Gait Speed and Survival in Older Adults | Geriatrics | JAMA | JAMA Network
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1.
Reuben DB. Medical care for the final years of life: “When you're 83, it's not going to be 20 years.”  JAMA. 2009;302(24):2686-269420040557PubMedGoogle ScholarCrossref
2.
Lubitz J, Cai L, Kramarow E, Lentzner H. Health, life expectancy, and health care spending among the elderly.  N Engl J Med. 2003;349(11):1048-105512968089PubMedGoogle ScholarCrossref
3.
Fried LP, Kronmal RA, Newman AB,  et al.  Risk factors for 5-year mortality in older adults.  JAMA. 1998;279(8):585-5929486752PubMedGoogle ScholarCrossref
4.
Lee SJ, Lindquist K, Segal MR, Covinsky KE. Development and validation of a prognostic index for 4-year mortality in older adults.  JAMA. 2006;295(7):801-80816478903PubMedGoogle ScholarCrossref
5.
Schonberg MA, Davis RB, McCarthy EP, Marcantonio ER. Index to predict 5-year mortality of community-dwelling adults aged 65 and older using data from the National Health Interview Survey.  J Gen Intern Med. 2009;24(10):1115-112219649678PubMedGoogle ScholarCrossref
6.
Cesari M, Kritchevsky SB, Newman AB,  et al; Health, Aging and Body Composition Study.  Added value of physical performance measures in predicting adverse health-related events.  J Am Geriatr Soc. 2009;57(2):251-25919207142PubMedGoogle ScholarCrossref
7.
Cesari M, Kritchevsky SB, Penninx BW,  et al.  Prognostic value of usual gait speed in well-functioning older people.  J Am Geriatr Soc. 2005;53(10):1675-168016181165PubMedGoogle ScholarCrossref
8.
Markides KS, Stroup-Benham C, Black S, Satis S, Perkowski L, Ostir G. The health of Mexican American elderly: Selected findings from the Hispanic EPESE. In: Wykle ML, Ford A, ed. Serving Minority Elders in the 21st Century. New York, NY: Springer; 1999:72-90
9.
Ostir GV, Kuo YF, Berges IM, Markides KS, Ottenbacher KJ. Measures of lower body function and risk of mortality over 7 years of follow-up.  Am J Epidemiol. 2007;166(5):599-60517566063PubMedGoogle ScholarCrossref
10.
Rolland Y, Lauwers-Cances V, Cesari M, Vellas B, Pahor M, Grandjean H. Physical performance measures as predictors of mortality in a cohort of community-dwelling older French women.  Eur J Epidemiol. 2006;21(2):113-12216518679PubMedGoogle ScholarCrossref
11.
Rosano C, Newman AB, Katz R, Hirsch CH, Kuller LH. Association between lower digit symbol substitution test score and slower gait and greater risk of mortality and of developing incident disability in well-functioning older adults.  J Am Geriatr Soc. 2008;56(9):1618-162518691275PubMedGoogle ScholarCrossref
12.
Woo J, Ho SC, Yu AL. Walking speed and stride length predicts 36 months dependency, mortality, and institutionalization in Chinese aged 70 and older.  J Am Geriatr Soc. 1999;47(10):1257-126010522962PubMedGoogle Scholar
13.
Abellan van Kan G, Rolland Y, Andrieu S,  et al.  Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people.  J Nutr Health Aging. 2009;13(10):881-88919924348PubMedGoogle ScholarCrossref
14.
Hall WJ. Update in geriatrics.  Ann Intern Med. 2006;145(7):538-54317015872PubMedGoogle ScholarCrossref
15.
Lavsky-Shulan M, Wallace RB, Kohout FJ, Lemke JH, Morris MC, Smith IM. Prevalence and functional correlates of low back pain in the elderly: the Iowa 65+ Rural Health Study.  J Am Geriatr Soc. 1985;33(1):23-283155530PubMedGoogle Scholar
16.
Visser M, Deeg DJ, Lips P, Harris TB, Bouter LM. Skeletal muscle mass and muscle strength in relation to lower-extremity performance in older men and women.  J Am Geriatr Soc. 2000;48(4):381-38610798463PubMedGoogle Scholar
17.
Visser M, Goodpaster BH, Kritchevsky SB,  et al.  Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons.  J Gerontol A Biol Sci Med. 2005;60(3):324-33315860469PubMedGoogle ScholarCrossref
18.
Ferrucci L, Bandinelli S, Benvenuti E,  et al.  Subsystems contributing to the decline in ability to walk.  J Am Geriatr Soc. 2000;48(12):1618-162511129752PubMedGoogle Scholar
19.
Orwoll E, Blank JB, Barrett-Connor E,  et al.  Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study.  Contemp Clin Trials. 2005;26(5):569-58516084776PubMedGoogle ScholarCrossref
20.
 Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–94. Hyattsville, MD: National Center for Health Statistics, US Dept of Health and Human Services Services; 2004. PHS 94–1308
21.
Studenski S, Perera S, Wallace D,  et al.  Physical performance measures in the clinical setting.  J Am Geriatr Soc. 2003;51(3):314-32212588574PubMedGoogle ScholarCrossref
22.
