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.

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.

Effects of a Group Exercise Program on Risk Factors for Falls in Frail Older Adults

1994 ◽  
Vol 2 (1) ◽  
pp. 25-37 ◽  
Author(s):  
Ellen F. Binder ◽  
Marybeth Brown ◽  
Suzanne Craft ◽  
Kenneth B. Schechtman ◽  
Stanley J. Birge
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Exercise Program ◽  
Knee Extensor ◽  
Community Dwelling ◽  
Moderate Intensity ◽  
Group Exercise ◽  
Frail Older Adults ◽  
The Mean ◽  
Risk Factors For Falls

Fifteen community dwelling older adults, ages 66 to 97 years, with at least one risk factor for recurrent falls, attended a thrice weekly group exercise class for 8 weeks. In post- versus preexercise comparisons, knee extensor torque at 0°/sec increased by 16.5% (p= 0.055); time to perform the stand-up test once, and five times consecutively, improved by 29.4 and 27.4%, respectively (p= 0.05,p= 0.01); gait speed for 24 feet increased by 16.5% (p< 0.001); and performance of the progressive Romberg test of balance improved with a mean increase of 1.1 ± 0.9 positions (p= 0.001). Participants reported a significant increase in the mean number of times per week that they went out of their apartment/home independent of exercising, and a significant increase in the mean number of city blocks they could walk. Performance data for nine exercise participants at 1-yr postintervention are presented. A low- to moderate-intensity groups exercise program can effect improvements in lower extremity strength, gait speed, balance, and self-reported mobility function in frail older adults.

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.

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 Hilliness and the Development of Walking Difficulties Among Community-Dwelling Older People

2018 ◽  
Vol 32 (5-6) ◽  
pp. 278-284 ◽  
Author(s):  
Kirsi E. Keskinen ◽  
Merja Rantakokko ◽  
Kimmo Suomi ◽  
Taina Rantanen ◽  
Erja Portegijs
Keyword(s):  
Older Adults ◽  
Socioeconomic Factors ◽  
Behavioral Health ◽  
Odds Ratio ◽  
Road Network ◽  
Community Dwelling ◽  
Community Dwelling Older People ◽  
The Mean ◽  
Community Dwelling Older Adults

Objective: The objective of this study is to study the associations of objectively defined hilliness with the prevalence and incidence of walking difficulties among community-dwelling older adults, and to explore whether behavioral, health, or socioeconomic factors would fully or partially explain these associations. Method: Baseline interviews ( n = 848, 75-90 years) on difficulties in walking 500 m, frequency of moving through the neighborhood, and perceived hilliness as a barrier to outdoor mobility were conducted. Two-year follow-up interviews ( n = 551) on difficulties in walking 500 m were conducted among participants without baseline walking difficulties. Hilliness objectively defined as the mean slope in 500-m road network. Results: Logistic regression showed that hilliness was associated with incident walking difficulties at the 2-year follow-up (odds ratio [OR] = 1.66, 95% confidence interval [CI] = [1.09, 2.51]) but not with the prevalence of walking difficulties at baseline. Adding behavioral, health, or socioeconomic factors to the models did not markedly change the results. Discussion: Greater hilliness should be considered a risk factor for developing walking difficulties among older adults.

scholarly journals Serum Sodium and Cognition in Older Community-Dwelling Men

2018 ◽  
Vol 13 (3) ◽  
pp. 366-374 ◽  
Author(s):  
Kristen L. Nowak ◽  
Kristine Yaffe ◽  
Eric S. Orwoll ◽  
Joachim H. Ix ◽  
Zhiying You ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Serum Sodium ◽  
Older Men ◽  
Community Dwelling ◽  
Common Finding ◽  
Lower Serum ◽  
The Mean

Background and objectivesMild hyponatremia is a common finding in older adults; however, the association of lower serum sodium with cognition in older adults is currently unknown. We determined whether lower normal serum sodium is associated with cognitive impairment and risk of cognitive decline in community-dwelling older men.Design, setting, participants, & measurementsFive thousand four hundred thirty-five community-dwelling men aged ≥65 years who participated in Osteoporotic Fractures in Men, a cohort study with a median follow-up for cognitive function of 4.6 years, were included in this analysis. Multivariable logistic regression was used to examine the association between baseline fasting serum sodium levels and the odds of prevalent cognitive impairment (cross-sectional analysis; modified Mini-Mental Status [3MS] score <1.5 SD [<84] below or Trail Making Test Part B time >1.5 SD above the mean [>223 seconds]) and cognitive decline (prospective analysis [n=3611]; decrease in follow-up 3MS score or increase in Trails B time >1.5 SD of the mean score/time change [>9 or >67 seconds]).ResultsParticipants were aged 74±6 years with a fasting mean serum sodium level of 141±3 mmol/L. Fifteen percent (n=274), 12% (n=225), and 13% (n=242) had prevalent cognitive impairment in tertiles 1, 2, and 3, respectively. After adjustment, lower serum sodium was associated with prevalent cognitive impairment (tertile 1 [126–140 mmol/L] versus tertile 2 [141–142 mmol/L], odds ratio [OR], 1.30; 95% confidence interval [95% CI], 1.06 to 1.61). Fourteen percent (n=159), 10% (n=125), and 13% (n=159) had cognitive decline in tertiles 1, 2, and 3, respectively. Lower serum sodium was also associated with cognitive decline (tertile 1 versus tertile 2, OR, 1.37; 95% CI, 1.06 to 1.77). Tertile 3 (143–153 mmol/L) was additionally associated with cognitive decline. Results were similar in sensitivity analyses according to clinical cut-offs and by quartiles.ConclusionsIn community-dwelling older men, serum sodium between 126–140, and 126–140 or 143–153 mmol/L, are independently associated with prevalent cognitive impairment and cognitive decline, respectively.

