scholarly journals Walking Skill Can Be Assessed in Older Adults: Validity of the Figure-of-8 Walk Test

2010 ◽  
Vol 90 (1) ◽  
pp. 89-99 ◽  
Author(s):  
Rebecca J. Hess ◽  
Jennifer S. Brach ◽  
Sara R. Piva ◽  
Jessie M. VanSwearingen
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Coefficient Of Variation ◽  
Gait Speed ◽  
Fear Of Falling ◽  
Movement Control ◽  
Community Dwelling ◽  
Walk Test ◽  
Step Width ◽  
Mobility Disability

Background The Figure-of-8 Walk Test (F8W) involves straight and curved paths and was designed to represent walking skill in everyday life. Objective The purposes of this study were to validate the measure in older adults with walking difficulties and to explore correlates of the curved-path walking measure not represented by a straight-path walking measure. Design Fifty-one community-dwelling older adults with mobility disability participated in 2 baseline visits as part of an intervention study. Methods The F8W time, steps, and smoothness and measures of gait (gait speed, modified Gait Abnormality Rating Scale [GARS-M]), physical function (Late Life Function and Disabilities Index [LLFDI], Survey of Activities and Fear of Falling in the Elderly [SAFFE], Gait Efficacy Scale [GES], Physical Performance Test [PPT], and fall history), and movement control and planning (gait variability, Trail Making Test B [Trails B]) were recorded in each test session. Bivariate correlations for the F8W with each variable were conducted to examine concurrent and construct validity. Adjusted linear regression analyses were performed to explore the variance in mobility explained by F8W independent of gait speed. Results Figure-of-8 Walk Test time correlated with gait (gait speed, r=−.570; GARS-M, r=.281), physical function (LLFDI function, r=−.469; SAFFE restriction subscale, r=.370; PPT, r=−.353), confidence in walking (GES, r=−.468), and movement control (step length coefficient of variation, r=.279; step width coefficient of variation, r=−.277; Trails B, r=.351). Figure-of-8 Walk Test steps correlated with step width variability (r=−.339) and was related to fear of falling (t=−2.50). All correlations were significant (P<.05). Limitations This pilot study had a small sample size, and further research is needed. Conclusions The F8W is a valid measure of walking skill among older adults with mobility disability and may provide information complementary to gait speed.

scholarly journals Resistance training improves mobility disability in community-dwelling older adults: a meta-analysis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 904-904
Author(s):  
Christina Prevett ◽  
Kevin Moncion ◽  
Stuart Phillips ◽  
Julie Richardson ◽  
Ada Tang
Keyword(s):  
Older Adults ◽  
Resistance Training ◽  
Physical Function ◽  
Gait Speed ◽  
Positive Impact ◽  
Community Dwelling ◽  
Mobility Disability ◽  
Exercise Interventions ◽  
Walking Capacity ◽  
Community Dwelling Older Adults

Abstract Mobility disability is the impairment in function that affects the performance of daily tasks due to declines in physical function. Exercise interventions, particular resistance training, may have a positive impact on mobility disability, but the evidence for the effects of resistance training in older adults with mobility disability has not been previously systematically reviewed. This study was a systematic review of evidence related to resistance training on physical function for adults over 65 years of age with mobility disability. Four databases (PEDro, MedLine, Ovid, Web of Science) were searched from inception to February 2, 2021 for randomized controlled trials. Twenty-four articles from 22 studies (3,656 participants) were included in the review. Mean participant age ranged from 63-87 years and exercise interventions ranged from 10 weeks to 12 months in duration. Greater changes in 6-minute Walk Test (6MWT) distance (n=638, p<0.0001; mean difference (MD) 16.1 metres; 95%CI 12.3-19.9), lower extremity strength (n=785, p<0.0001; standard MD 2.01; 95%CI 1.27-2.75) and usual gait speed (n=2,106, p<0.001; MD 0.05 metres/second, 95%CI 0.03-0.07) were seen with resistance training as compared to control. These results were maintained if resistance training was a sole intervention or a component of a multi-component program. Sensitivity analysis based on risk of bias concerns did not change results. This review demonstrates that resistance training improves walking capacity, strength and walking speed in community-dwelling older adults and may facilitate aging in place. Since improvements in strength and gait speed contribute to independence, our results indicate highly beneficial outcomes for older persons.

