Identification of Disability Risk in Addition to Slow Walking Speed in Older Adults

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Hiroyuki Shimada ◽  
Takehiko Doi ◽  
Sangyoon Lee ◽  
Kota Tsutsumimoto ◽  
Seongryu Bae ◽  
...  
Keyword(s):  
Older Adults ◽  
Regression Models ◽  
Walking Speed ◽  
Word List ◽  
Normal Walking ◽  
Slow Walking ◽  
List Memory ◽  
Walking Speeds ◽  
Walking Group ◽  
Slow Walking Speed

<b><i>Introduction:</i></b> A cutoff speed of 1.0 m/s for walking at a comfortable pace is critical for predicting future functional decline. However, some older adults with walking speeds below the cutoff point maintain an independent living. We aimed to identify specific predictors of disability development in older adults with slow walking speeds in contrast to those with a normal walking speed. <b><i>Methods:</i></b> This prospective cohort study on 12,046 community-dwelling independent Japanese older adults (mean age, 73.6 ± 5.4 years) was conducted between 2011 and 2015. Participants were classified into slow walking speed (comfortable walking speed slower than 1.0 m/s) and normal walking speed (speed of 1.0 m/s or faster) groups and followed up to assess disability incidence for 24 months after baseline assessments. Cox proportional hazards regression models were used to identify predictors of disability development in the slow and normal walking groups. <b><i>Results:</i></b> Overall, 26.8% of participants had a slow walking speed. At follow-up, 17.3% and 5.1% of participants in the slow and normal walking groups, respectively, developed disability (<i>p</i> &#x3c; 0.01). Cox regression models revealed that age (hazard ratio 1.07, 95% confidence interval 1.05–1.09), walking speed (0.12, 0.07–0.22), grip strength (0.97, 0.95–0.99), Parkinson’s disease (4.65, 2.59–8.33), word list memory-immediate recognition score (0.90, 0.85–0.97), word list memory-delayed recall score (0.94, 0.89–1.00), Symbol Digit Substitution Test (SDST) score (0.98, 0.96–0.99), and 15-item Geriatric Depression Scale (GDS) score (1.04, 1.01–1.07) were significantly associated with disability incidence in the slow walking group. In the normal walking group, age, grip strength, depression, diabetes, cognition, GDS score, and reduced participation in outdoor activity were significantly associated with disability incidence; however, there was no significant association with walking speed. <b><i>Conclusions:</i></b> Decreased walking speeds have considerably greater impact on disability development in older adults with a slow walking speed than in those with a normal walking speed. Health-care providers should explore modifiable factors for reducing walking speed; they should also encourage improvement of risk factors such as muscle weakness and depression to reduce disability risk in older adults with slow walking speeds.

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

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.

scholarly journals Using hand grip strength to detect slow walking speed in older adults: the Yilan study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yen-Huai Lin ◽  
Hsi-Chung Chen ◽  
Nai-Wei Hsu ◽  
Pesus Chou
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Walking Speed ◽  
Area Under The Curve ◽  
Hand Grip Strength ◽  
Stepwise Multiple Linear Regression ◽  
Optimal Cutoff ◽  
Hand Grip ◽  
Slow Walking ◽  
Slow Walking Speed