Neuropsychological Effects of Cybercycling for Older Adults: One-Year Follow-Up

2010 ◽  
Author(s):  
Cay Anderson-Hanley ◽  
Paul Arciero ◽  
Joseph Nimon ◽  
Vadim Yerkohin ◽  
Veronica Hopkins ◽  
...  
Keyword(s):  
Older Adults ◽  
Neuropsychological Effects ◽  
One Year

scholarly journals The Seniors’ Community Hub: An Integrated Model of Care for the Identification and Management of Frailty in Primary Care

Geriatrics ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 18
Author(s):  
Marjan Abbasi ◽  
Sheny Khera ◽  
Julia Dabravolskaj ◽  
Bernadette Chevalier ◽  
Kelly Parker
Keyword(s):  
Primary Care ◽  
Gait Speed ◽  
Family Physicians ◽  
Community Dwelling ◽  
Integrated Models ◽  
Care Services ◽  
Interprofessional Teamwork ◽  
Team Working ◽  
Centered Care

(1) Background: Integrated models of primary care deliver the comprehensive and preventative approach needed to identify and manage frailty in older people. Seniors’ Community Hub (SCH) was developed to deliver person-centered, evidence-informed, coordinated, and integrated care services to older community dwelling adults living with frailty. This paper aims to describe the SCH model, and to present patient-oriented results of the pilot. (2) Methods: SCH was piloted in an academic clinic with six family physicians. Eligible patients were community dwelling, 65 years of age and older, and considered to be at risk of frailty (eFI > 0.12). Health professionals within the clinic received training in geriatrics and interprofessional teamwork to form the SCH team working with family physicians, patients and caregivers. The SCH intervention consisted of a team-based multi-domain assessment with person-centered care planning and follow-up. Patient-oriented outcomes (EQ-5D-5L and EQ-VAS) and 4-metre gait speed were measured at initial visit and 12 months later. (3) Results: 88 patients were enrolled in the pilot from April 2016–December 2018. No statistically significant differences in EQ-5D-5L/VAS or the 4-metre gait speed were detected in 38 patients completing the 12-month assessment. (4) Conclusions: Future larger scale studies of longer duration are needed to demonstrate impacts of integrated models of primary care on patient-oriented outcomes for older adults living with frailty.

scholarly journals Dual Decline in Gait and Cognition Is Associated With Future Dementia: Evidence for a Phenotype

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 264-264
Author(s):  
Manuel Montero Odasso ◽  
Mark Speechley ◽  
Richard Camicioli ◽  
Nellie Kamkar ◽  
Qu Tian ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Regression Models ◽  
Community Dwelling ◽  
Hierarchical Regression ◽  
Chi Square ◽  
Cox Models ◽  
Incident Dementia ◽  
Risk Of Progression ◽  
Community Dwelling Older Adults

Abstract BACKGROUND: The concurrent decline in gait speed and cognition are associated with future dementia. However, the clinical profile of those who present with dual-decline has not yet been described. We aimed to describe the phenotype and risk for incident dementia of individuals who present a dual-decline in comparison with non dual-decliners. METHODS: Prospective cohort of community-dwelling older adults free of dementia at baseline. We evaluated participants’ gait speed, cognition, medical status, functionality, incidence of adverse events, and dementia biannually over 7 years. Gait speed was assessed with a 6-meter electronic-walkway, and global cognition was assessed using the MoCA test. We compared characteristics between dual-decliners and non dual-decliners using t-test, Chi-square, and hierarchical regression models. We estimated incident dementia using Cox models. RESULTS: Among 144 participants (mean age 74.23 ± 6.72 years, 54% women), 17% progressed to dementia. Dual-decliners had a three-fold risk (HR: 3.12, 95%CI:1.23-7.93, p=0.017) of progression to dementia compared with non dual-decliners. Dual-decliners were significantly older with a higher prevalence of hypertension and dyslipidemia (p=0.002). Hierarchical regression models show that age and sex alone explained 3% of the variation in the dual-decliners group, while adding hypertension and dyslipidemia increased the explained variation to 8% and 10 %, respectively. The risk of becoming a dual-decliner was 4-fold if hypertension was present. CONCLUSION: Older adults with concurrent decline in gait speed and cognition represent a group at the highest risk of progression to dementia. These dual-decliners have a distinct phenotype with a higher prevalence of hypertension, a potentially treatable condition.

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