Prognostic value of usual gait speed in well-functioning older people-results from the health, aging and body composition study
Prognostic value of usual gait speed in well-functioning older people-results from the health, aging and body composition study
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DOI：
10.1111/j.1532-5415.2005.53501.x
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发表时间：
2005-10-01
影响因子：
6.3
通讯作者：
Pahor, M
中科院分区：
文献类型：
--
作者：
Cesari, M;Kritchevsky, SB;Pahor, M
定义通常步态速度的临床相关切点，并研究其对老年人健康相关事件的预测价值。前瞻性队列研究。健康、衰老和身体成分研究。三千四十七名功能良好的老年人（平均年龄74.2岁）。在基线时评估6米的正常步态速度。参与者被随机分为两组，以确定（样本A， n= 2031），然后验证（样本B， n= 1016）通常的步态-速度临界值。根据A样本的步态速度计算持续下肢受限事件发生率（平均随访4.9年）。根据持续下肢受限事件确定临界点（定义高风险（< 1 m/s）和低风险（>= 1 m/s）组）。在样本B中，使用Cox回归分析评估已确定的主要健康相关事件（持续性严重下肢受限、死亡和住院）切点的预测价值。风险组和健康相关结果之间存在分级反应。高危组患者出现持续性下肢受限（RR= 2.20, 95%可信区间(CI)=1.76-2.74）、持续性重度下肢受限（RR=2.29, 95% CI=1.63-3.20）、死亡（RR=1.64, 95% CI=1.14-2.37）和住院（RR=1.48, 95% CI=1.02-2.13）的风险高于低危组。在功能良好的老年人中，通常步态速度低于1米/秒可识别出健康相关结果的高风险人群。提供临床有意义的通常步态速度切点可以促进其在临床和研究环境中的使用。
To define clinically relevant cutpoints for usual gait speed and to investigate their predictive value for health-related events in older persons.Prospective cohort study.Health, Aging and Body Composition Study.Three thousand forty-seven well-functioning older persons (mean age 74.2).Usual gait speed on a 6-m course was assessed at baseline. Participants were randomly divided into two groups to identify (Sample A; n=2,031) and then validate (Sample B; n=1,016) usual gait-speed cutpoints. Rates of persistent lower extremity limitation events (mean follow-up 4.9 years) were calculated according to gait speed in Sample A. A cutpoint (defining high- (< 1 m/s) and low risk (>= 1 m/s) groups) was identified based on persistent lower extremity limitation events. The predictive value of the identified cutpoints for major health-related events (persistent severe lower extremity limitation, death, and hospitalization) was evaluated in Sample B using Cox regression analyses.A graded response was seen between risk groups and health-related outcomes. Participants in the high-risk group had a higher risk of persistent lower extremity limitation (rate ratio (RR)=2.20, 95% confidence interval (CI)=1.76-2.74), persistent severe lower extremity limitation (RR=2.29, 95% CI=1.63-3.20), death (RR=1.64, 95% CI=1.14-2.37), and hospitalization (RR=1.48, 95% CI=1.02-2.13) than those in the low-risk group.Usual gait speed of less than 1 m/s identifies persons at high risk of health-related outcomes in well-functioning older people. Provision of a clinically meaningful cutpoint for usual gait speed may facilitate its use in clinical and research settings.