GAIT SPEED AND HANDGRIP STRENGTH AS PREDICTORS OF INCIDENT DISABILITY IN MEXICAN OLDER ADULTS

2014 ◽  
pp. 1-4
Author(s):  
T. LOPEZ-TEROS ◽  
L.M. GUTIERREZ-ROBLEDO ◽  
M.U. PEREZ-ZEPEDA
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Daily Living ◽  
Handgrip Strength ◽  
Statistical Significance ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Performance Tests ◽  
One Year

Physical performance tests are associated with different adverse outcomes in older people. Theobjective of this study was to test the association between handgrip strength and gait speed with incidentdisability in community-dwelling, well-functioning, Mexican older adults (age ≥70 years). Incident disability wasdefined as the onset of any difficulty in basic or instrumental activities of daily living. Of a total of 133participants, 52.6% (n=70) experienced incident disability during one year of follow-up. Significant associationsof handgrip strength (odds ratio [OR] 0.96, 95% confidence interval [95%CI] 0.93-0.99) and gait speed (OR0.27, 95%CI 0.07-0.99) with incident disability were reported. The inclusion of covariates in the models reducedthe statistical significance of the associations without substantially modifying the magnitude of them. Handgripstrength and gait speed are independently associated with incident disability in Mexican older adults.

scholarly journals Past Gait Speed as an Independent Predictor of Mortality in Older Adults Beyond Current Gait Speed

2021 ◽  
Author(s):  
Joshua Solomon ◽  
Julia Chabot ◽  
Philippe Desmarais ◽  
Marie-France Forget ◽  
Quoc Dinh Nguyen
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Data Interpretation ◽  
Community Dwelling ◽  
Prognostic Information ◽  
Mortality Risks ◽  
Hazard Ratios ◽  
The Mean ◽  
One Year

Abstract Background We investigated whether past values of gait speed in older adults provide additional prognostic information beyond current gait speed alone. We assessed various models to best describe past and current value for prediction. Methods We used data from the first five yearly rounds of the National Health and Ageing Trends Study, starting from 2011. The cohort consisted of 4289 community-dwelling participants aged 65 years and older. Gait speed was measured at baseline (Y1) and one year later (Y2). Three-year follow-up for mortality started in year 2. We estimated hazard ratios of various models using combinations of Y1 gait speed, Y2 gait speed, and change in gait speed from Y1 to Y2. Results The mean gait speed at year 2 was 0.77 m/s (0.26) and slightly increased by a mean of 0.04 m/s (0.20) from Y1 to Y2. A 0.1 m/s higher gait speed at Y2 was associated with decreased mortality (HR, 0.81 [0.78, 0.84]). Gait speed improvement from Y1 to Y2 decreased mortality (HR, 0.95 [0.92, 0.99] per 0.1 m/s increase). Models including both Y2 gait speed and change indicated that improvement in gait speed was associated with increased mortality (HR, 1.05 [1.00, 1.11]), independently of Y1 gait speed. Conclusions Past gait speed is predictive of mortality, independent of current gait speed, however, gait speed recovery does not completely negate mortality risks. Past gait speed information is a useful measure for risk prediction in older adults, but the direction of time is important for modelling and data interpretation.

scholarly journals How wearable sensors have been utilised to evaluate frailty in older adults: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Grainne Vavasour ◽  
Oonagh M. Giggins ◽  
Julie Doyle ◽  
Daniel Kelly
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Gait Speed ◽  
Outcome Measurement ◽  
Wearable Sensors ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Ageing Population ◽  
Application Development ◽  
Community Dwelling Older Adults

Abstract Background Globally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world’s population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide. Aim The aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults. Method Electronic databases Medline, Science Direct, Scopus, and CINAHL were systematically searched March 2020 and November 2020. A search constraint of articles published in English, between January 2010 and November 2020 was applied. Papers included were primary observational studies involving; older adults aged > 60 years, used a wearable sensor to provide quantitative measurements of physical activity (PA) or mobility and a measure of frailty. Studies were excluded if they used non-wearable sensors for outcome measurement or outlined an algorithm or application development exclusively. The methodological quality of the selected studies was assessed using the Appraisal Tool for Cross-sectional Studies (AXIS). Results Twenty-nine studies examining the use of wearable sensors to assess and discriminate between stages of frailty in older adults were included. Thirteen different body-worn sensors were used in eight different body-locations. Participants were community-dwelling older adults. Studies were performed in home, laboratory or hospital settings. Postural transitions, number of steps, percentage of time in PA and intensity of PA together were the most frequently measured parameters followed closely by gait speed. All but one study demonstrated an association between PA and level of frailty. All reports of gait speed indicate correlation with frailty. Conclusions Wearable sensors have been successfully used to evaluate frailty in older adults. Further research is needed to identify a feasible, user-friendly device and body-location that can be used to identify signs of pre-frailty in community-dwelling older adults. This would facilitate early identification and targeted intervention to reduce the burden of frailty in an ageing population.

