Multisystem physiologic impairments and changes in gait speed of older adults

J Gerontol A Biol Sci Med Sci. 2015 Mar;70(3):319-24. doi: 10.1093/gerona/glu176. Epub 2014 Nov 7.

Abstract

Background: Slowed gait is an important health indicator in older adults but a single identifiable cause is often lacking. We assessed whether a summary index measuring impairments across multiple physiologic systems was associated with slowed gait in older individuals.

Methods: Data from the Cardiovascular Health Study (n = 3,010) were used to assess associations between baseline physiologic index (measuring vasculature, brain, kidneys, lungs, and glucose metabolism; range 0-10 with 0-2 points/system and lower score indicating higher function) and annual gait speed (m/s) over 6 years. Participants with complete data on the physiologic index and at least two gait speed measures were included. Mean gait speed and 95% confidence intervals (CI) by category of index were calculated using mixed effects models.

Results: Those with scores of three or higher on the index had significantly slower gait speed at baseline compared to those with scores of 0-2 (7-10: mean speed = 0.83 m/s, 95% CI: 0.80, 0.84; 0-2: mean speed = 1.01 m/s, 95% CI: 0.99, 1.03). Those with higher indices also had faster decline in gait speed compared to those with lower scores after adjustment for demographic and health characteristics (7-10: change in speed = -0.020 m/s/year, 95% CI: -0.024, -0.016; 0-2: change in speed= -0.010 m/s/year, 95% CI: -0.014, -0.006).

Conclusions: Greater impairment across five organ systems was associated with slower gait speed and greater declines in gait speed over 6 years. Impairments accumulated over multiple physiologic systems may make older adults more vulnerable to slow gait speed.

Keywords: Epidemiology.; Gait; Physical function.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Brain / physiology
  • Cardiovascular Physiological Phenomena
  • Cohort Studies
  • Female
  • Gait / physiology*
  • Geriatric Assessment*
  • Glucose / metabolism
  • Health Status Indicators*
  • Humans
  • Kidney / physiology
  • Lung / physiology
  • Male
  • Sensitivity and Specificity
  • Time Factors

Substances

  • Glucose