.57 m/s). Prevalence of self-reported mobility limitation was lowest in the “fast” or “very fast” (11% for men and 19% for women) and highest in the “slow” (60.5% in men and 71.0% in women). Rounding the two slower cut-points to 0.60 m/s and 0.75 m/s reclassified very few participants. Conclusions Cut-points in walking speed of ~0.60 m/s and 0.75 m/s discriminate those with self-reported mobility limitation from those without.

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Exploring effective items of physical function in slow walking speed and self-reported mobility limitation in community-dwelling older adults

Geriatrics and Gerontology International ◽

10.1111/j.1447-0594.2011.00726.x ◽

2011 ◽

Vol 12 (1) ◽

pp. 50-58 ◽

Cited By ~ 11

Author(s):

Mi-Ji Kim ◽

Noriko Yabushita ◽

Kiyoji Tanaka

Keyword(s):

Older Adults ◽

Physical Function ◽

Walking Speed ◽

Community Dwelling ◽

Mobility Limitation ◽

Slow Walking ◽

Community Dwelling Older Adults ◽

Slow Walking Speed

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Associations between locomotive and non-locomotive physical activity and physical performance in older community-dwelling females with and without locomotive syndrome: a cross-sectional study

Journal of PHYSIOLOGICAL ANTHROPOLOGY ◽

10.1186/s40101-021-00268-8 ◽

2021 ◽

Vol 40 (1) ◽

Author(s):

Tomohiro Nishimura ◽

Atsushi Hagio ◽

Kanako Hamaguchi ◽

Toshiyuki Kurihara ◽

Motoyuki Iemitsu ◽

...

Keyword(s):

Physical Activity ◽

Walking Speed ◽

Cross Sectional Study ◽

Community Dwelling ◽

Step Test ◽

Locomotive Syndrome ◽

Sectional Study ◽

Cross Sectional ◽

Slow Walking ◽

Slow Walking Speed

Abstract Background Locomotive syndrome (LS) is a condition of reduced mobility due to a disorder of the locomotive system. Increasing moderate to vigorous physical activity (MVPA) has been recommended to prevent LS. However, to increase daily MVPA is difficult for older people with LS. The MVPA consists of not only locomotive activities such as walking but also non-locomotive activities such as household activities. The aim of this study was to examine the associations between locomotive/non-locomotive MVPA and physical performance in older females with and without LS. Methods Participants of this cross-sectional study were 143 older community-dwelling Japanese females. The participants were divided into two groups based on the results of the stand-up test: the normal group (NL) (n = 86) and the LS group (n = 57). Both the locomotive and non-locomotive PA seperately measured with its intensity. The intensity of physical activity (PA) was calculated as METs and classified as sedentary behavior (SB 1–1.5 metabolic equivalent tasks (METs)), low-intensity physical activity (LPA 1.6–2.9 METs), and MVPA (≥ 3 METs). For example, locomotive LPA is slow walking speed of 54 m/min, and locomotive MVPA is walking speed of 67 m/min. While non-locomotive LPA is office work and cooking, non-locomotive MVPA is housecleaning. Physical function was evaluated by handgrip strength, walking speed, and 2-step test. Results Walking speed, hand-grip strength, 2-step test, daily step counts, and all PA measurements were not significantly different between two groups. In the LS, locomotive MVPA (r = 0.293, p < 0.05) and total MVPA (r = 0.299, p < 0.05) was significantly correlated with walking speed, but not in the NL. Conclusions Walking speed was positively correlated with locomotive MVPA and total MVPA in the LS group, but not in NL group. This result suggests that slow walking speed in older people with LS occur in connection with lower locomotive MVPA and total MVPA.

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Motoric cognitive risk syndrome and incident dementia in older adults from the Québec NuAge cohort

Age and Ageing ◽

10.1093/ageing/afaa235 ◽

2020 ◽

Author(s):

Olivier Beauchet ◽

Harmehr Sekhon ◽

Liam Cooper-Brown ◽

Cyrille P Launay ◽

Pierrette Gaudreau ◽

...

Keyword(s):

