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Prognostic Value of Usual Gait Speed in Well‐Functioning Older People—Results from the Health, Aging and Body Composition Study
Author(s) -
Cesari Matteo,
Kritchevsky Stephen B.,
Penninx Brenda W. H. J.,
Nicklas Barbara J.,
Simonsick Eleanor M.,
Newman Anne B.,
Tylavsky Frances A.,
Brach Jennifer S.,
Satterfield Suzanne,
Bauer Douglas C.,
Visser Marjolein,
Rubin Susan M.,
Harris Tamara B.,
Pahor Marco
Publication year - 2005
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2005.53501.x
Subject(s) - medicine , gait , confidence interval , relative risk , proportional hazards model , prospective cohort study , preferred walking speed , cohort study , physical therapy , rate ratio , physical medicine and rehabilitation
Objectives: To define clinically relevant cutpoints for usual gait speed and to investigate their predictive value for health‐related events in older persons. Design: Prospective cohort study. Setting: Health, Aging and Body Composition Study. Participants: Three thousand forty‐seven well‐functioning older persons (mean age 74.2). Measurements: Usual gait speed on a 6‐m course was assessed at baseline. Participants were randomly divided into two groups to identify (Sample A; n=2,031) and then validate (Sample B; n=1,016) usual gait‐speed cutpoints. Rates of persistent lower extremity limitation events (mean follow‐up 4.9 years) were calculated according to gait speed in Sample A. A cutpoint (defining high‐ (<1 m/s) and low risk (≥1 m/s) groups) was identified based on persistent lower extremity limitation events. The predictive value of the identified cutpoints for major health‐related events (persistent severe lower extremity limitation, death, and hospitalization) was evaluated in Sample B using Cox regression analyses. Results: A graded response was seen between risk groups and health‐related outcomes. Participants in the high‐risk group had a higher risk of persistent lower extremity limitation (rate ratio (RR)=2.20, 95% confidence interval (CI)=1.76–2.74), persistent severe lower extremity limitation (RR=2.29, 95% CI=1.63–3.20), death (RR=1.64, 95% CI=1.14–2.37), and hospitalization (RR=1.48, 95% CI=1.02–2.13) than those in the low‐risk group. Conclusion: Usual gait speed of less than 1 m/s identifies persons at high risk of health‐related outcomes in well‐functioning older people. Provision of a clinically meaningful cutpoint for usual gait speed may facilitate its use in clinical and research settings.