scholarly journals The course of gait speed during a 400m walk test of mobility limitations in community-dwelling older adults

2021 ◽  
Author(s):  
Ulrich Lindemann ◽  
Sebastian Krumpoch ◽  
Clemens Becker ◽  
Cornel C. Sieber ◽  
Ellen Freiberger
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Gait Speed ◽  
Short Distance ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Walk Test ◽  
Mobility Limitations ◽  
History Of ◽  
Community Dwelling Older Adults

Abstract Background The 400‑m walk test (400MWT) of usual gait speed is an assessment of mobility limitations in geriatric medicine and sarcopenic research. Objective The aim of this study was to describe the course of gait speed during a 400MWT in community-dwelling older adults in terms of physical, psychological and general health-related outcomes. Possible plateau phases during the 400MWT could enable integrated measurements of short distance walk tests. Methods In this study 148 community-dwelling older adults (mean age 80.4 ± 4.4 years, 61% women) performed a 400MWT at comfortable gait speed. Additionally, an 8m walk test was carried out and history of falling, sex, comorbidities, fear of falling, executive function and gait variability were determined as covariates. Results Gait speed was higher in the beginning and the end of the 400MWT compared to the middle part with respect to all analyzed covariates. Mean gait speed of the 8 m walk test was significantly faster than mean gait speed of the 400MWT (t (df = 147) = 0.07, p = 0.001). Conclusion The course of gait speed during a 400MWT performed by community-dwelling older adults was not affected by sex, gait variability, comorbidity, history of falling, fear of falling or executive function. Gait speed measurements of the 400MWT do not fully represent assessment of supervised short distance gait speed in community-dwelling adults.

The Association of Mobility Determinants and Life Space Among Older Adults

2021 ◽  
Author(s):  
Pamela M Dunlap ◽  
Andrea L Rosso ◽  
Xiaonan Zhu ◽  
Brooke N Klatt ◽  
Jennifer S Brach
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Energy Cost ◽  
Community Dwelling ◽  
Walk Test ◽  
Personal Factors ◽  
Linear Regression Models ◽  
Life Space ◽  
Mobility Disability ◽  
Energy Cost Of Walking

Abstract Background It is important to understand the factors associated with life space mobility so that mobility disability can be prevented/treated. The purpose of this study was to identify the association between mobility determinants and life space among older adults. Methods This study was a cross-sectional analysis of 249 community-dwelling older adults (mean age=77.4 years, 65.5% female, 88% white) who were recruited for a randomized, controlled, clinical intervention trial. Associations between cognitive, physical, psychosocial, financial, and environmental mobility determinants and the Life Space Assessment (LSA) at baseline were determined using Spearman’s correlation coefficients and one-way analysis of variance. Multivariate analysis was performed using multivariable linear regression models. Results The mean LSA score for the sample was 75.3 (SD=17.8). Personal factors (age, gender, education, comorbidities), cognitive (Trail Making Test A and B), physical (gait speed, lower extremity power, Six Minute Walk Test, Figure of 8 Walk Test, tandem stance, energy cost of walking, and Late Life Function and Disability Function Scale), psychosocial (Modified Gait Efficacy Scale), and financial (neighborhood socio-economic status) domains of mobility were significantly associated with LSA score. In the final regression model, age (β=-0.43), lower extremity power (β=0.03), gait efficacy (β=0.19), and energy cost of walking (β=-57.41) were associated with life space (R 2=0.238). Conclusions Younger age, greater lower extremity power, more confidence in walking, and lower energy cost of walking were associated with greater life space. Clinicians treating individuals with mobility disability should consider personal, physical, and psychosocial factors assessing barriers to life space mobility.

