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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #360746

Research Project: Sarcopenia, Nutrition, and Physical Activity

Location: Jean Mayer Human Nutrition Research Center On Aging

Title: Gait speed and mobility disability: revisiting meaningful levels in diverse clinical populations

Author
item Miller, Michael - Wake Forest University
item Magaziner, Jay - University Of Maryland
item Marsh, Anthony - Wake Forest University
item Fielding, Roger - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item Gill, Thomas - Yale University
item King, Abby - Stanford University
item Kritchevsky, Stephen - Wake Forest University
item Manini, Todd - University Of Florida
item Mcdermott, Mary - Northwestern University
item Neiberg, Rebecca - Wake Forest University
item Orwig, Denise - University Of Maryland
item Santanasto, Adam - University Of Pittsburgh
item Pahor, Marco - University Of Florida
item Guralnik, Jack - University Of Maryland
item Rejeski, W. Jack - Wake Forest University

Submitted to: Journal of the American Geriatrics Society
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/28/2018
Publication Date: 4/2/2018
Citation: Miller, M.E., Magaziner, J., Marsh, A.P., Fielding, R.A., Gill, T.M., King, A.C., Kritchevsky, S., Manini, T., McDermott, M.M., Neiberg, R., Orwig, D., Santanasto, A.J., Pahor, M., Guralnik, J., Rejeski, W. 2018. Gait speed and mobility disability: revisiting meaningful levels in diverse clinical populations. Journal of the American Geriatrics Society. 66(5):954-961. https://doi.org/10.1111/jgs.15331.
DOI: https://doi.org/10.1111/jgs.15331

Interpretive Summary: We investigated the variation of clinically meaningful levels of walking speed relative to self-reported mobility disability (SR-MD) across several randomized studies. We used five longitudinal studies with older adults in different states of health to explore this relationship [Lifestyle Interventions and Independence for Elders Pilot (LIFE-P), LIFE, Trial of Angiotensin-Converting Enzyme Inhibition and Novel Cardiovascular Risk Factors (TRAIN), Baltimore Hip Fracture Study (BHS2), Invecchiare in Chianti (InCHIANTI)]. The average walking speed of participants was greater than 1.0 m/s in InCHIANTI and TRAIN, 0.79 m/s in LIFE-P/LIFE, and 0.46 m/sec in BHS2. Of individuals with SR-MD, average walking speed was 0.08 m/s slower in LIFE-P/LIFE, 0.19 m/s slower in TRAIN, 0.22 m/s slower in BHS2, and 0.36 m/s slower in InCHIANTI. The optimal cutpoint for classifying SR-MD ranged from 0.3 m/s in BHS2 to 1.0 m/s in TRAIN. The relationship between absolute levels of walking speed and SR-MD varies between populations. Across diverse clinical populations, clinical interpretations of how change in usual pace walking speed relates to development of SR-MD depend on the absolute baseline gait speed.

Technical Abstract: OBJECTIVES: To investigate the heterogeneity of clinically meaningful levels of gait speed relative to self-reported mobility disability (SR-MD). DESIGN: Five longitudinal studies with older adults in different health states (onset of acute event, presence of chronic condition, sedentary, community living) were used to explore the relationship between gait speed and SR-MD. SETTING: Lifestyle Interventions and Independence for Elders Pilot (LIFE-P), LIFE, Trial of Angiotensin-Converting Enzyme Inhibition and Novel Cardiovascular Risk Factors (TRAIN), Baltimore Hip Fracture Study (BHS2), Invecchiare in Chianti (InCHIANTI). PARTICIPANTS: Individuals aged 65 and older (N=3,540): sedentary, community dwelling (LIFE-P/LIFE), with hip fracture (BHS2), random population-based sample (InCHIANTI), high cardiovascular risk (TRAIN). MEASUREMENTS: Usual-pace gait speed across 3 to 4 m and SR-MD, defined as inability to walk approximately 1 block or climb 1 flight of stairs. RESULTS: The mean gait speed of participants without SR-MD was greater than 1.0 m/s in InCHIANTI and TRAIN, 0.79 m/s in LIFE-P/LIFE, and 0.46 m/sec in BHS2. Of individuals with SR-MD, mean gait speed was 0.08 m/s slower in LIFE-P/LIFE, 0.19 m/s slower in TRAIN, 0.22 m/s slower in BHS2, and 0.36 m/s slower in InCHIANTI. The optimal gait speed cutpoint for minimizing SR-MD misclassification rates ranged from 0.3 m/s in BHS2 to 1.0 m/s in TRAIN. In longitudinal analyses, development of SR-MD was dependent on initial gait speed and change in gait speed (p<.001). CONCLUSION: The relationship between absolute levels of gait speed and SR-MD may be context specific, and there may be variations between populations. Across diverse clinical populations, clinical interpretations of how change in usual pace gait speed relates to development of SR-MD depend on where on the gait speed continuum change occurs.