Cummings SR, Black DM, Nevitt MC,  et al; The Study of Osteoporotic Fractures Research Group.  Appendicular bone density and age predict hip fracture in women.  JAMA. 1990;263(5):665-6682404146PubMedGoogle ScholarCrossref
23.
Fried LP, Borhani NO, Enright P,  et al.  The Cardiovascular Health Study.  Ann Epidemiol. 1991;1(3):263-2761669507PubMedGoogle ScholarCrossref
24.
Guralnik JM, Ferrucci L, Pieper CF,  et al.  Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery.  J Gerontol A Biol Sci Med Sci. 2000;55(4):M221-M23110811152PubMedGoogle ScholarCrossref
25.
Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants.  Age Ageing. 1997;26(1):15-199143432PubMedGoogle ScholarCrossref
26.
Guralnik JM, Simonsick EM, Ferrucci L,  et al.  A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission.  J Gerontol. 1994;49(2):M85-M948126356PubMedGoogle ScholarCrossref
27.
Washburn RA, Smith KW, Jette AM, Janney CA. The Physical Activity Scale for the Elderly (PASE): development and evaluation.  J Clin Epidemiol. 1993;46(2):153-1628437031PubMedGoogle ScholarCrossref
28.
Martin FC, Hart D, Spector T, Doyle DV, Harari  D. Fear of falling limiting activity in young-old women is associated with reduced functional mobility rather than psychological factors.  Age Ageing. 2005;34(3):281-28715863412PubMedGoogle ScholarCrossref
29.
Lawless JF. Statistical Models and Methods for Lifetime Data. New York, NY: Wiley; 2002
30.
Thernau TM, Grambsch PM. Modeling Survival Data: Extending the Cox Model. New York, NY: Springer; 2000
31.
Cochran WG. The combination of estimates from different experiments.  Biometrics. 1954;10(1):101-129Google ScholarCrossref
32.
Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis.  Stat Med. 2002;21(11):1539-155812111919PubMedGoogle ScholarCrossref
33.
DerSimonian R, Laird N. Meta-analysis in clinical trials.  Control Clin Trials. 1986;7(3):177-1883802833PubMedGoogle ScholarCrossref
34.
Klein JP, Moeschberger M. Survival Analysis: Techniques for Censored and Truncated Data. New York, NY: Springer; 1997
35.
Katsahian S, Latouche A, Mary JY, Chevret S, Porcher R. Practical methodology of meta-analysis of individual patient data using a survival outcome.  Contemp Clin Trials. 2008;29(2):220-23017884735PubMedGoogle ScholarCrossref
36.
Kalbfleisch JD, Prentice RL. The Statistical Analysis of Failure Time Data. New York, NY: Wiley; 1980
37.
Apfel CC, Kranke P, Greim CA, Roewer N. What can be expected from risk scores for predicting postoperative nausea and vomiting?  Br J Anaesth. 2001;86(6):822-82711573590PubMedGoogle ScholarCrossref
38.
Dear KB. Iterative generalized least squares for meta-analysis of survival data at multiple times.  Biometrics. 1994;50(4):989-10027787011PubMedGoogle ScholarCrossref
39.
Atkinson HH, Rosano C, Simonsick EM,  et al; Health ABC study.  Cognitive function, gait speed decline, and comorbidities.  J Gerontol A Biol Sci Med Sci. 2007;62(8):844-85017702875PubMedGoogle ScholarCrossref
40.
Baezner H, Blahak C, Poggesi A,  et al; LADIS Study Group.  Association of gait and balance disorders with age-related white matter changes.  Neurology. 2008;70(12):935-94218347315PubMedGoogle ScholarCrossref
41.
Buchman AS, Boyle PA, Leurgans SE, Evans DA, Bennett DA. Pulmonary function, muscle strength, and incident mobility disability in elders.  Proc Am Thorac Soc. 2009;6(7):581-58719934353PubMedGoogle ScholarCrossref
42.
Callisaya ML, Blizzard L, Schmidt MD, McGinley JL, Lord SR, Srikanth VK. A population-based study of sensorimotor factors affecting gait in older people.  Age Ageing. 2009;38(3):290-29519264860PubMedGoogle ScholarCrossref
43.
Cham R, Studenski SA, Perera S, Bohnen NI. Striatal dopaminergic denervation and gait in healthy adults.  Exp Brain Res. 2008;185(3):391-39817973106PubMedGoogle ScholarCrossref
44.
Cuoco A, Callahan DM, Sayers S, Frontera WR, Bean J, Fielding RA. Impact of muscle power and force on gait speed in disabled older men and women.  J Gerontol A Biol Sci Med Sci. 2004;59(11):1200-120615602076PubMedGoogle ScholarCrossref
45.
Fitzpatrick AL, Buchanan CK, Nahin RL,  et al; Ginkgo Evaluation of Memory (GEM) Study Investigators.  Associations of gait speed and other measures of physical function with cognition in a healthy cohort of elderly persons.  J Gerontol A Biol Sci Med Sci. 2007;62(11):1244-125118000144PubMedGoogle ScholarCrossref
46.
Fried LF, Lee JS, Shlipak M,  et al.  Chronic kidney disease and functional limitation in older people.  J Am Geriatr Soc. 2006;54(5):750-75616696739PubMedGoogle ScholarCrossref
47.