scholarly journals Prospective GERiatric Observational (ProGERO) Study: Cohort Design and Preliminary Results

2020 ◽  
Author(s):  
Marcos Daniel Saraiva ◽  
Luís Fernando Rangel ◽  
Julia Lusis Lassance Cunha ◽  
Thereza Cristina Ariza Rotta ◽  
Christian Douradinho ◽  
...  
Keyword(s):  
Older Adults ◽  
Healthy Aging ◽  
Hospital Admissions ◽  
Handgrip Strength ◽  
Academic Medical Center ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Charlson Comorbidity Index Score ◽  
Study Cohort ◽  
Demographic Changes

Abstract Background: The demographic changes in Brazil as a result of population aging is one of the fastest in the world. The far-reaching new challenges that come with a large older population are particularly disquieting in low- and middle-income countries (LMICs). Longitudinal studies must be completed in LMICs to investigate the social and biological determinants of aging and the consequences of such demographic changes in their context. Therefore, we designed the Prospective GERiatric Observational (ProGERO) study, a longitudinal study of older adults in Brazil, to collect data both on healthy aging and chronic diseases, and investigate characteristics associated with adverse outcomes in this population. Methods: The ProGERO study takes place in a geriatric outpatient clinic in the largest academic medical center in Latin America. We performed baseline health examinations in 2017 and will complete subsequent in-person visits every three years when new participants will also be recruited. We will use periodic telephone interviews to collect information on the outcomes of interest between in-person visits. The baseline evaluation included data on demographics, medical history, physical examination, and comprehensive geriatric assessment (CGA; including multimorbidity, medications, social support, functional status, cognition, depressive symptoms, nutritional status, pain assessment, frailty, gait speed, handgrip strength, and chair-stands test). We used a previously validated CGA-based model to rank participants according to mortality risk (low, medium, high). Our selected outcomes were falls, disability, health services utilization (emergency room visits and hospital admissions), institutionalization, and death. We will follow participants for at least ten years.Results: We included 1,336 participants with a mean age of 82±8 years old. Overall, 70% were women, 31% were frail, and 43% had a Charlson comorbidity index score ≥3. According to our CGA-based model, the incidence of death in one year varied significantly across categories (low-risk=0.6%; medium-risk=7.4%; high-risk=17.5%; P<0.001).Conclusion: The ProGERO study will provide detailed clinical data and explore the late-life trajectories of community-dwelling older patients during a follow-up period of at least 10 years. Moreover, the study will substantially contribute to new information on the predictors of healthy and pathological aging in older adults from LMICs.

scholarly journals The Impact Of Frailty On Admission To Home Care Services And Nursing Homes: Eight-Year Follow-Up Of A Community-Dwelling, Older Adult, Spanish Cohort

2020 ◽  
Author(s):  
Francisco Cegri ◽  
Francesc Orfila ◽  
Rosa M Abellana ◽  
María Pastor-Valero
Keyword(s):  
Older Adults ◽  
Nursing Homes ◽  
Home Care ◽  
Primary Healthcare ◽  
Daily Living ◽  
Community Dwelling ◽  
Older Age ◽  
Age Dependence ◽  
Primary Healthcare Centers