Clinical and Ambulatory Gait Speed in Older Adults: Associations With Several Physical, Mental, and Cognitive Health Outcomes

2020 ◽  
Vol 100 (4) ◽  
pp. 718-727
Author(s):  
Miguel Á De la Cámara ◽  
Sara Higueras-Fresnillo ◽  
Kabir P Sadarangani ◽  
Irene Esteban-Cornejo ◽  
David Martinez-Gomez ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Predictive Validity ◽  
Gait Speed ◽  
Well Being ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Walk Test ◽  
Physical And Mental Health ◽  
Cognitive Health

Abstract Background Although clinical gait speed may indicate health and well-being in older adults, there is a lack of studies comparing clinical tests with ambulatory gait speed with regard to several health outcomes. Objective The objective of this study was to examine the associations of clinical gait speed, measured by the 2.44-m walk test and the ambulatory gait speed with several physical, mental, and cognitive health outcomes in older adults. Design A cross-sectional design was used. Methods The study population comprised 432 high-functioning, community-dwelling older adults (287 women) aged between 65 and 92 years. Clinical and ambulatory gait speeds were measured using the 2.44-m walk test and a portable gait analysis device, respectively. Multiple linear regressions were used to examine the association of clinical and ambulatory gait speeds with several health outcomes (body mass index, waist circumference, systolic and diastolic blood pressure, chronic conditions, self-rated health, exhaustion, upper- and lower-body strength, physical and mental health status, cognitive status, and self-rated cognitive status). Results The results showed that the average gait speed for clinical and ambulatory measures cannot be directly compared. Clinical gait speed was associated with 7 health outcomes, and the ambulatory gait speed was associated with 6 health outcomes. The significant associations between measures of gait speed and the health outcomes converged in 5 of the 13 health outcomes studied; however, the strength of associations was singly different between measures. Limitations The short monitoring time, the inability to distinguish between the ambulatory gait speed inside the home and outdoor gait speed, and the under-representative sample are limitations of the study. Conclusion The results indicated differences in the number and strength of associations between clinical and ambulatory gait speed. Both measures have construct validity because they have been associated with physical and health outcomes; however, they may have different predictive validity. Further research should be conducted to compare their predictive validity in longitudinal designs.

scholarly journals Cross-sectional associations of housework with cognitive, physical and sensorimotor functions in younger and older community-dwelling adults: the Yishun Study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e052557
Author(s):  
Shuen Yee Lee ◽  
Benedict Wei Jun Pang ◽  
Lay Khoon Lau ◽  
Khalid Abdul Jabbar ◽  
Wei Ting Seah ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Gait Speed ◽  
High Volume ◽  
Community Dwelling ◽  
Functional Health ◽  
Attention And Memory ◽  
Recreational Physical Activity ◽  
Cross Sectional ◽  
Sit To Stand

