Andrea L Rosso1, Jason L Sanders2, Alice M Arnold3, Robert M Boudreau4, Calvin H Hirsch5, Michelle C Carlson6, Caterina Rosano4, Stephen B Kritchevsky7, Anne B Newman4. 1. Department of Epidemiology, School of Public Health, University of Pittsburgh, Pennsylvania. alr143@pitt.edu. 2. Harvard Affiliated Emergency Medicine Residency, Massachusetts General Hospital & Brigham and Women's Hospital, Massachusetts. 3. Department of Biostatistics, School of Public Health, University of Washington, Seattle. 4. Department of Epidemiology, School of Public Health, University of Pittsburgh, Pennsylvania. 5. Division of General Medicine, University of California, Davis Medical Center, Sacramento. 6. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 7. The Sticht Center on Aging and Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina.
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.
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.
Authors: J M Guralnik; L Ferrucci; C F Pieper; S G Leveille; K S Markides; G V Ostir; S Studenski; L F Berkman; R B Wallace Journal: J Gerontol A Biol Sci Med Sci Date: 2000-04 Impact factor: 6.053
Authors: L Ferrucci; S Bandinelli; E Benvenuti; A Di Iorio; C Macchi; T B Harris; J M Guralnik Journal: J Am Geriatr Soc Date: 2000-12 Impact factor: 5.562
Authors: D H O'Leary; J F Polak; S K Wolfson; M G Bond; W Bommer; S Sheth; B M Psaty; A R Sharrett; T A Manolio Journal: Stroke Date: 1991-09 Impact factor: 7.914
Authors: Joshua I Barzilay; Richard A Kronmal; John S Gottdiener; Nicholas L Smith; Gregory L Burke; Russell Tracy; Peter J Savage; Michelle Carlson Journal: J Am Coll Cardiol Date: 2004-06-16 Impact factor: 24.094
Authors: W T Longstreth; Corinne Dulberg; Teri A Manolio; Michael R Lewis; Norman J Beauchamp; Daniel O'Leary; Jeff Carr; Curt D Furberg Journal: Stroke Date: 2002-10 Impact factor: 7.914
Authors: Anne B Newman; Robert M Boudreau; Barbara L Naydeck; Linda F Fried; Tamara B Harris Journal: J Gerontol A Biol Sci Med Sci Date: 2008-06 Impact factor: 6.053
Authors: Terrie E Moffitt; Daniel W Belsky; Andrea Danese; Richie Poulton; Avshalom Caspi Journal: J Gerontol A Biol Sci Med Sci Date: 2016-10-07 Impact factor: 6.053
Authors: Matthew D L O'Connell; Megan M Marron; Robert M Boudreau; Mark Canney; Jason L Sanders; Rose Anne Kenny; Stephen B Kritchevsky; Tamara B Harris; Anne B Newman Journal: J Gerontol A Biol Sci Med Sci Date: 2019-04-23 Impact factor: 6.053
Authors: Maria Theresa D Opina; Tina E Brinkley; Michelle Gordon; Mary F Lyles; Barbara J Nicklas Journal: J Gerontol A Biol Sci Med Sci Date: 2019-11-13 Impact factor: 6.053
Authors: Andrea L Rosso; Andrea L Metti; Kimberly Faulkner; Mark Redfern; Kristine Yaffe; Lenore Launer; C Elizabeth Shaaban; Neelesh K Nadkarni; Caterina Rosano Journal: J Alzheimers Dis Date: 2019 Impact factor: 4.472
Authors: Monty Montano; Shalender Bhasin; Richard T D'Aquila; Kristine M Erlandson; William J Evans; Nicholas T Funderburg; Amy Justice; Lishomwa C Ndhlovu; Bisola Ojikutu; Marco Pahor; Savita Pahwa; Alice S Ryan; Jennifer Schrack; Michael B Schultz; Paola Sebastiani; David A Sinclair; Julia Tripp; Bruce Walker; Julie A Womack; Raymond Yung; R Keith Reeves Journal: AIDS Res Hum Retroviruses Date: 2019-09-23 Impact factor: 2.205
Authors: Jennifer A Schrack; Vadim Zipunnikov; Eleanor M Simonsick; Stephanie Studenski; Luigi Ferrucci Journal: J Gerontol A Biol Sci Med Sci Date: 2016-02-05 Impact factor: 6.053
Authors: Teemu J Niiranen; Danielle M Enserro; Martin G Larson; Ramachandran S Vasan Journal: J Gerontol A Biol Sci Med Sci Date: 2019-10-04 Impact factor: 6.053
Authors: Ferenc Deak; Willard M Freeman; Zoltan Ungvari; Anna Csiszar; William E Sonntag Journal: J Gerontol A Biol Sci Med Sci Date: 2015-11-20 Impact factor: 6.053
Authors: John R Best; Teresa Liu-Ambrose; Robert M Boudreau; Hilsa N Ayonayon; Suzanne Satterfield; Eleanor M Simonsick; Stephanie Studenski; Kristine Yaffe; Anne B Newman; Caterina Rosano Journal: J Gerontol A Biol Sci Med Sci Date: 2016-04-10 Impact factor: 6.053