Abstract Background The aim of this study is to identify the factors that anticipate the future inclusion of community-dwelling individuals aged ≥ 70 years in home care programmes (HC) and nursing homes (NH), and to develop the corresponding prediction models. Methods Study design: prospective, multicenter, cohort study in 23 primary healthcare centers located in Catalonia, Spain, with an eight-year follow-up (2005-2013). Participants: the cohort was made up of 616 individuals. Data collection: baseline interview included a multidimensional assessment carried out by primary health care professionals. Outcome variables were collected during follow-up by consulting electronic healthcare records, telephone contacts, and the Central Registry of Catalonia for mortality. Statistical analysis: a prognostic index for a HC and NH at eight years was estimated for each patient. Death prior to these events was considered a competing risk event, and Fine–Gray regression models were used. The internal validity of the predictive models was tested for 150 bootstrap re-samples. Results At baseline, mean age was 76.4 years, 55.5% were women, and 22% lived alone. During follow-up, 19.2% entered a HC program, 8.2% a NH, and 15.4% died without presenting an event. Of those who entered a NH, 31.5% had previously been in a HC program. Multivariate competitive risk models for a HC and NH showed that the risk of a HC entry was associated with older age, dependence on the Instrumental Activities of the Daily Living, and slow gait measured by Timed-up-and-go test. An increased risk of being admitted to a NH was associated with older age, dependence on the Instrumental Activities of the Daily Living, augmented number of prescriptions, and the presence of social risk. Conclusions Prognostic models based on comprehensive geriatric assessments can predict the need for the commencement of HC and NH admission in community-dwelling older adults. Our findings underline the necessity to measure functional capacity, mobility, number of prescriptions, and social aspects of older adults in primary healthcare centers. In such a setting they can be offered longitudinal holistic assessments so as to benefit from preventive actions in order to remain independent in the community for as long as possible.

scholarly journals Gait Speed Maintenance Is Associated With Sensorimotor and Frontoparietal Network Connectivity Among Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 544-545
Author(s):  
Chun Liang Hsu ◽  
Brad Manor ◽  
Lewis Lipsitz
Keyword(s):  
Neural Network ◽  
Older Adults ◽  
Gait Speed ◽  
Network Connectivity ◽  
Community Dwelling ◽  
Connectivity Pattern ◽  
Precentral Gyrus ◽  
Mobility Impairment ◽  
Frontoparietal Network

Abstract Mobility impairment is a geriatric giant. Particularly, slow gait is associated with elevated risk for cognitive decline, disabilities and dementia. Gait is the product of complex neural network interactions and changes in their connectivity pattern may negatively impact gait speed. However, mechanistic neural correlates for gait speed maintenance and decline remained unclear. As such, the aim of this study is to investigate differences in neural network connectivity in older adults with and without gait speed decline over 24 months. This sub-analysis included 35 community-dwelling older adults age &gt;70 years from the MOBILIZE Boston Study. Baseline assessments included four-meter gait speed test and resting-state fMRI. Gait speed was reassessed at a 24-month follow-up. Participants were stratified to “Maintainer” and “Decliner” groups based upon a cut-off of &gt;0.05 m/s decline in gait speed from baseline to follow-up. A priori selected functional network included sensori-motor network (SMN) and frontoparietal network (FPN). Multivariate analysis of variance was performed to determine between group differences in network connectivity. Discriminant analysis was conducted to identify relative contribution of network connectivity to group classification. Between the 14 Maintainers and 21 Decliners (mean age 83.9 years), Maintainers were younger (p=0.088). After adjusting for age, Maintainers exhibited lower SMN premotor-precentral gyrus connectivity (p=0.023), greater FPN ventral visual-supramarginal gyrus connectivity (p=0.025), and trend level greater SMN-FPN cerebellum-occipital connectivity (p=0.053). Premotor-precentral gyrus connectivity showed greatest contribution to discriminant function. These preliminary findings suggest aberrant connectivity patterns of the SMN and FPN may be predictive of older adults’ ability to maintain gait speed.

GAIT SPEED AS A PREDICTOR OF RESPIRATORY MUSCLE FUNCTION, STRENGTH, AND FRAILTY SYNDROME IN COMMUNITY-DWELLING ELDERLY PEOPLE

2015 ◽  
pp. 1-5
Author(s):  
A.N. PARENTONI ◽  
V.A. MENDONÇA ◽  
K.D. DOS SANTOS ◽  
L.F. SÁ ◽  
F.O. FERREIRA ◽  
...  
Keyword(s):  
Elderly People ◽  
Gait Speed ◽  
Muscle Function ◽  
Handgrip Strength ◽  
Statistical Significance ◽  
Multivariate Model ◽  
Community Dwelling ◽  
Inspiratory Pressure ◽  
Frailty Syndrome ◽  
Maximal Inspiratory Pressure