Holtzer R, Verghese J, Xue X, Lipton RB. Cognitive processes related to gait velocity.  Neuropsychology. 2006;20(2):215-22316594782PubMedGoogle ScholarCrossref
48.
Kerrigan DC, Lee LW, Collins JJ, Riley PO, Lipsitz LA. Reduced hip extension during walking.  Arch Phys Med Rehabil. 2001;82(1):26-3011239282PubMedGoogle ScholarCrossref
49.
Kuo CK, Lin LY, Yu YH, Wu KH, Kuo HK. Inverse association between insulin resistance and gait speed in nondiabetic older men.  BMC Geriatr. 2009;9:4919922671PubMedGoogle ScholarCrossref
50.
Nebes RD, Pollock BG, Halligan EM, Kirshner MA, Houck PR. Serum anticholinergic activity and motor performance in elderly persons.  J Gerontol A Biol Sci Med Sci. 2007;62(1):83-8517301043PubMedGoogle ScholarCrossref
51.
Rosano C, Aizenstein HJ, Studenski S, Newman  AB. A regions-of-interest volumetric analysis of mobility limitations in community-dwelling older adults.  J Gerontol A Biol Sci Med Sci. 2007;62(9):1048-105517895446PubMedGoogle ScholarCrossref
52.
Volpato S, Blaum C, Resnick H, Ferrucci L, Fried LP, Guralnik JM.Women's Health and Aging Study.  Comorbidities and impairments explaining the association between diabetes and lower extremity disability.  Diabetes Care. 2002;25(4):678-68311919124PubMedGoogle ScholarCrossref
53.
Jones LM, Waters DL, Legge M. Walking speed at self-selected exercise pace is lower but energy cost higher in older versus younger women.  J Phys Act Health. 2009;6(3):327-33219564661PubMedGoogle Scholar
54.
Mian OS, Thom JM, Ardigò LP, Narici MV, Minetti AE. Metabolic cost, mechanical work, and efficiency during walking in young and older men.  Acta Physiol (Oxf). 2006;186(2):127-13916497190PubMedGoogle ScholarCrossref
55.
Cesari M, Onder G, Zamboni V,  et al.  Physical function and self-rated health status as predictors of mortality.  BMC Geriatr. 2008;8:3419102751PubMedGoogle ScholarCrossref
56.
Markides KS, Black SA, Ostir GV, Angel RJ, Guralnik JM, Lichtenstein M. Lower body function and mortality in Mexican American elderly people.  J Gerontol A Biol Sci Med Sci. 2001;56(4):M243-M24711283198PubMedGoogle ScholarCrossref
57.
Inouye SK, Peduzzi PN, Robison JT, Hughes JS, Horwitz RI, Concato J. Importance of functional measures in predicting mortality among older hospitalized patients.  JAMA. 1998;279(15):1187-11939555758PubMedGoogle ScholarCrossref
58.
Keeler E, Guralnik JM, Tian H, Wallace RB, Reuben DB. The impact of functional status on life expectancy in older persons.  J Gerontol A Biol Sci Med Sci. 2010;65(7):727-73320363833PubMedGoogle ScholarCrossref
59.
Mazzaglia G, Roti L, Corsini G,  et al.  Screening of older community-dwelling people at risk for death and hospitalization: the Assistenza Socio-Sanitaria in Italia project.  J Am Geriatr Soc. 2007;55(12):1955-196017944891PubMedGoogle ScholarCrossref
60.
Ostbye T, Steenhuis R, Wolfson C, Walton R, Hill G. Predictors of five-year mortality in older Canadians.  J Am Geriatr Soc. 1999;47(10):1249-125410522960PubMedGoogle Scholar
61.
Keeler E, Guralnik JM, Tian H, Wallace RB, Reuben DB. The impact of functional status on life expectancy in older persons.  J Gerontol A Biol Sci Med Sci. 2010;65(7):727-73320363833PubMedGoogle ScholarCrossref
62.
 United States Life Tables, 2010. http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr_21.pdf). Accessed November 29, 2010 
63.
Graham JE, Ostir GV, Fisher SR, Ottenbacher KJ. Assessing walking speed in clinical research.  J Eval Clin Pract. 2008;14(4):552-56218462283PubMedGoogle ScholarCrossref
64.
Graham JE, Ostir GV, Kuo YF, Fisher SR, Ottenbacher KJ. Relationship between test methodology and mean velocity in timed walk tests: a review.  Arch Phys Med Rehabil. 2008;89(5):865-87218452733PubMedGoogle ScholarCrossref
65.
Gill TM. Assessment of function and disability in longitudinal studies.  J Am Geriatr Soc. 2010;58:(suppl 2)  S308-S31221029059PubMedGoogle ScholarCrossref
66.
Newman AB, Simonsick EM, Naydeck BL,  et al.  Association of long-distance corridor walk performance with mortality, cardiovascular disease, mobility limitation, and disability.  JAMA. 2006;295(17):2018-202616670410PubMedGoogle ScholarCrossref
67.
Solway S, Brooks D, Lacasse Y, Thomas S. A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain.  Chest. 2001;119(1):256-27011157613PubMedGoogle ScholarCrossref
68.
Simonsick EM, Newman AB, Visser M,  et al; Health, Aging and Body Composition Study.  Mobility limitation in self-described well-functioning older adults.  J Gerontol A Biol Sci Med Sci. 2008;63(8):841-84718772472PubMedGoogle ScholarCrossref
Original Contribution
January 5, 2011