Older Adults ◽

Successful Aging ◽

Walking Speed ◽

Community Dwelling ◽

Slow Walking ◽

Cognitive Risk ◽

Incident Dementia ◽

Cognitive Complaint ◽

Slow Walking Speed

Abstract Background The co-occurrence of slow walking speed and subjective cognitive complaint (SCC) in non-demented individuals defines motoric cognitive risk syndrome (MCR), which is a pre-dementia stage. There is no information on the association between MCR and incident dementia in Québec’s older population. Objective The study aims to examine the association of MCR and its individual components (i.e. SCC and slow walking speed) with incident dementia in community-dwelling older adults living in the province of Québec (Canada). Design Québec older people population-based observational cohort study with 3 years of follow-up. Setting Community dwellings. Subjects A subset of participants (n = 1,098) in ‘Nutrition as a determinant of successful aging: The Québec longitudinal study’ (NuAge). Methods At baseline, participants with MCR were identified. Incident dementia was measured at annual follow-up visits using the Modified Mini-Mental State (≤79/100) test and Instrumental Activity Daily Living scale (≤6/8) score values. Results The prevalence of MCR was 4.2% at baseline and the overall incidence of dementia was 3.6%. MCR (Hazard Ratio (HR) = 5.18, with 95% confidence interval (CI) = [2.43–11.03] and P ≤ 0.001) and SCC alone (HR = 2.54, with 95% CI = [1.33–4.85] and P = 0.005) were associated with incident dementia, but slow walking speed was not (HR = 0.81, with 95%CI = [0.25–2.63] and P = 0.736). Conclusions MCR and SCC are associated with incident dementia in NuAge study participants.

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Validation and verification of predictive salivary biomarkers for oral health

Scientific Reports ◽

10.1038/s41598-021-85120-w ◽

2021 ◽

Vol 11 (1) ◽

Cited By ~ 1

Author(s):

Nagihan Bostanci ◽

Konstantinos Mitsakakis ◽

Beral Afacan ◽

Kai Bao ◽

Benita Johannsen ◽

...

Keyword(s):

Oral Health ◽

Predictive Accuracy ◽

Statistical Tests ◽

Area Under The Curve ◽

Regression Tree ◽

High Sensitivity ◽

Oral Health Status ◽

Classification And Regression Tree ◽

Cart Analysis ◽

Salivary Biomarkers

AbstractOral health is important not only due to the diseases emerging in the oral cavity but also due to the direct relation to systemic health. Thus, early and accurate characterization of the oral health status is of utmost importance. There are several salivary biomarkers as candidates for gingivitis and periodontitis, which are major oral health threats, affecting the gums. These need to be verified and validated for their potential use as differentiators of health, gingivitis and periodontitis status, before they are translated to chair-side for diagnostics and personalized monitoring. We aimed to measure 10 candidates using high sensitivity ELISAs in a well-controlled cohort of 127 individuals from three groups: periodontitis (60), gingivitis (31) and healthy (36). The statistical approaches included univariate statistical tests, receiver operating characteristic curves (ROC) with the corresponding Area Under the Curve (AUC) and Classification and Regression Tree (CART) analysis. The main outcomes were that the combination of multiple biomarker assays, rather than the use of single ones, can offer a predictive accuracy of > 90% for gingivitis versus health groups; and 100% for periodontitis versus health and periodontitis versus gingivitis groups. Furthermore, ratios of biomarkers MMP-8, MMP-9 and TIMP-1 were also proven to be powerful differentiating values compared to the single biomarkers.

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The Association of Vision, Hearing, and Dual-Sensory Loss with Walking Speed and Incident Slow Walking: Longitudinal and Time to Event Analyses in the Health and Retirement Study

Seminars in Hearing ◽

10.1055/s-0041-1726017 ◽

2021 ◽

Vol 42 (01) ◽

pp. 075-084

Author(s):

Ahmed F. Shakarchi ◽

Lama Assi ◽

Abhishek Gami ◽

Christina Kohn ◽

Joshua R. Ehrlich ◽

...

Keyword(s):

Walking Speed ◽

Linear Models ◽

Sensory Loss ◽

Health And Retirement Study ◽

Time To Event ◽

Slow Walking ◽

Public Health Challenges ◽

Nationally Representative ◽

Retirement Study ◽

Slow Walking Speed

AbstractWith the aging of the population, vision (VL), hearing (HL), and dual-sensory (DSL, concurrent VL and HL) loss will likely constitute important public health challenges. Walking speed is an indicator of functional status and is associated with mortality. Using the Health and Retirement Study, a nationally representative U.S. cohort, we analyzed the longitudinal relationship between sensory loss and walking speed. In multivariable mixed effects linear models, baseline walking speed was slower by 0.05 m/s (95% confidence interval [CI] = 0.04–0.07) for VL, 0.02 (95% CI = 0.003–0.03) for HL, and 0.07 (95% CI = 0.05–0.08) for DSL compared with those without sensory loss. Similar annual declines in walking speeds occurred in all groups. In time-to-event analyses, the risk of incident slow walking speed (walking speed < 0.6 m/s) was 43% (95% CI = 25–65%), 29% (95% CI = 13–48%), and 35% (95% CI = 13–61%) higher among those with VL, HL, and DSL respectively, relative to those without sensory loss. The risk of incident very slow walking speed (walking speed < 0.4 m/s) was significantly higher among those with HL and DSL relative to those without sensory loss, and significantly higher among those with DSL relative to those with VL or HL alone. Addressing sensory loss and teaching compensatory strategies may help mitigate the effect of sensory loss on walking speed.

