TY - JOUR
T1 - Gait Speed and Mobility Disability
T2 - Revisiting Meaningful Levels in Diverse Clinical Populations
AU - for the LIFE Investigators
AU - Miller, Michael E.
AU - Magaziner, Jay
AU - Marsh, Anthony P.
AU - Fielding, Roger A.
AU - Gill, Thomas M.
AU - King, Abby C.
AU - Kritchevsky, Stephen
AU - Manini, Todd
AU - McDermott, Mary M.
AU - Neiberg, Rebecca
AU - Orwig, Denise
AU - Santanasto, Adam J.
AU - Pahor, Marco
AU - Guralnik, Jack
AU - Rejeski, W. Jack
N1 - Funding Information:
A detailed list of research investigators and grant support can be found in Supplementary Text S1. Financial Disclosure: The following LIFE Study awards funded design, methods, subject recruitment, data collection, analysis, and preparation of the paper: National Institute on Aging (NIA), National Institutes of Health (NIH) Cooperative Agreement UO1 AG22376 and supplement 3U01AG022376–05A2S from the National Heart, Lung and Blood Institute, and sponsored in part by the Intramural Research Program, NIA, NIH. The research is partially supported by the Claude D. Pepper Older Americans Independence Centers at the University of Florida (1P30AG028740), Wake Forest University (1P30AG021332), Tufts University (1P30AG031679), University of Pittsburgh (P30AG024827), and Yale University (P30AG021342) and the NIH National Center for Research Resources Clinical and Translational Science Awards at Stanford University (UL1 RR025744), Tufts University is also supported by the Boston Rehabilitation Outcomes Center (1R24HD065688–01A1). Dr. Gill (Yale University) is the recipient of Academic Leadership Award K07AG3587 from the NIA. Dr. Fielding (Tufts University) is partially supported by the U.S. Department of Agriculture under Agreement 58–1950–0-014. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the U.S. Department of Agriculture. BHS2 was supported by the NIH Grants R01 AG06322, R01 HD0073, and R37 AG09901. NIH Grants R37 AG009901 and P30 AG028747 supported current analyses of BHS2. Conflict of Interest: The authors have no financial or personal conflicts. Author Contributions: Study concept and design: MEM, JM, AM, JG, WJR. Acquisition of data, critical revision for important intellectual content: all authors. Analysis and interpretation of data: MEM, RN, JM, AM, JG, WJR. Drafting of the manuscript: MEM, JM, AM, JG, WJR. MEM had full access to all of the data and takes responsibility for the integrity of the data and the accuracy of the data analyses. All authors have approved the final version of the manuscript. Sponsor's Role: The NIH sponsor was a voting member (1 of 12 votes) of the LIFE Steering Committee, which approved the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, and approval of the manuscript; and decision to submit the manuscript for publication.
Funding Information:
Financial Disclosure: The following LIFE Study awards funded design, methods, subject recruitment, data collection, analysis, and preparation of the paper: National Institute on Aging (NIA), National Institutes of Health (NIH) Cooperative Agreement UO1 AG22376 and supplement 3U01AG022376–05A2S from the National Heart, Lung and Blood Institute, and sponsored in part by the Intramural Research Program, NIA, NIH. The research is partially supported by the Claude D. Pepper Older Americans Independence Centers at the University of Florida (1P30AG028740), Wake Forest University (1P30AG021332), Tufts University (1P30AG031679), University of Pittsburgh (P30AG024827), and Yale University (P30AG021342) and the NIH National Center for Research Resources Clinical and Translational Science Awards at Stanford University (UL1 RR025744), Tufts University is also supported by the Boston Rehabilitation Outcomes Center (1R24HD065688–01A1). Dr. Gill (Yale University) is the recipient of Academic Leadership Award K07AG3587 from the NIA. Dr. Fielding (Tufts University) is partially supported by the U.S. Department of Agriculture under Agreement 58–1950–0-014. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the U.S. Department of Agriculture. BHS2 was supported by the NIH Grants R01 AG06322, R01 HD0073, and R37 AG09901. NIH Grants R37 AG009901 and P30 AG028747 supported current analyses of BHS2.
Publisher Copyright:
© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society
PY - 2018/5
Y1 - 2018/5
N2 - 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.
AB - 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.
KW - mobility disability
KW - stair climb
KW - usual-pace 3- to 4-m gait speed
UR - http://www.scopus.com/inward/record.url?scp=85044789502&partnerID=8YFLogxK
U2 - 10.1111/jgs.15331
DO - 10.1111/jgs.15331
M3 - Article
C2 - 29608795
AN - SCOPUS:85044789502
SN - 0002-8614
VL - 66
SP - 954
EP - 961
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 5
ER -