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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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