Shortdistance gait speed is a reliable measure associated with falls, 1 hospitalizations, 2 disability, 3 and survival in older adults. Gait speed and survival in older adults columbia university. One approach to assess gait speed is with the timed up and. This study aimed to evaluate whether gait speed and grip strength predicted clinical outcomes among older adults with blood cancers. Gait speed and survival in older adults geriatrics jama jama. Gait speed and dismobility in older adults sciencedirect.
Improvement in usual gait speed predicts better survival in older adults. The aims of the present study were to assess the reliability of the 4mgs and the relationship with established health outcome measures in chronic obstructive pulmonary disease copd. Gait speed has been defined as the 6 vital signs in older adults, and it is almost the perfect measurement 28 because it may reflect functional, physiological, and mental changes in older adults. First, gait speed might help identify older adults with a high probability of living for 5 or 10 more years, who may be appropriate targets for preventive interventions that require years for benefit. In communitydwelling older adults, the prevalence of frailty is estimated to be 10%. In older adults, faster gait speed is associated with increased survival duration, with a gait speed of approximately 0. Results gait speed was associated with survival in all studies. The beneficial effect of cr participation did not differ by gait speed.
Survival estimates help individualize goals of care for geriatric patients, but life tables fail to account for the great variability in survival. Furthermore, gait speed adds substantially to the predictive values of age and gender and is similar in predictive value to more complex measures of health. Declines in older adult step length, stride length, ankle range. Gait speed is used increasingly to predict function and future wellbeing among healthy elderly people as well as for those with longterm medical conditions. Walkingor gait speed is a powerful indicator of vitality, says stephanie studenski, a professor at the university of pittsburghs. Gait speed, comorbid conditions, operative variables, and vital status during the. Gait speed and survival in older adults journal of the. Improvement in usual gait speed predicts better survival. Gait speed assessment in older adults journal of the american.
In an analysis that included data from 9 studies, having higher measures of walking speed among older adults was associated with increased length of survival, according to a new study. Gait speed is an important measure of functional ability and has been widely used in older adults as an indicator of frailty. Gait speed, grip strength, and clinical outcomes in older patients. Relationship of clinic based gait speed measurement to limitations in community based activities in older adults, archives of physical medicine and rehabilitation, 925, 844846. Slow gait speed and cardiac rehabilitation participation. Walking speed associated with survival in older adults. Objective to evaluate the relationship between gait speed and survival. Gait speed was associated with survival in all studies pooled hazard ratio per 0. Gait speed and survival in older adults, journal of the american medical association, 3051, 5058. Both slow gait speed and lack of cr participation were associated with increased 1. Examining trajectories of gait speed in older adults is important as.
Pooled analysis of 9 cohort studies collected between 1986 and 2000, using individual data from 34 485 communitydwelling older adults aged 65 years or older with baseline gait speed data, followed up. When selecting outcome measures such as walking speed, it is important to include the circumstances under which the measurement is made to avoid bias and ensure accurate recommendations. A clinical classification of dismobility could provide the inpatient health care team with meaningful information about the older patients underlying health conditions and future prognosis, and provides an opportunity to discuss and implement treatment options with patients and. Pdf gait speed and survival in older adults researchgate. However, the diversity in measurement protocols in clinical settings creates variability in outcome measures. Gait speed has potential to be implemented in practice, using a stop watch and a 4m course. Gait speed and survival in older adults stephanie studenski, md, mph subashan perera, phd kushang patel, phd caterina rosano, md, phd kimberly faulkner, phd marco inzitari, md, phd jennifer brach, phd julie chandler, phd peggy cawthon, phd elizabeth barrett connor, md michael nevitt, phd marjolein visser, phd stephen kritchevsky, phd stefania. Factors associated with lower gait speed among the elderly living in. January 4, 2011 gait speed is associated with survival in older adults, according to the results of a pooled analysis reported in the january 5 issue of the journal of the american medical. Gait speed and survival in patients with brain metastases. Survival increased across the full range of gait speeds, with significant increments per 0. Studenski and colleagues on communitydwelling senior citizens, which links baseline gait speed with the rate of survival in persons 65 years of age and older, independent of factors, including gender, body mass index bmi, and blood pressure.
Human gait is highly complex, involving the peripheral and central nervous system, including motor, sensory, sensorial, and neurocognitive pathways, and gait dysfunction is common in the elderly people. Incremental value of gait speed in predicting prognosis of. Then measure and mark 5 feet before the start, and 5 feet after the middle 5 meter section. Gait speed is a strong predictor of health outcomes, mobility, and survival in older adults. Walking speed predicts life expectancy of older adults. Trajectories of gait speed predict mortality in wellfunctioning. Gait speed and survival of older surgical patient with cancer. Survival increased across the full range of gait speeds, with significant increments. Gait speed and operative mortality in older adults. Gait speed and survival in older adults geriatrics. Improvement in usual gait speed predicts better survival in older adults article in journal of the american geriatrics society 5511.
