Advertisement

Aging Clinical and Experimental Research

, Volume 31, Issue 1, pp 59–66 | Cite as

Estimation of reduced walking speed using simple measurements of physical and psychophysiological function in community-dwelling elderly people: a cross-sectional and longitudinal study

  • Takuji Adachi
  • Kuniyasu Kamiya
  • Yuji Kono
  • Kotaro Iwatsu
  • Yuko Shimizu
  • Ikumi Honda
  • Sumio YamadaEmail author
Original Article
  • 35 Downloads

Abstract

Background

Early detection of reduced mobility function is important in elderly people. Usual walking speed is useful to assess mobility function, but is often not feasible in a community setting.

Aims

This study aimed to explore a simple surrogate indicator of usual walking speed in elderly people.

Methods

The participants were 516 community-dwelling elderly people. As a baseline survey, the usual walking speed and candidates of surrogate indicators including physical function and psychophysiological function were measured. After 2 years, the occurrence of mobility limitation was assessed.

Results

In cross-sectional analysis, a linear regression model with maximum step length, age, and sex presented the most favourable adjusted R2 of 0.426 for estimating usual walking speed. Maximum step length (MSL) also showed good predictive accuracy for usual walking speed < 0.8 m/s {area under the curve [AUC] 0.908 [95% confidence interval (CI) 0.811, 1.000]} and < 1.0 m/s [AUC 0.883 (95% CI) 0.832, 0.933)] in receiver-operating characteristic (ROC) analysis. In longitudinal analysis, the predictive accuracy of MSL for mobility limitation [AUC 0.813 (95% CI 0.752, 0.874)] was similar to that of usual walking speed [AUC 0.808 (95% CI 0.747, 0.869)] in ROC analysis.

Conclusions and discussion

The results of this study suggest that MSL may serve as a simple surrogate indicator of UWS in elderly people.

Keywords

Screening test Walking speed Mobility limitation Community-dwelling elderly 

Notes

Funding

This study was supported by a grant from the Suzuken Memorial Foundation (Grant no. 14–021; clinical principal investigator: Yuko Shimizu) and by a Grant-in-Aid from the Japan Society for the Promotion of Science (Grant no. 26293446; clinical principal investigator: Ikumi Honda).

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Ethics Committee of the School of Health Sciences, Nagoya University (approval number 2012-0131).

Informed consent

Informed consent was obtained from all participants included in this study.

