Gait Speed Predicts Incident Disability: A Pooled Analysis
Gait Speed Predicts Incident Disability: A Pooled Analysis
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DOI：
10.1093/gerona/glv126
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发表时间：
2016-01-01
影响因子：
5.1
通讯作者：
Studenski, Stephanie A.
中科院分区：
文献类型：
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作者：
Perera, Subashan;Patel, Kushang V.;Studenski, Stephanie A.
随着年龄的增长，功能独立是个人和社会的一个重要目标。简单的预后指标可以为健康促进和护理计划提供信息，但由于功能测量的异质性，证据受到限制。我们对 27,220 名 65 岁或以上社区居住老年人的七项研究的数据进行了汇总分析，他们的基线步态速度，随后是残疾和死亡率。结果是无法洗澡或穿衣或无法或依赖他人洗澡或穿衣； 3 年内行走 A1/4 - A1/2 英里或爬 10 级台阶有困难。基线步态较快的参与者发生残疾的发生率较低。在步态速度越来越快的亚组（定义为 0.2 m/s 宽的间隔，从 < 0.4 到千分之 1.4 m/s）中，男性的 3 年洗澡或穿衣依赖率从 10% 趋向于 1%，女性从 15% 趋向 1%，而男性的行动困难从 47% 趋向于 4%，女性从 40% 趋向于 6%。男性洗澡或穿衣依赖的速度每提高 0.1 m/s 的年龄调整相对风险比为 0.68 (0.57-0.81)，女性为 0.74 (0.66-0.82)；对于行动困难，男性：0.75（0.68-0.82），女性：0.73（0.67-0.80）。综合残疾和死亡率的结果相似。基于年龄、性别、种族、体重指数、既往住院情况和选定的慢性病的亚组的效果基本一致。在存在多种其他残疾危险因素的情况下，步态速度显着增加了接受者操作特征曲线下的面积。在老年人中，步态速度可以预测 3 年洗澡或穿衣依赖、行动困难以及残疾和死亡率的综合结果的发生率。
Functional independence with aging is an important goal for individuals and society. Simple prognostic indicators can inform health promotion and care planning, but evidence is limited by heterogeneity in measures of function.We performed a pooled analysis of data from seven studies of 27,220 community-dwelling older adults aged 65 or older with baseline gait speed, followed for disability and mortality. Outcomes were incident inability or dependence on another person in bathing or dressing; and difficulty walking A1/4 - A1/2 mile or climbing 10 steps within 3 years.Participants with faster baseline gait had lower rates of incident disability. In subgroups (defined by 0.2 m/s-wide intervals from < 0.4 to a parts per thousand yen1.4 m/s) with increasingly greater gait speed, 3-year rates of bathing or dressing dependence trended from 10% to 1% in men, and from 15% to 1% in women, while mobility difficulty trended from 47% to 4% in men and 40% to 6% in women. The age-adjusted relative risk ratio per 0.1 m/s greater speed for bathing or dressing dependence in men was 0.68 (0.57-0.81) and in women: 0.74 (0.66-0.82); for mobility difficulty, men: 0.75 (0.68-0.82), women: 0.73 (0.67-0.80). Results were similar for combined disability and mortality. Effects were largely consistent across subgroups based on age, gender, race, body mass index, prior hospitalization, and selected chronic conditions. In the presence of multiple other risk factors for disability, gait speed significantly increased the area under the receiver operator characteristic curve.In older adults, gait speed predicts 3 year incidence of bathing or dressing dependence, mobility difficulty, and a composite outcome of disability and mortality.