Reliability of two gait speed tests of different timed phases and equal non-timed phases in community-dwelling older persons

Background: Circulating osteoprogenitor (COP) cells are a surrogate of the bone marrow mesenchymal stem cells with high levels observed in osteoporosis and the initial stages of fracture healing. Conversely, a low percentage of COP cells (%COP) is strongly associated with frailty and disability. However, it is unknown whether %COP is associated with sarcopenia, a musculoskeletal disease closely related to frailty. Objectives: This study sought to determine the associations between %COP and sarcopenia defined using the Sarcopenia Definitions and Outcomes Consortium (SDOC) criteria. Methods: Data from a random sample of 73 community-dwelling older persons enrolled in the Nepean Osteoporosis and Frailty study (median age 74 years; 60% female) were analyzed. %COP was quantified by flow cytometry using selective gating of CD45/osteocalcin (OCN) + cells. Sarcopenia was defined using handgrip strength and gait speed with cut points as per the SDOC criteria. Linear regression was used for analysis. Results: Sarcopenia was identified in 19% of participants, all of whom were frail. After adjusting for age, sex, and interleukin 6, sarcopenic participants had 36% lower %COP (95% confidence interval [CI] −56%, −6%, p = 0.024). Both grip strength and gait speed showed associations with %COP (p = 0.065 and 0.002, respectively); however, after adjusting for age and frailty, only gait speed remained associated with %COP (0.1 m/s increase in gait velocity was associated with a 5% increase in %COP cells (95% CI 0%, 10%, p = 0.052). Conclusions: High levels of %COP are associated with better muscle function. Future longitudinal studies are required to elucidate the clinical utility of %COP as a potential biomarker or disease stratifier for sarcopenia.

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The Association between Different Levels of Alcohol Use and Gait under Single and Dual Task in Community-Dwelling Older Persons Aged 65 to 70 Years

Current Gerontology and Geriatrics Research ◽

10.1155/2016/2018507 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Laurence Seematter-Bagnoud ◽

Christophe Büla ◽

Brigitte Santos-Eggimann

Keyword(s):

Alcohol Use ◽

Dual Task ◽

Gait Speed ◽

Older Persons ◽

Heavy Drinking ◽

Community Dwelling ◽

Cross Sectional ◽

Single Task ◽

Moderate Drinking

Objectives. This study aimed to describe the cross-sectional and longitudinal association between alcohol intake and gait parameters in older persons.Methods. Community-dwelling persons aged 65–70 years (N=807). Information on health, functional status, and alcohol use was self-reported at baseline and at 3-year follow-up, whereas gait speed and stride-to-stride variability were measured while walking only (single task) and under dual tasking (counting backwards).Results. Compared to light-to-moderate drinking, heavy drinking was associated with slower gait speed in single task (adj. coeff.: −.040, 95% CI: −.0.78 to −.002,p=.035). No significant association was observed between heavy drinking and gait speed variability. Nondrinkers walked significantly slower than light-to-moderate drinkers in dual task and had significantly higher gait speed variability in both single and dual task, but these associations disappeared after adjustment for comorbidity. At follow-up, 35.2% and 34.1% of the participants walked significantly slower in single and dual task, respectively. This proportion varied a little across drinking categories.Conclusion. At baseline, heavy alcohol consumption was significantly associated with slower gait speed in single task. Selective survival of the fittest heavy drinkers probably explains why this association faded in longitudinal analyses. The trend of poorer gait performance in nondrinkers disappeared after adjustment for comorbidity, suggesting confounding by a worse health status.

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The predictive value of gait speed and maximum step length for falling in community-dwelling older persons

Age and Ageing ◽

10.1093/ageing/afu151 ◽

2014 ◽

Vol 44 (2) ◽

pp. 294-299 ◽

Cited By ~ 12

Author(s):

K. T. J. Bongers ◽

Y. Schoon ◽

M. J. Graauwmans ◽

H. J. Schers ◽

R. J. Melis ◽

...

