Joe Verghese1,2, Emmeline Ayers1. 1. Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA. 2. Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
Abstract
BACKGROUND: While reports of mobility problems are common with aging, their relationship to new onset of slow gait is unknown. Our objective was to examine the validity of subjective motoric complaints for predicting the incidence of slow gait. METHODS: Ambulatory community-residing participants (mean age 76.6, 55% women) with gait speeds in the normal range enrolled in an aging cohort. Five subjective motoric complaints were assessed. Incident slow gait (walking speed 1 SD below age and sex means) was the primary outcome. RESULTS: Of the 548 participants at baseline, 90 had prevalent slow gait and 253 participants (73.7%) reported one or more subjective motoric complaints. Subjective motoric complaints were more common in women than men (1.78 vs 1.23). Over a median follow-up of 3.34 years, 68 participants developed new onset slow gait. All 5 questions predicted incident slow gait (adjusted hazard ratios varying from 2.26 to 4.44). More subjective motoric complaints were associated with increased risk of developing incident slow gait (hazard ratio per complaint 1.81). Predictive validity of subjective motoric complaints for incident slow gait was unchanged when using alternate outcome definitions, accounting for diagnostic misclassification, recall bias, or adjusting for multiple confounders. CONCLUSIONS: Subjective motoric complaints are a harbinger of mobility disability, and can help improve clinical risk assessments and identify high-risk individuals for interventions to prevent onset of slow gait.
BACKGROUND: While reports of mobility problems are common with aging, their relationship to new onset of slow gait is unknown. Our objective was to examine the validity of subjective motoric complaints for predicting the incidence of slow gait. METHODS: Ambulatory community-residing participants (mean age 76.6, 55% women) with gait speeds in the normal range enrolled in an aging cohort. Five subjective motoric complaints were assessed. Incident slow gait (walking speed 1 SD below age and sex means) was the primary outcome. RESULTS: Of the 548 participants at baseline, 90 had prevalent slow gait and 253 participants (73.7%) reported one or more subjective motoric complaints. Subjective motoric complaints were more common in women than men (1.78 vs 1.23). Over a median follow-up of 3.34 years, 68 participants developed new onset slow gait. All 5 questions predicted incident slow gait (adjusted hazard ratios varying from 2.26 to 4.44). More subjective motoric complaints were associated with increased risk of developing incident slow gait (hazard ratio per complaint 1.81). Predictive validity of subjective motoric complaints for incident slow gait was unchanged when using alternate outcome definitions, accounting for diagnostic misclassification, recall bias, or adjusting for multiple confounders. CONCLUSIONS: Subjective motoric complaints are a harbinger of mobility disability, and can help improve clinical risk assessments and identify high-risk individuals for interventions to prevent onset of slow gait.
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