Citation

Boulifard DA, Ayers E, Verghese J. J. Am. Med. Dir. Assoc. 2019; ePub(ePub): ePub.

Affiliation

Department of Neurology, Albert Einstein College of Medicine, Bronx, NY; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1016/j.jamda.2019.06.002

PMID

31395494

Abstract

OBJECTIVES: To determine home-based gait speed performance and its associations with sociodemographic and health-related factors among older adults.

DESIGN: Cross-sectional analysis of a nationally representative US population sample. SETTING AND PARTICIPANTS: Homes of Health and Retirement Study (HRS) participants.

METHODS: Walk test data measured at home over 2.5 m were aggregated for 6983 individuals, aged ≥65 years (mean age 74.8 ± 6.9 years, 54.2% women), from the 2006 and 2008 HRS waves. Means for gait speed at normal pace were determined for demographic and clinical groupings; association of gait speed with demographic, socioeconomic status, and health factors were examined. Four-year mortality was predicted from baseline slow gait status defined using demographic-based cutoff scores as well as commonly recommended cutoff scores (100 or 60 cm/s).

RESULTS: Home-based gait speed (cm/s) means were lower for female than male (9.6% difference), older than younger (18.0% difference), African American than white (20.5% difference), and Hispanic than Non-Hispanic (10.3% difference) participants. Differences by age group, race, and ethnicity remained significant within sexes (P < .001). Lower speed was associated with African American race and all health problems; higher speed was associated with higher socioeconomic status and alcohol consumption. Four-year mortality was predicted by slow gait status. Predictive validity was, in general, higher for slow gait cutoff scores defined by demographic characteristics.

CONCLUSIONS AND IMPLICATIONS: Mean gait speed measured at home differs among older (aged ≥65 years) US resident population groups defined by sex, age, race, ethnicity, health status, and combinations of these factors, and predicts 4-year mortality when substantially slower than group-based norms. These findings may assist researchers and clinicians in determining normal and abnormal gait performance in older adults in community settings.

Copyright © 2019 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Gait speed; demographics; medical conditions; mortality; race disparities; socioeconomic status