Keyword(s):

Predictive Value ◽

Gait Speed ◽

Older Persons ◽

Step Length ◽

Community Dwelling

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Skeletal Muscle Apoptotic Signaling Predicts Thigh Muscle Volume and Gait Speed in Community-Dwelling Older Persons: An Exploratory Study

PLoS ONE ◽

10.1371/journal.pone.0032829 ◽

2012 ◽

Vol 7 (2) ◽

pp. e32829 ◽

Cited By ~ 56

Author(s):

Emanuele Marzetti ◽

Hazel A. Lees ◽

Todd M. Manini ◽

Thomas W. Buford ◽

Juan M. Aranda ◽

...

Keyword(s):

Skeletal Muscle ◽

Gait Speed ◽

Exploratory Study ◽

Older Persons ◽

Community Dwelling ◽

Muscle Volume ◽

Thigh Muscle ◽

Apoptotic Signaling

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The effect of different test protocols and walking distances on gait speed in older persons

Aging Clinical and Experimental Research ◽

10.1007/s40520-020-01703-z ◽

2020 ◽

Author(s):

Sebastian Krumpoch ◽

Ulrich Lindemann ◽

Anja Rappl ◽

Clemens Becker ◽

Cornel C. Sieber ◽

...

Keyword(s):

Gait Speed ◽

Older Persons ◽

Community Dwelling ◽

Assessment Tools ◽

Walking Distance ◽

Test Protocol ◽

Gait Characteristics ◽

Study Results ◽

Significant Difference ◽

Usual Gait Speed

Abstract Background and aims Walking is the core physical activity of older persons. The assessment of walking capacity is increasingly important for clinical purposes and clinical research. Differences between assessment tools and protocols for short walks to obtain gait characteristics can be responsible for changes, e.g., in gait speed from 0.1 to 0.2 m/s. The purpose of this study was to generate further knowledge for the harmonization and/or standardization of short walk-test protocols for assessing gait characteristics under supervised conditions. Methods For this cross-sectional study, 150 community-dwelling older adults (mean age 80.5 ± 4.5 years) were recruited. Participants performed eight walks differing in the distance (8-versus 4-m), static versus dynamic trials and comparing different test speed instructions (usual versus maximal) on an electronic walkway. Results A meaningful significant difference in mean usual gait speed was documented comparing the 4-m dynamic and static test protocol (0.12 m/s; p = 0.001). For the same comparison over an 8-m distance (dynamic versus static) and for the comparison between usual gait speed over 4-and 8-m, the differences in gait speed were smaller, but still statistically significant (p = 0.001). Conclusions Gait speed was faster, if the test protocol did not include a static start or stop. The differences were greater for a shorter walking distance. This aspect should be considered for the comparison of study results and is particularly relevant for systematic reviews and meta-analyses.

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Feasibility of repeated self-measurements of maximum step length and gait speed by community-dwelling older persons

BMJ Open ◽

10.1136/bmjopen-2016-011538 ◽

2016 ◽

Vol 6 (8) ◽

pp. e011538 ◽

Cited By ~ 4

Author(s):

Kim T J Bongers ◽

Yvonne Schoon ◽

Marcel G M Olde Rikkert

Keyword(s):

Gait Speed ◽

Older Persons ◽

Step Length ◽

Community Dwelling

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The impact of functional limitations on disability and the moderating effects of psychological attributes in community-dwelling older persons

PsycEXTRA Dataset ◽

10.1037/e536922011-045 ◽

1998 ◽

Author(s):

G. I. J. M. Kempen ◽

M. J. G. van Heuvelen ◽

E. van Sonderen ◽

R. H. S. van den Brink ◽

A. C. Kooijman ◽

...

Keyword(s):

Older Persons ◽

Functional Limitations ◽

Community Dwelling ◽

Moderating Effects ◽

Psychological Attributes ◽

The Impact

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Increasing Life-Space Mobility in Community-Dwelling Older Persons With Cognitive Impairment Following Rehabilitation: A Randomized Controlled Trial

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa254 ◽

2020 ◽

Author(s):

Phoebe Ullrich ◽

Christian Werner ◽

Martin Bongartz ◽

Tobias Eckert ◽

Bastian Abel ◽

...