References

  1. 1.
    Hardy SE, Kang Y, Studenski SA et al (2011) Ability to walk 1/4 mile predicts subsequent disability, mortality, and health care costs. J Gen Intern Med 26:130–135.  https://doi.org/10.1007/s11606-010-1543-2 CrossRefGoogle Scholar
  2. 2.
    Cummings SR, Studenski S, Ferrucci L (2014) A diagnosis of dismobility–giving mobility clinical visibility: a Mobility Working Group recommendation. JAMA 311:2061–2062.  https://doi.org/10.1001/jama.2014.3033 CrossRefGoogle Scholar
  3. 3.
    Montero-Odasso M, Schapira M, Soriano ER et al (2005) Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. J Gerontol A Biol Sci Med Sci 60:1304–1309.  https://doi.org/10.1093/gerona/60.10.1304 CrossRefGoogle Scholar
  4. 4.
    Shinkai S, Watanabe S, Kumagai S et al (2000) Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Age Ageing 29:441–446.  https://doi.org/10.1093/ageing/29.5.441 CrossRefGoogle Scholar
  5. 5.
    Studenski S, Perera S, Patel K et al (2011) Gait speed and survival in older adults. JAMA 305:50–58.  https://doi.org/10.1001/jama.2010.1923 CrossRefGoogle Scholar
  6. 6.
    Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 39:412–423.  https://doi.org/10.1093/ageing/afq034 CrossRefGoogle Scholar
  7. 7.
    Chen L-K, Liu L-K, Woo J et al (2014) Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 15:95–101.  https://doi.org/10.1016/j.jamda.2013.11.025 CrossRefGoogle Scholar
  8. 8.
    Shimada H, Makizako H, Doi T et al (2013) Combined prevalence of frailty and mild cognitive impairment in a population of elderly Japanese people. J Am Med Dir Assoc 14:518–524.  https://doi.org/10.1016/j.jamda.2013.03.010 CrossRefGoogle Scholar
  9. 9.
    Gale CR, Cooper C, Sayer AA (2015) Prevalence of frailty and disability: findings from the English longitudinal study of ageing. Age Ageing 44:162–165.  https://doi.org/10.1093/ageing/afu148 CrossRefGoogle Scholar
  10. 10.
    Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M56.  https://doi.org/10.1093/gerona/56.3.M146 CrossRefGoogle Scholar
  11. 11.
    Peters DM, Fritz SL, Krotish DE (2013) Assessing the reliability and validity of a shorter walk test compared with the 10-Meter Walk Test for measurements of gait speed in healthy, older adults. J Geriatr Phys Ther 36:24–30.  https://doi.org/10.1519/JPT.0b013e318248e20d CrossRefGoogle Scholar
  12. 12.
    Graham JE, Ostir GV, Fisher SR et al (2008) Assessing walking speed in clinical research: a systematic review. J Eval Clin Pract 14:552–562.  https://doi.org/10.1111/j.1365-2753.2007.00917.x CrossRefGoogle Scholar
  13. 13.
    Bongers KTJ, Schoon Y, Graauwmans MJ et al (2015) Safety, feasibility, and reliability of the maximal step length, gait speed, and chair test measured by seniors themselves: the senior step study. J Aging Phys Act 23:438–443.  https://doi.org/10.1123/japa.2013-0231 CrossRefGoogle Scholar
  14. 14.
    Saito T, Fujita N, Omori Y et al (2015) Which performance test is feasible to evaluate physical function in frail community-dwelling older people who have been certified as needing long-term care ? Rigakuryoho Gijutsu to Kenkyu 43:43–48 (in Japanese) Google Scholar
  15. 15.
    Buchner DM, Larson EB, Wagner EH et al (1996) Evidence for a non-linear relationship between leg strength and gait speed. Age Ageing 25:386–391.  https://doi.org/10.1093/ageing/25.5.386 CrossRefGoogle Scholar
  16. 16.
    Nishimura T, Arima K, Okabe T et al (2017) Usefulness of chair stand time as a surrogate of gait speed in diagnosing sarcopenia. Geriatr Gerontol Int 659–661.  https://doi.org/10.1111/ggi.12766
  17. 17.
    Medell JL, Alexander NB (2000) A clinical measure of maximal and rapid stepping in older women. J Gerontol Ser A Biol Sci Med Sci 55:M429–M433.  https://doi.org/10.1300/J074v12n01_07 CrossRefGoogle Scholar
  18. 18.
    Cho BL, Scarpace D, Alexander NB (2004) Tests of stepping as indicators of mobility, balance, and fall risk in balance-impaired older adults. J Am Geriatr Soc 52:1168–1173.  https://doi.org/10.1111/j.1532-5415.2004.52317.x CrossRefGoogle Scholar
  19. 19.
    Schoon Y, Weerdesteyn V, Stunnenberg A et al (2010) Sense and simplicity: maximum step length is also reliable, feasible, and valid in very old adults. J Am Geriatr Soc 58:2444–2445.  https://doi.org/10.1111/j.1532-5415.2010.03193.x CrossRefGoogle Scholar
  20. 20.
    Soumare A, Tavernier B, Alperovitch A et al (2009) A cross-sectional and longitudinal study of the relationship between walking speed and cognitive function in community-dwelling elderly people. J Gerontol A Biol Sci Med Sci 64:1058–1065.  https://doi.org/10.1093/gerona/glp077 CrossRefGoogle Scholar
  21. 21.
    Ble A, Volpato S, Zuliani G et al (2005) Executive function correlates with walking speed in older persons: The InCHIANTI study. J Am Geriatr Soc 53:410–415.  https://doi.org/10.1111/j.1532-5415.2005.53157.x CrossRefGoogle Scholar