Abstract Background Walking speed is an important health indicator in older adults, although its measurement can be challenging because of the functional decline due to aging and limited environment. The aim of this study was to examine whether hand grip strength can be a useful proxy for detecting slow walking speed in this population. Methods A cross-sectional study was conducted using the cohort from the Yilan Study in Taiwan. Community-dwelling older adults aged 65 years and older were included. Slow walking speed was defined as a 6-meter walking speed < 1.0 m/s, according to the 2019 Asian Working Group for Sarcopenia diagnostic criteria. Stepwise multiple linear regression was used to determine the most significant variables associated with walking speed. Receiver operating characteristic analysis was used to determine the optimal cutoff values for hand grip strength in detecting slow walking speed. Results A total of 301 participants with an average age of 73.9 ± 6.8 years were included; 55.1 % participants were women. In stepwise multiple linear regression analysis that included various variables, hand grip strength was found to be the most explainable factor associated with walking speed among all participants and among participants of each sex. The optimal cutoff values for hand grip strength in the detection of slow walking speed were 19.73 kg for all participants (sensitivity: 55 %, specificity: 83 %, area under the curve: 0.74, accuracy: 66.9 %), 35.10 kg for men (sensitivity: 92 %, specificity: 42 %, area under the curve: 0.70, accuracy: 66.4 %), and 17.93 kg for women (sensitivity: 62 %, specificity: 80 %, area under the curve: 0.76, accuracy: 67.9 %). Conclusions Hand grip strength was found to be a useful proxy for the identification of slow walking speed in older adults.

scholarly journals The Association of Vision, Hearing, and Dual Sensory Impairments With Walking Speed and Incident Slow Walking

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 216-216
Author(s):  
Ahmed Shakarchi ◽  
Varshini Varadaraj ◽  
Lama Assi ◽  
Nicholas Reed ◽  
Bonnielin Swenor
Keyword(s):  
Older Adults ◽  
Walking Speed ◽  
Linear Models ◽  
Population Based ◽  
Adverse Outcomes ◽  
Sensory Impairment ◽  
Slow Walking ◽  
Increased Risk ◽  
Sensory Impairments ◽  
Walking Speeds

Abstract Vision (VI), hearing (HI) and dual sensory (DSI, concurrent VI and HI) impairments are increasing in prevalence as populations age. Walking speed is an established health indicator associated with adverse outcomes, including mortality. Using the population-based Health and Retirement Study, we analyzed the longitudinal relationship between sensory impairment and walking speed. In multivariable mixed-effects linear models, we found differences in baseline walking speed (m/s) by sensory impairment: Beta=-0.05 (95%CI=-0.07, -0.04), Beta=-0.02 (95%CI=--0.03, -0.003), and Beta=-0.07 (95%CI=--0.08, -0.05) for VI, HI and DSI, respectively, as compared to those without sensory impairment. However, similar annual declines (0.014 m/s) in walking speeds occurred in all groups. In time-to-event analyses, events were defined as “slow walking” (speed &lt;0.60m/s) and “very slow walking” (&lt;0.40m/s). Incident “slow walking” was 43% (95%CI=25%, 65%), 29% (95%CI=13%, 48%) and 35% (95%CI=13%, 61%) greater in VI, HI and DSI, respectively, than the no sensory impairment group, while incident “very slow walking” was 21% (95%CI=-4%, 54%), 30% (95%CI=3%, 63%) and 89% (95%CI=47%, 143%) greater; the increase was significantly greater in DSI than VI and HI. These results suggest that older adults with vision and hearing impairments walk slower and are at increased risk of slow walking than older adults without these sensory impairments. Additionally, older adults with DSI are at greatest risk of very slow walking.

scholarly journals Slow walking speed and cardiovascular death in well functioning older adults: prospective cohort study

BMJ ◽  
2009 ◽  
Vol 339 (nov10 2) ◽  
pp. b4460-b4460 ◽  
Author(s):  
J. Dumurgier ◽  
A. Elbaz ◽  
P. Ducimetiere ◽  
B. Tavernier ◽  
A. Alperovitch ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Walking Speed ◽  
Cardiovascular Death ◽  
Slow Walking ◽  
Slow Walking Speed

Relationship Between Qtc Prolongation And Slow Walking Speed In Older Adults

2015 ◽  
Vol 47 ◽  
pp. 852
Author(s):  
Miji Kim ◽  
Hunkyung Kim ◽  
Hideyo Yoshida ◽  
Takao Suzuki
Keyword(s):  
Older Adults ◽  
Walking Speed ◽  
Qtc Prolongation ◽  
Slow Walking ◽  
Slow Walking Speed

scholarly journals Split-Belt Treadmill Adaptation Shows Different Functional Networks for Fast and Slow Human Walking