Background: Gait speed is considered a predictor of adverse health outcomes and functional decline in the elderly. This decline is also identified in respiratory muscles. Objective: To assess the impact of gait speed in maximal inspiratory pressure, maximal expiratory pressure, handgrip strength, and the different types of frailty syndrome in community-dwelling elderly people. Design: Cross-sectional study. Participants: Women (aged ≥ 65 years) were classified into different frailty phenotypes (n = 106). Measurements: Gait speed (10 m), handgrip strength (Jamar dynamometer), and maximum inspiratory and expiratory pressures (GerAr manovacuometer, MV-150/300 model) were measured. Linear regression analyses were conducted to determine the influence of gait speed and age on handgrip strength, maximal inspiratory pressure, and maximal expiratory pressure. Logistic regression was performed to assess the influence of gait speed and frailty age (α = 0.05). Results: A total of 106 elderly women participated in the study (73.96 ± 6.91 years). Thirty-two subjects were not frail, 42 were pre-frail, and 32 were frail. Gait speed and age significantly predicted handgrip strength and frailty (p < 0.05). In the multivariate model, gait speed had the greatest contribution, while age lost statistical significance. Regarding maximal inspiratory and maximal expiratory pressures, gait speed and age were significant explanatory variables (p < 0.05). In the multivariate model, gait speed lost statistical significance to predict maximal inspiratory pressure. Conclusion: Gait speed was confirmed to be a predictor of some health outcomes, including respiratory muscle function. The results suggest that interventions to increase gait speed may contribute to improve respiratory function and muscle strength, and decrease the risk of frailty among elderly people

scholarly journals Risk factors for functional decline and institutionalisation among community-dwelling older adults with mild to severe Alzheimer’s disease: one year of follow-up

2006 ◽  
Vol 35 (3) ◽  
pp. 308-310 ◽  
Author(s):  
Maria E. Soto ◽  
Sandrine Andrieu ◽  
Sophie Gillette-Guyonnet ◽  
Christelle Cantet ◽  
Fati Nourhashemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Functional Decline ◽  
Community Dwelling ◽  
One Year ◽  
Community Dwelling Older Adults

scholarly journals Associations of sarcopenia components with physical activity and nutrition in Australian older adults performing exercise training

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ewelina Akehurst ◽  
David Scott ◽  
Juan Peña Rodriguez ◽  
Carol Alonso Gonzalez ◽  
Jasmaine Murphy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Muscle Mass ◽  
Physical Performance ◽  
Gait Speed ◽  
Protein Intake ◽  
Handgrip Strength ◽  
The Elderly ◽  
Community Dwelling ◽  
Timed Up And Go

Abstract Background The risk of progressive declines in skeletal muscle mass and strength, termed sarcopenia, increases with age, physical inactivity and poor diet. The purpose of this study was to explore and compare associations of sarcopenia components with self-reported physical activity and nutrition in older adults participating in resistance training at Helsinki University Research [HUR] and conventional gyms for over a year, once a week, on average. Methods The study looked at differences between HUR (n = 3) and conventional (n = 1) gyms. Muscle strength (via handgrip strength and chair stands), appendicular lean mass (ALM; via dual energy X-ray absorptiometry) and physical performance (via gait speed over a 4-m distance, short physical performance battery, timed up and go and 400-m walk tests) were evaluated in 80 community-dwelling older adults (mean ± SD 76.5 ± 6.5 years). Pearson correlations explored associations for sarcopenia components with self-reported physical activity (via Physical Activity Scale for the Elderly [PASE]) and nutrition (via Australian Eating Survey). Results No differences in PASE and the Australian Recommended Food Score (ARFS) were observed between HUR and conventional gyms, however HUR gym participants had a significantly higher self-reported protein intake (108 ± 39 g vs 88 ± 27 g; p = 0.029) and a trend to have higher energy intake (9698 ± 3006 kJ vs 8266 ± 2904 kJ; p = 0.055). In both gym groups, gait speed was positively associated with self-reported physical activity (r = 0.275; p = 0.039 and r = 0.423; p = 0.044 for HUR and conventional gyms, respectively). ALM was positively associated with protein (p = 0.047, r = 0.418) and energy (p = 0.038, r = 0.435) intake in the conventional gym group. Similar associations were observed for ALM/h2 in the HUR group. None of the sarcopenia components were associated with ARFS in either gym group. Conclusion Older adults attending HUR and conventional gyms had similar self-reported function and nutrition (but not protein intake). Inadequate physical activity was associated with low gait speed and inadequate nutrition and low protein ingestion associated with low lean mas, even in older adults participating in exercise programs. Optimal physical activity and nutrition are important for maintaining muscle mass and function in older adults.

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