M U Pérez-Zepeda1, J G González-Chavero2, R Salinas-Martinez2, L M Gutiérrez-Robledo1. 1. Clinical and Epidemiologic Research Department at Instituto Nacional de Geriatría, Mexico City, México. 2. Centro Regional para el Estudio del Adulto Mayor, Departamento de Medicina Interna, Hospital Universitario "Doctor José Eleuterio González", Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Abstract
BACKGROUND: Physical performance tests play a major role in the geriatric assessment. In particular, gait speed has shown to be useful for predicting adverse outcomes. However, risk factors for slow gait speed (slowness) are not clearly described. OBJECTIVES: To determine risk factors associated with slowness in Mexican older adults. DESIGN: A two-step process was adopted for exploring the antecedent risk factors of slow gait speed. First, the cut-off values for gait speed were determined in a representative sample of Mexican older adults. Then, antecedent risk factors of slow gait speed (defined using the identified cut-points) were explored in a nested, cohort case-control study. SETTING PARTICIPANTS: One representative sample of a cross-sectional survey for the first step and the Mexican Health and Aging Study (a cohort characterized by a 10-year follow-up). MEASUREMENTS: A 4-meter usual gait speed test was conducted. Lowest gender and height-stratified groups were considered as defining slow gait speed. Sociodemographic characteristics, comorbidities, psychological and health-care related variables were explored to find those associated with the subsequent development of slow gait speed. Unadjusted and adjusted logistic regression models were performed. RESULTS: In the final model, age, diabetes, hypertension, and history of fractures were associated with the development of slow gait speed. CONCLUSIONS: Early identification of subjects at risk of developing slow gait speed may halt the path to disability due to the robust association of this physical performance test with functional decline.
BACKGROUND: Physical performance tests play a major role in the geriatric assessment. In particular, gait speed has shown to be useful for predicting adverse outcomes. However, risk factors for slow gait speed (slowness) are not clearly described. OBJECTIVES: To determine risk factors associated with slowness in Mexican older adults. DESIGN: A two-step process was adopted for exploring the antecedent risk factors of slow gait speed. First, the cut-off values for gait speed were determined in a representative sample of Mexican older adults. Then, antecedent risk factors of slow gait speed (defined using the identified cut-points) were explored in a nested, cohort case-control study. SETTING PARTICIPANTS: One representative sample of a cross-sectional survey for the first step and the Mexican Health and Aging Study (a cohort characterized by a 10-year follow-up). MEASUREMENTS: A 4-meter usual gait speed test was conducted. Lowest gender and height-stratified groups were considered as defining slow gait speed. Sociodemographic characteristics, comorbidities, psychological and health-care related variables were explored to find those associated with the subsequent development of slow gait speed. Unadjusted and adjusted logistic regression models were performed. RESULTS: In the final model, age, diabetes, hypertension, and history of fractures were associated with the development of slow gait speed. CONCLUSIONS: Early identification of subjects at risk of developing slow gait speed may halt the path to disability due to the robust association of this physical performance test with functional decline.
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