ObjectivesRegular moderate-to-vigorous intensity recreational physical activity (PA) improves physical and cognitive functions. However, the age-associated relationships between non-recreational PA and functional ability remain less explored. We examined the associations between housework and functional health among younger and older Singaporean community-dwelling adults.DesignCross-sectional study.Setting and participantsYounger (<65 years, n=249) and older (≥65 years, n=240) community-dwelling adults were randomly recruited from a large residential town in Singapore.Outcome measuresPhysical function was assessed using Short Physical Performance Battery (SPPB), repeated-chair-sit-to-stand and gait speed. Cognitive and sensorimotor functions were assessed using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Physiological Profile Assessment (PPA), respectively.MethodsLight housework (LH) and heavy housework (HH), recreational, and occupational and transport-related PAs were assessed using PA questionnaires. Participants were dichotomised into low-volume and high-volume LH and HH groups. Results were adjusted for level of recreational and other non-recreational PAs.ResultsAmong older but not younger adults, RBANS scores were 8% and 5% higher in high HH and LH groups compared with low HH and LH groups, respectively (p=0.012 and p=0.016). Specifically, HH was associated with 14% higher attention score (p=0.014), and LH was associated with 12% and 8% higher immediate and delayed memory scores, respectively (p<0.001 and p=0.004). In older adults, sit-to-stand time and PPA scores were 8% and 23% lower in the high HH group than the low HH group, respectively (p=0.011 and p=0.040). SPPB and gait speed did not differ with age or HH. LH was not associated with physical or sensorimotor function.ConclusionsAmong older adults, housework is associated with higher cognitive function, specifically in attention and memory. Associations of housework with physical function and sensorimotor performance were intensity dependent. Housework PA is positively associated with functional health among community-dwelling older adults, independent of recreation and other non-recreational PAs. Further longitudinal and intervention studies are needed to establish causality.

scholarly journals Differences in fear of falling and fall risk indicators among white and black older adults: a cross sectional study

2019 ◽  
Author(s):  
Allison Anne Bay ◽  
Smrithi Ramachandran ◽  
Hayley A. Silverstein ◽  
Jiayang Song ◽  
Ariel R. Hart ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Wilcoxon Test ◽  
Risk Indicators ◽  
Physical Component Score ◽  
Component Score ◽  
Community Dwelling Older Adults

Abstract Background Falling among older adults is common and can cause chronic health complications. This study investigated differences between White and Black community-dwelling older adults in fall history, fear of falling, and indicators of fall risk.Methods All assessments and analyses were conducted in a clinical laboratory at Emory University in the Department of General Medicine and Geriatrics on 84 diverse community-dwelling older adults (White, n=37; Black, n=47). Statistical analyses included one-way ANOVA for continuous variables, the Fisher exact test for categorical variables, the Mann-Whitney-Wilcoxon test for ordinal variables, and an ordinal logistic regression model to examine which factors predicted fear of falling. Measures included fall history, fear of falling, and fall risk indicators. The Montreal Cognitive Assessment, Activities-Specific Balance Confidence Score, Gait Speed, Short Form 12 Physical Component Score and Mental Component Score, fear of falling and quality of life rating scales and demographics questionnaires were administered.Results Falls history was not significantly different between groups. Black participants had significantly fewer years of education (p=.007), lower MoCA scores (p=0.002), and slower fast gait speed (p=0.032) than White participants. However, Black participants reported significantly less fear of falling (p=0.043). Race (Black/White) (p=<0.001), sex (p=0.028), preferred gait speed (p=0.036), and a dichotomous variable of use of assistive device for walking (p=0.023) were significant predictors of fear of falling in the logistical model.Conclusions These factors may explain the observed differences in fear of falling observed between white and black groups in this study. This work offers an explanation of possible factors related to the well-documented yet poorly understood fact that while Black older adults have more risk factors for falling, White older adults tend to fall more frequently and are more afraid of falling.

Elevated IL-6 and CRP levels are associated with incident self-reported major mobility disability: A pooled analysis of older adults with slow gait speed

2021 ◽  
Author(s):  
Daniel P Beavers ◽  
Stephen B Kritchevsky ◽  
Thomas M Gill ◽  
Walter T Ambrosius ◽  
Stephen D Anton ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Proportional Hazards ◽  
Pooled Analysis ◽  
Relative Effect ◽  
Community Dwelling ◽  
Mobility Disability ◽  
Reactive Protein ◽  
Increased Risk ◽  
Unit Increase

