Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force - 06/12/24

Doi : 10.1007/s12603-009-0246-z 
Gabor Abellan Van Kan 1, 13, , , Y. Rolland 1, 2, S. Andrieu 2, 3, J. Bauer 4, O. Beauchet 5, M. Bonnefoy 6, M. Cesari 7, L.M. Donini 8, S. Gillette-Guyonnet 1, 2, M. Inzitari 9, F. Nourhashemi 1, 2, G. Onder 10, P. Ritz 11, A. Salva 9, M. Visser 12, B. Vellas 1, 2
1 Gérontopôle, Department of Geriatric Medicine, Toulouse University Hospital, Toulouse, France 
2 INSERM U-558, University Toulouse-III, Toulouse, France 
3 Department of Epidemiology and Public Health, University Toulouse-III, Toulouse, France 
4 Department of Geriatric Medicine, University of Erlangen-Nuremberg, Nurnberg, Germany 
5 Department of Geriatric Medicine, Angers University Hospital, Angers, France 
6 Department of Geriatric Medicine, Centre Hospitalier Lyon Sud, Pierre-Benite, France 
7 Department of Aging and Geriatric Reseach, Institute on Aging, University of Florida, Gainesville, USA 
8 Department of Medical Physiopathology, “Sapienza” University of Rome, Rome, Italy 
9 Institut Catala de l'Envelliment, University Autonoma de Barcelona, Barcelona, Spain 
10 Department of Geriatric Medicine, Catholic University of Sacred Heart, Rome, Italy 
11 Pole Cardiologie et Métabolique, Service d'Endocrinologie, Rangueil University Hospital, Toulouse, France 
12 Department of Health Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit, and the EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands 
13 Gérontopôle, Department of Geriatric Medicine, Toulouse University Hospital, 170, avenue de Casselardit, 31059, Toulouse, cedex 9, France 

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Abstract

Introduction

The use of a simple, safe, and easy to perform assessment tool, like gait speed, to evaluate vulnerability to adverse outcomes in community-dwelling older people is appealing, but its predictive capacity is still questioned. The present manuscript summarises the conclusions of an expert panel in the domain of physical performance measures and frailty in older people, who reviewed and discussed the existing literature in a 2-day meeting held in Toulouse, France on March 12–13, 2009. The aim of the IANA Task Force was to state if, in the light of actual scientific evidence, gait speed assessed at usual pace had the capacity to identify community-dwelling older people at risk of adverse outcomes, and if gait speed could be used as a single-item tool instead of more comprehensive but more time-consuming assessment instruments.

Methods

A systematic review of literature was performed prior to the meeting (Medline search and additional pearling of reference lists and key-articles supplied by Task Force members). Manuscripts were retained for the present revision only when a high level of evidence was present following 4 pre-selected criteria: a) gait speed, at usual pace, had to be specifically assessed as a single-item tool, b) gait speed should be measured over a short distance, c) at baseline, participants had to be autonomous, community-dwelling older people, and d) the evaluation of onset of adverse outcomes (i.e. disability, cognitive impairment, institutionalisation, falls, and/or mortality) had to be assessed longitudinally over time. Based on the prior criteria, a final selection of 27 articles was used for the present manuscript.

Results

Gait speed at usual pace was found to be a consistent risk factor for disability, cognitive impairment, institutionalisation, falls, and/or mortality. In predicting these adverse outcomes over time, gait speed was at least as sensible as composite tools.

Conclusions

Although more specific surveys needs to be performed, there is sufficient evidence to state that gait speed identifies autonomous community-dwelling older people at risk of adverse outcomes and can be used as a single-item assessment tool. The assessment at usual pace over 4 meters was the most often used method in literature and might represent a quick, safe, inexpensive and highly reliable instrument to be implemented.

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Keywords : Gait Speed, Physical Performance Measure, Body Composition Study, Composite Tool, Slow Gait Speed


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Vol 13 - N° 10

P. 881-889 - décembre 2009 Retour au numéro
Article précédent Article précédent
  • Bradypedia: Is gait speed ready for clinical use?
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