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Relationship of an advanced glycation end product, plasma carboxymethyl-lysine, with slow walking speed in older adults: the InCHIANTI study

European Journal of Applied Physiology ◽

10.1007/s00421-009-1192-5 ◽

2009 ◽

Vol 108 (1) ◽

pp. 191-195 ◽

Cited By ~ 51

Author(s):

Richard D. Semba ◽

Stefania Bandinelli ◽

Kai Sun ◽

Jack M. Guralnik ◽

Luigi Ferrucci

Keyword(s):

Older Adults ◽

Walking Speed ◽

Advanced Glycation ◽

Advanced Glycation End Product ◽

Slow Walking ◽

Carboxymethyl Lysine ◽

Relationship Of ◽

Slow Walking Speed

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Cognitive and Behavioral Domains That Reliably Differentiate Normal Aging and Dementia in Down Syndrome

Brain Sciences ◽

10.3390/brainsci11091128 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1128

Author(s):

Jordan P. Harp ◽

Lisa M. Koehl ◽

Kathryn L. Van Pelt ◽

Christy L. Hom ◽

Eric Doran ◽

...

Keyword(s):

Primary Care ◽

Down Syndrome ◽

Area Under The Curve ◽

Regression Tree ◽

Classification And Regression Tree ◽

Vineland Adaptive Behavior Scales ◽

Cart Analysis ◽

Dementia Screening ◽

Significant Difference ◽

Unit Increase

Primary care integration of Down syndrome (DS)-specific dementia screening is strongly advised. The current study employed principal components analysis (PCA) and classification and regression tree (CART) analyses to identify an abbreviated battery for dementia classification. Scale- and subscale-level scores from 141 participants (no dementia n = 68; probable Alzheimer’s disease n = 73), for the Severe Impairment Battery (SIB), Dementia Scale for People with Learning Disabilities (DLD), and Vineland Adaptive Behavior Scales—Second Edition (Vineland-II) were analyzed. Two principle components (PC1, PC2) were identified with the odds of a probable dementia diagnosis increasing 2.54 times per PC1 unit increase and by 3.73 times per PC2 unit increase. CART analysis identified that the DLD sum of cognitive scores (SCS < 35 raw) and Vineland-II community subdomain (<36 raw) scores best classified dementia. No significant difference in the PCA versus CART area under the curve (AUC) was noted (D(65.196) = −0.57683; p = 0.57; PCA AUC = 0.87; CART AUC = 0.91). The PCA sensitivity was 80% and specificity was 70%; CART was 100% and specificity was 81%. These results support an abbreviated dementia screening battery to identify at-risk individuals with DS in primary care settings to guide specialized diagnostic referral.

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Does slow walking speed predict all-cause mortality and knee replacement in adults with knee osteoarthritis?

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2019.02.631 ◽

2019 ◽

Vol 27 ◽

pp. S260

Author(s):

H. Master ◽

L.M. Thoma ◽

T. Neogi ◽

M. LaValley ◽

M. Christiansen ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Knee Replacement ◽

Walking Speed ◽

Slow Walking ◽

All Cause Mortality ◽

Slow Walking Speed

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Artificial liver support system therapy in acute-on-chronic hepatitis B liver failure: Classification and regression tree analysis

Scientific Reports ◽

10.1038/s41598-019-53029-0 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 3

Author(s):

Kaizhou Huang ◽

Feiyang Ji ◽

Zhongyang Xie ◽

Daxian Wu ◽

Xiaowei Xu ◽

...

Keyword(s):

High Risk ◽

Hepatitis B ◽

Regression Tree ◽

Classification And Regression Tree ◽

Artificial Liver ◽

Liver Support ◽

Artificial Liver Support ◽

Cart Analysis ◽

Classification And Regression ◽

Cart Model

Abstract Artificial liver support systems (ALSS) are widely used to treat patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). The aims of the present study were to investigate the subgroups of patients with HBV-ACLF who may benefit from ALSS therapy, and the relevant patient-specific factors. 489 ALSS-treated HBV-ACLF patients were enrolled, and served as derivation and validation cohorts for classification and regression tree (CART) analysis. CART analysis identified three factors prognostic of survival: hepatic encephalopathy (HE), prothrombin time (PT), and total bilirubin (TBil) level; and two distinct risk groups: low (28-day mortality 10.2–39.5%) and high risk (63.8–91.1%). The CART model showed that patients lacking HE and with a PT ≤ 27.8 s and a TBil level ≤455 μmol/L experienced less 28-day mortality after ALSS therapy. For HBV-ACLF patients with HE and a PT > 27.8 s, mortality remained high after such therapy. Patients lacking HE with a PT ≤ 27.8 s and TBil level ≤ 455 μmol/L may benefit markedly from ALSS therapy. For HBV-ACLF patients at high risk, unnecessary ALSS therapy should be avoided. The CART model is a novel user-friendly tool for screening HBV-ACLF patient eligibility for ALSS therapy, and will aid clinicians via ACLF risk stratification and therapeutic guidance.

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