Abstract Background Elevated Interleukine-6 (IL-6) and C-reactive protein (CRP) are associated with aging-related reductions in physical function, but little is known about their independent and combined relationships with major mobility disability (MMD), defined as the self-reported inability to walk a quarter-mile. Methods We estimated the absolute and relative effect of elevated baseline IL-6, CRP, and their combination on self-reported MMD risk among older adults (≥68 years; 59% female) with slow gait speed (&lt;1.0m/s). Participants were MMD-free at baseline. IL-6 and CRP were assessed using a central laboratory. The study combined a cohort of community dwelling high-functioning older adults (Health ABC) with two trials of low-functioning adults at risk of MMD (LIFE-P, LIFE). Analyses utilized Poisson regression for absolute MMD incidence and proportional hazards models for relative risk. Results We found higher MMD risk per unit increase in log IL-6 [HR=1.26 (95% CI 1.13 to 1.41)]. IL-6 meeting pre-determined threshold considered to be high (&gt;2.5 pg/mL) was similarly associated with higher risk of MMD [HR=1.31 (95% CI: 1.12 to 1.54)]. Elevated CRP (CRP &gt;3.0 mg/L) was also associated with increased MMD risk [HR=1.38 (95% CI: 1.10 to 1.74)]. The CRP effect was more pronounced among participants with elevated IL-6 [HR=1.62 (95% CI: 1.12 to 2.33)] compared to lower IL-6 levels [HR=1.19 (95% CI: 0.85 to 1.66)]. Conclusions High baseline IL-6 and CRP were associated with increased risk of MMD among older adults with slow gait speed. A combined biomarker model suggests CRP was associated with MMD when IL-6 was elevated.

scholarly journals Association between Pneumonia, Fracture, Stroke, Heart Attack and Other Hospitalizations with Changes in Mobility Disability and Gait Speed in Older Adults

2021 ◽  
Vol 10 (17) ◽  
pp. 3802
Author(s):  
Joshua D. Brown ◽  
Reiko Sato ◽  
John E. Morley
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Repeated Measures ◽  
Heart Attack ◽  
Physical Activity Intervention ◽  
Self Report ◽  
Walk Test ◽  
Short Term ◽  
Mobility Disability

Pathophysiological changes after acute hospitalizations may influence physical functioning in older adults, which can lead to disability and loss of independence. This study evaluated the association between pneumonia, fracture, heart attack, stroke, and other hospitalizations with major mobility disability (MMD) and gait speed. This was a secondary analysis of the Lifestyle Interventions and Independence for Elders (LIFE) Study, which was conducted across eight sites during 2010–2013 with longitudinal follow-up for 1635 individuals over an average of 2.6 years. Participants included adults ≥70 years old with pre-existing mobility limitations randomized to a physical activity intervention or a health education control arm. Hospitalizations were recorded via self-report and adjudicated by medical reviewers. MMD was measured by the inability to complete a 400 m walk test, or other proxies, as a binary outcome. Gait speed was recorded during the walk test in meters per second (m/s) and measured on a linear scale. Mixed-effects repeated measures regression adjusted for baseline demographics, comorbid conditions, and frailty. Among the 1635 participants, there were 1458 hospitalizations, which included 80 (5.5% of all hospitalizations) cases of pneumonia, 92 (6.3%) hospitalized fractures, 87 (6.0%) heart attacks, and 61 (4.2%) strokes. In the short-term measurement period immediately following hospitalization (1 day to 6 months), stroke (OR = 3.98 (3.41–4.54)) had the strongest association with MMD followed by fracture (OR = 3.03 (2.54–3.52)), pneumonia (OR = 2.76 (2.23–3.30)), and heart attack (OR = 2.03 (1.52–2.53)). Associations with long-term (6–12 months after) MMD were decreased or not significant for all causes. Pneumonia, fracture, stroke, and other hospitalizations were associated with short-term relative gait speed changes between −4.8% up to −19.5%, and only fracture was associated with long-term changes. Hospitalizations for pneumonia, heart attack, stroke, and fractures were associated with short-term decreases in mobility in older adults. Older adults may be at risk for decreased mobility and disability following acute hospitalizations, with the magnitude determined by the cause of the precipitating event.

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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