2010 ◽  
Vol 103 (1) ◽  
pp. 183-191 ◽  
Author(s):  
Erin V. L. Vasudevan ◽  
Amy J. Bastian
Keyword(s):  
Walking Speed ◽  
Healthy Adult ◽  
Motor Pattern ◽  
Specific Pattern ◽  
Functional Networks ◽  
Slow Walking ◽  
Partial Overlap ◽  
Walking Speeds ◽  
Short Time ◽  
Slow Walking Speed

New walking patterns can be learned over short time scales (i.e., adapted in minutes) using a split-belt treadmill that controls the speed of each leg independently. This leads to storage of a modified motor pattern that is expressed as an aftereffect in regular walking conditions and must be de-adapted to return to normal. Here we asked whether the nervous system adapts a general walking pattern that is used across many speeds or a specific pattern affecting only the two speeds experienced during split-belt training. In experiment 1, we tested three groups of healthy adult subjects walking at different split-belt speed combinations and then assessed aftereffects at a range of speeds. We found that aftereffects were largest at the slower speed that was used in split-belt training in all three groups, and it decayed gradually for all other speeds. Thus adaptation appeared to be more strongly linked to the slow walking speed. This result suggests a separation in the functional networks used for fast and slow walking. We tested this in experiment 2 by adapting walking to split belts and then determining how much fast regular walking washed out the slow aftereffect and vice versa. We found that 23–38% of the aftereffect remained regardless of which speed was washed out first. This demonstrates that there is only partial overlap in the functional networks coordinating different walking speeds. Taken together, our results suggest that there are some neural networks for controlling locomotion that are recruited specifically for fast versus slow walking in humans, similar to recent findings in other vertebrates.

A study of the accuracy of the Fitbit Zip in measuring steps both indoors and outdoors in a mixed rehabilitation population

2021 ◽  
pp. 026921552110352
Author(s):  
Craig Farmer ◽  
Maayken EL van den Berg ◽  
Sally Vuu ◽  
Christopher J Barr
Keyword(s):  
Walking Speed ◽  
Random Order ◽  
Step Count ◽  
Outpatient Rehabilitation ◽  
Rehabilitation Hospital ◽  
Slow Walking ◽  
Walking Speeds ◽  
Minute Walk ◽  
Slow Walking Speed ◽  
Indoor And Outdoor

Objective: To assess (1) step count accuracy of the Fitbit Zip, compared to manual step count, in people receiving outpatient rehabilitation, in indoor and outdoor conditions, and (2) impact of slow walking speed on Fitbit accuracy. Design: Observational study. Setting: A metropolitan rehabilitation hospital. Subjects: Adults ( n = 88) attending a subacute rehabilitation outpatient clinic with walking speeds of between 0.4 and 1.0 m/s. Interventions: Two 2-minute walk tests, one indoors and one outdoors, completed in random order. Main measures: Step count recorded manually by observation and by a Fitbit Zip, attached to the shoe on the dominant or non-affected side. Subgroup analysis included assessment accuracy for those considered limited community walkers (slower than 0.8 m/s) and those considered community walkers (faster than 0.8 m/s). Results: The Fitbit significantly ( P < 0.05) undercounted steps compared to manual step count, indoors and outdoors, with percentage agreement slightly higher outdoors (mean 92.4%) than indoors (90.1%). Overall, there was excellent consistent agreement between the Fitbit and manual step count for both indoor (ICC 0.83) and outdoor (ICC 0.88) walks. The accuracy of the Fitbit was significantly ( P < 0.05) reduced in those who walked slower than 0.8 m/s outdoors (ICC 0.80) compared to those who walk faster than 0.8 m/s (ICC 0.90). Conclusions: The Fitbit Zip shows high step count accuracy with manual step count in a mixed subacute rehabilitation population. However, accuracy is affected by walking speed, with decreased accuracy in limited community walkers.

scholarly journals 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

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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