Keyword(s):

Cognitive Impairment ◽

Older Persons ◽

Controlled Trial ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Life Space ◽

Home Based ◽

Independent Life

Abstract Background Community-dwelling older persons with cognitive impairment (CI) following discharge from geriatric rehabilitation are at high risk of losing life-space mobility (LSM). Interventions to improve their LSM are, however, still lacking. The aim of this study was to evaluate the effects of a CI-specific, home-based physical training and activity promotion program on LSM. Methods Older persons with mild-to-moderate CI (Mini-Mental State Examination: 17–26 points) discharged home from rehabilitation were included in this double-blinded, randomized, placebo-controlled trial with a 12-week intervention period and 12-week follow-up period. The intervention group received a CI-specific, home-based strength, balance, and walking training supported by tailored motivational strategies. The control group received a placebo activity. LSM was evaluated by the Life-Space Assessment in Persons with Cognitive Impairment, including a composite score for LSM and 3 subscores for maximal, equipment-assisted, and independent life space. Mixed-model repeated-measures analyses were used. Results One hundred eighteen participants (82.3 ± 6.0 years) with CI (Mini-Mental State Examination: 23.3 ± 2.4) were randomized. After the intervention, the home-based training program resulted in a significant benefit in the Life-Space Assessment in Persons with Cognitive Impairment composite scores (b = 8.15; 95% confidence interval: 2.89–13.41; p = .003) and independent life-space subscores (b = 0.39; 95% confidence interval: 0.00–0.78; p = .048) in the intervention group (n = 63) compared to control group (n = 55). Other subscores and follow-up results were not significantly different. Conclusions The home-based training program improved LSM and independent life space significantly in this vulnerable population. Effects were not sustained over the follow-up. The program may represent a model for improved transition from rehabilitation to the community to prevent high risk of LSM restriction.

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

Geriatrics ◽

10.3390/geriatrics6010018 ◽

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.

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Incidence and multidimensional predictors of occasional and recurrent falls among Malaysian community‐dwelling older persons

BMC Geriatrics ◽

10.1186/s12877-021-02103-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Theng Choon Ooi ◽

Devinder Kaur Ajit Singh ◽

Suzana Shahar ◽

Nor Fadilah Rajab ◽

Divya Vanoh ◽

...

Keyword(s):

Incidence Rate ◽

Older Persons ◽

Test Score ◽

Community Dwelling ◽

Chair Stand ◽

Stand Test ◽

Chair Stand Test ◽

Recurrent Falls ◽

History Of

Abstract Background Falls incidence rate and comprehensive data on factors that predict occasional and repeated falls from large population-based studies are scarce. In this study, we aimed to determine the incidence of falls and identify predictors of occasional and recurrent falls. This was done in the social, medical, physical, nutritional, biochemical, cognitive dimensions among community-dwelling older Malaysians. Methods Data from 1,763 Malaysian community-dwelling older persons aged ≥ 60 years were obtained from the LRGS-TUA longitudinal study. Participants were categorized into three groups according to the presence of a single fall (occasional fallers), ≥two falls (recurrent fallers), or absence of falls (non-fallers) at an 18-month follow-up. Results Three hundred and nine (17.53 %) participants reported fall occurrences at an 18-month follow-up, of whom 85 (27.51 %) had two or more falls. The incidence rate for occasional and recurrent falls was 8.47 and 3.21 per 100 person-years, respectively. Following multifactorial adjustments, being female (OR: 1.57; 95 % CI: 1.04–2.36), being single (OR: 5.31; 95 % CI: 3.36–37.48), having history of fall (OR: 1.86; 95 % CI: 1.19–2.92) higher depression scale score (OR: 1.10; 95 % CI: 1.02–1.20), lower hemoglobin levels (OR: 0.90; 95 % CI: 0.81-1.00) and lower chair stand test score (OR: 0.93; 95 % CI: 0.87-1.00) remained independent predictors of occasional falls. While, having history of falls (OR: 2.74; 95 % CI: 1.45–5.19), being a stroke survivor (OR: 8.57; 95 % CI: 2.12–34.65), higher percentage of body fat (OR: 1.04; 95 % CI: 1.01–1.08) and lower chair stand test score (OR: 0.87; 95 % CI: 0.77–0.97) appeared as recurrent falls predictors. Conclusions Having history of falls and lower muscle strength were predictors for both occasional and recurrent falls among Malaysian community-dwelling older persons. Modifying these predictors may be beneficial in falls prevention and management strategies among older persons.

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