  22. 22.
    Tiedemann A, Sherrington C, Lord SR (2005) Physiological and psychological predictors of walking speed in older community-dwelling people. Gerontology 51:390–395.  https://doi.org/10.1159/000088703 CrossRefGoogle Scholar
  23. 23.
    Verghese J, Wang C, Holtzer R (2011) Relationship of clinic-based gait speed measurement to limitations in community-based activities in older adults. Arch Phys Med Rehabil 92:844–846.  https://doi.org/10.1016/j.apmr.2010.12.030 CrossRefGoogle Scholar
  24. 24.
    Liu-Ambrose T, Pang MYC, Eng JJ (2007) Executive function is independently associated with performances of balance and mobility in community-dwelling older adults after mild stroke: Implications for falls prevention. Cerebrovasc Dis 23:203–210.  https://doi.org/10.1159/000097642 CrossRefGoogle Scholar
  25. 25.
    Bongers KTJ, Schoon Y, Graauwmans MJ et al (2015) The predictive value of gait speed and maximum step length for falling in community-dwelling older persons. Age Ageing 44:294–299.  https://doi.org/10.1093/ageing/afu151 CrossRefGoogle Scholar
  26. 26.
    Bongers KTJ, Schoon Y, Olde Rikkert MGM (2016) Feasibility of repeated self-measurements of maximum step length and gait speed by community-dwelling older persons. BMJ Open 6:e011538.  https://doi.org/10.1136/bmjopen-2016-011538 CrossRefGoogle Scholar
  27. 27.
    Morio Y, Omori Y, Izawa K et al (2007) The development of Functional Reach Test using the telescoping rod. Sogo Rehabil 35:487–493.  https://doi.org/10.11477/mf.1552100853 (in Japanese) Google Scholar
  28. 28.
    Duncan PW, Studenski S, Chandler J et al (1992) Functional reach: predictive validity in a sample of elderly male veterans. J Gerontol 47:M93-M98.  https://doi.org/10.1093/geronj/47.3.M93 CrossRefGoogle Scholar
  29. 29.
    Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198.  https://doi.org/10.1016/0022-3956(75)90026-6 CrossRefGoogle Scholar
  30. 30.
    Reitan RM (1958) Validity of the Trail Making Test as an indicator of organic brain damage. Percept Mot Skills 8:271–276.  https://doi.org/10.2466/PMS.8.7.271-276 CrossRefGoogle Scholar
  31. 31.
    Hoyl MT, Alessi CA, Harker JO et al (1999) Development and testing of a five-item version of the Geriatric Depression Scale. J Am Geriatr Soc 47:873–878.  https://doi.org/10.1111/j.1532-5415.1999.tb03848.x CrossRefGoogle Scholar
  32. 32.
    Hirota C, Watanabe M, Sun W et al (2010) Association between the Trail Making Test and physical performance in elderly Japanese. Geriatr Gerontol Int 10:40–47.  https://doi.org/10.1111/j.1447-0594.2009.00557.x CrossRefGoogle Scholar
  33. 33.
    Shimizu Y, Yamada S, Suzuki M et al (2010) Development of the performance measure for activities of daily living-8 for patients with congestive heart failure: a preliminary study. Gerontology 56:459–466.  https://doi.org/10.1159/000248628 CrossRefGoogle Scholar
  34. 34.
    Kamiya K, Sasou K, Fujita M et al (2013) Predictors for increasing eligibility level among home help service users in the Japanese long-term care insurance system. Biomed Res Int 2013:374130.  https://doi.org/10.1155/2013/374130 CrossRefGoogle Scholar
  35. 35.
    Buchner DM (2008) One lap around the track: the standard for mobility disability? J Gerontol A Biol Sci Med Sci 63:586–587.  https://doi.org/10.1093/gerona/63.6.586 CrossRefGoogle Scholar
  36. 36.
    Shirooka H, Nishiguchi S, Fukutani N et al (2017) Cognitive impairment is associated with the absence of fear of falling in community-dwelling frail older adults. Geriatr Gerontol Int 17:232–238.  https://doi.org/10.1111/ggi.12702 CrossRefGoogle Scholar
  37. 37.
    DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845.  https://doi.org/10.2307/2531595 CrossRefGoogle Scholar
  38. 38.
    Lindemann U, Lundin-Olsson L, Hauer K et al (2008) Maximum step length as a potential screening tool for falls in non-disabled older adults living in the community. Aging Clin Exp Res 20:394–399.  https://doi.org/10.1007/BF03325143 CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Takuji Adachi
    • 1
  • Kuniyasu Kamiya
    • 2
  • Yuji Kono
    • 3
  • Kotaro Iwatsu
    • 4
  • Yuko Shimizu
    • 5
  • Ikumi Honda
    • 6
  • Sumio Yamada
    • 5
    Email author
  1. 1.Program in Physical and Occupational TherapyNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Department of Hygiene and Public HealthOsaka Medical CollegeTakatsukiJapan
  3. 3.Department of RehabilitationFujita Health University Banbuntane Hotokukai HospitalNagoyaJapan
  4. 4.Department of RehabilitationHirakata Kohsai HospitalHirakataJapan
  5. 5.Department of Rehabilitation ScienceNagoya University Graduate School of MedicineNagoyaJapan
  6. 6.Department of NursingNagoya University Graduate School of MedicineNagoyaJapan

Personalised recommendations