Gait Speed as a Clinical Measure for Older Adults With Mobility Limitations

Gait speed has drawn increased attention as an indicator of healthy aging. It can be reliably measured, and it has been shown to be associated with functional factors such as falls risk and cognitive decline. While gait speed is increasingly popular as an indicator of overall function and a predictor of health outcomes, there is a lack of consensus on protocols for measuring gait speed, which makes it difficult to compare findings from different gait speed studies. There is also a lack of data on gait speed for individuals with mobility limitations. A forthcoming review in The Journals of Gerontology consolidates the research findings on gait speed assessment for older adults with mobility limitations.

The reviewers included only studies conducted in an inpatient or outpatient clinical setting with participants age 70 years or better. The diagnoses being treated in these settings included stroke, Parkinson’s disease, and orthopedic conditions requiring surgery. Other criteria for inclusion in the review were that the study included a minimum of 20 participants from the same population sample, and that participants were timed for gait speed over a distance of less than 50 feet on a level surface. Studies varied in their protocols in terms of distance, regarding whether participants had a moving start before being timed and the proportion of participants who used a mobility aid.

Unsurprisingly, mean gait speeds were slower for individuals with mobility limitations as compared to other samples of community-dwelling older adults. A surprising finding was that more-recent studies tended to show faster mean gait speeds. This may be evidence of the improving health of older adult populations, particularly when considering other published findings that suggest that, over the last few decades, average rates of functional decline are decreasing in the older adult population.

The authors examined which research variables related to gait speed and which did not. Factors that were not associated with gait speed across the studies included age, distance, whether a walking aid (such as a cane or walker) was permitted, and whether participants had a moving start or not. Gender was associated with gait speed, though it should be noted that none of the studies adjusted for height or weight in their analyses, so it is unclear whether gender or size is the relevant factor.

The review served to highlight some limitations in the overall literature, which suggest that reports of studies on gait speed will need to include more information in the future to allow for reviews and meta-analyses (which in turn will allow clinicians to draw conclusions about best practices from the literature). Few of the studies in the review provided information on the type of walking aid used by participants, for example, although it has been shown that the type of walking aid used influences mobility and speed.

Source:

Peel NM, Kuys SS, and Klein K. Gait speed as a measure in geriatric assessment in clinical settings: a systematic review. Journals of Gerontology A: Medical Sciences; (2012). DOI: 10.1093/gerona/gls174.

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