Gait speed and survival in older adults american college. Second, gait speed might be used to identify older adults with increased risk of early mortality, perhaps those with gait speeds slower than 0. In older adults hospitalized for ami, slow gait speed, a marker of frailty, at 1 month was common and associated with lower cr participation. The test can be performed with any patient able to walk 4 metres using the instructions below.
Improvement in usual gait speed predicts a substantial reduction in mortality. Gait speed and decline in gait speed as predictors of. Previous studies have shown that initial gait speed, or baseline gait speed, is a strong predictor of survival in older adults with walking. We used the 4m walking test as it was described as a quick, safe, easy, inexpensive and highly reliable measure, with the capacity to identify older adults at risk of poor clinical outcomes over time. Pooled analysis of 9 cohort studies collected between 1986 and 2000, using individual data from 34,485 communitydwelling older adults aged 65 years or older with baseline gait speed data, followed up for 6 to 21 years. A pooled analysis was conducted in nine cohort studies collected between 1986 and 2000, using individual data from 34,485 communitydwelling older adults ages 65 years or older with baseline gait speed data, and followup for 621 years. Because gait speed is easily measured, clinically interpretable, and potentially modi. Gait speed was associated with survival in older adults. Besides confirming the association with mortality and hospitalizations, this is the first study to test the incremental value of gait speed in predicting prognosis in older patients with hf in combination with a validated clinical risk score. Main outcome measures survival rates and life expectancy. Further research is needed to determine whether interventions to improve gait speed affect survival. Reliability and validity of 4metre gait speed in copd. In communitydwelling older adults, usual gait speed over 4 m 4mgs consistently predicts greater risk of adverse health outcomes. Incremental value of gait speed in predicting prognosis of older adults with heart failure.
Clinical and ambulatory gait speed in older adults. Gait speed as a vital sign in geriatric rehabilitation. To evaluate the relationship between gait speed and survival. Gait speed preferred and maximal university of missouri. In older adults, gait speed appears to be related to survival, according to research published in the jan. Gait speed associated with survival in older adults last updated. Gait speed may be reduced in studies that include older adults withdiseases. We prospectively recruited 448 patients aged 75 years and older presenting for initial consultation at the myelodysplastic syndromeleukemia, myeloma, or lymphoma clinic of a large tertiary hospital, who agreed to assessment of gait and grip.
Improved preferred gait speed in older adults is associated with increased survival rates. Design, setting, and participants pooled analysis of 9 cohort studies collected between 1986 and 2000, using individual data from 34,485 communitydwelling older adults aged 65 years or older with baseline gait speed data, followed up for 6 to 21 years. Frailty in older adults early identification and management 2017 1. To our knowledge, this is the first study that compares the associations of clinical and ambulatory gait speed with some health outcomes in older adults. Incremental value of gait speed in predicting prognosis of older adults with heart failure insights from the imagehf study giovanni pulignano, md,a donatella del sindaco, md,b andrea di lenarda, md,c gianfranco alunni, md,d michele senni, md,e luigi tarantini, md,f giovanni ciof.
A simple and quick screen for gait speed was evaluated in this study of hospitalized older patients. Among communitydwelling older adults, mean values for gait speed vary. In older adults, gait speed is a reliable indicator of overall health and functional status. A cohort of older adults was assembled within the sts adult cardiac surgery database as previously described. Gait speed gs is a simple and reliable measure that can provide similar information regarding risk of subsequent outcomes falls, hospitalization, disability, and mortality as a more. Functional performance in community living older adults. Gait speed in older patients with cancer is associated with mortality risk. Gait speed was calculated for each participant using distance in meters and time in seconds. Predictive value of gait speed and frailty indicators on. Gait speed, grip strength, and clinical outcomes in older. The data provided herein are intended to aid clinicians, investigators, and health system planners who seek simple indicators of health and survival in older adults. In this issue of blood, liu and colleagues demonstrate that gait speed is a valuable predictor of outcomes in older adults with hematologic malignancies, independent of age, performance status, comorbidities, aggressiveness of malignancy, and treatment type.
66 157 649 1046 1529 1199 949 1148 135 1152 119 1346 148 844 793 957 718 1319 1300 89 1536 1205 367 433 644 284 128 490 607 942 1208 1433 55 101 420 699 511 629 1047 1150 902