Gait Speed and Survival in Older Adults

Author Affiliations

Author Affiliations: Department of Medicine, Division of Geratric Medicine, School of Medicine (Drs Studenski and Perea), Department of Epidemiology, School of Public Health (Drs Rosano, Newman, and Cauley), Department of Physical Therapy, School of Health and Rehabilitation (Dr Brach), University of Pittsburgh, and National Personal Protective Technology Laboratory (Dr Faulkner), Pittsburgh, Pennsylvania; Laboratory of Epidemiology, Demography, and Biometry (Drs Patel, Harris, and Guralnik), and Clinical Research Branch, Intramural Research Program (Dr Ferrucci), National Institute on Aging, Bethesda, Maryland; Pere Virgili Hospital and Institute on Aging, Autonomous University of Barcelona, Barcelona, Spain (Dr Inzitari); Merck Research Laboratories, North Wales, Pennsylvania (Dr Chandler); California Pacific Medical Center Research Institute (Dr Cawthon), and University of California at San Francisco (Dr Nevitt), University of California at San Diego (Dr Barrett Connor); VU University, Amsterdam, the Netherlands (Dr Visser); Wake Forest University, Winston-Salem, North Carolina (Dr Kritchevsky); and Geriatric Unit, Azienda sanitaria firenze, Florence, Italy (Dr Badinelli).

JAMA. 2011;305(1):50-58. doi:10.1001/jama.2010.1923
Abstract

Context Survival estimates help individualize goals of care for geriatric patients, but life tables fail to account for the great variability in survival. Physical performance measures, such as gait speed, might help account for variability, allowing clinicians to make more individualized estimates.

Objective To evaluate the relationship between gait speed and survival.

Design, Setting, and Participants Pooled analysis of 9 cohort studies (collected between 1986 and 2000), using individual data from 34 485 community-dwelling older adults aged 65 years or older with baseline gait speed data, followed up for 6 to 21 years. Participants were a mean (SD) age of 73.5 (5.9) years; 59.6%, women; and 79.8%, white; and had a mean (SD) gait speed of 0.92 (0.27) m/s.

Main Outcome Measures Survival rates and life expectancy.

Results There were 17 528 deaths; the overall 5-year survival rate was 84.8% (confidence interval [CI], 79.6%-88.8%) and 10-year survival rate was 59.7% (95% CI, 46.5%-70.6%). Gait speed was associated with survival in all studies (pooled hazard ratio per 0.1 m/s, 0.88; 95% CI, 0.87-0.90; P < .001). Survival increased across the full range of gait speeds, with significant increments per 0.1 m/s. At age 75, predicted 10-year survival across the range of gait speeds ranged from 19% to 87% in men and from 35% to 91% in women. Predicted survival based on age, sex, and gait speed was as accurate as predicted based on age, sex, use of mobility aids, and self-reported function or as age, sex, chronic conditions, smoking history, blood pressure, body mass index, and hospitalization.

Conclusion In this pooled analysis of individual data from 9 selected cohorts, gait speed was associated with survival in older adults.

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