Home-Based Gait Speed Assessment: Normative Data and Racial/Ethnic Correlates Among Older Adults

David A. Boulifard, Emmeline I. Ayers, Joe Verghese

Research output: Contribution to journalArticle

Abstract

Objectives: To determine home-based gait speed performance and its associations with sociodemographic and health-related factors among older adults. Design: Cross-sectional analysis of a nationally representative US population sample. Setting and participants: Homes of Health and Retirement Study (HRS) participants. Methods: Walk test data measured at home over 2.5 m were aggregated for 6983 individuals, aged ≥65 years (mean age 74.8 ± 6.9 years, 54.2% women), from the 2006 and 2008 HRS waves. Means for gait speed at normal pace were determined for demographic and clinical groupings; association of gait speed with demographic, socioeconomic status, and health factors were examined. Four-year mortality was predicted from baseline slow gait status defined using demographic-based cutoff scores as well as commonly recommended cutoff scores (100 or 60 cm/s). Results: Home-based gait speed (cm/s) means were lower for female than male (9.6% difference), older than younger (18.0% difference), African American than white (20.5% difference), and Hispanic than Non-Hispanic (10.3% difference) participants. Differences by age group, race, and ethnicity remained significant within sexes (P <.001). Lower speed was associated with African American race and all health problems; higher speed was associated with higher socioeconomic status and alcohol consumption. Four-year mortality was predicted by slow gait status. Predictive validity was, in general, higher for slow gait cutoff scores defined by demographic characteristics. Conclusions and implications: Mean gait speed measured at home differs among older (aged ≥65 years) US resident population groups defined by sex, age, race, ethnicity, health status, and combinations of these factors, and predicts 4-year mortality when substantially slower than group-based norms. These findings may assist researchers and clinicians in determining normal and abnormal gait performance in older adults in community settings.

Original languageEnglish (US)
JournalJournal of the American Medical Directors Association
DOIs
StatePublished - Jan 1 2019

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Gait
Demography
Health
Retirement
Social Class
African Americans
Mortality
Population Groups
Hispanic Americans
Alcohol Drinking
Health Status
Age Groups
Cross-Sectional Studies
Research Personnel
Walking Speed
Population

Keywords

  • demographics
  • Gait speed
  • medical conditions
  • mortality
  • race disparities
  • socioeconomic status

ASJC Scopus subject areas

  • Nursing(all)
  • Health Policy
  • Geriatrics and Gerontology

Cite this

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title = "Home-Based Gait Speed Assessment: Normative Data and Racial/Ethnic Correlates Among Older Adults",
abstract = "Objectives: To determine home-based gait speed performance and its associations with sociodemographic and health-related factors among older adults. Design: Cross-sectional analysis of a nationally representative US population sample. Setting and participants: Homes of Health and Retirement Study (HRS) participants. Methods: Walk test data measured at home over 2.5 m were aggregated for 6983 individuals, aged ≥65 years (mean age 74.8 ± 6.9 years, 54.2{\%} women), from the 2006 and 2008 HRS waves. Means for gait speed at normal pace were determined for demographic and clinical groupings; association of gait speed with demographic, socioeconomic status, and health factors were examined. Four-year mortality was predicted from baseline slow gait status defined using demographic-based cutoff scores as well as commonly recommended cutoff scores (100 or 60 cm/s). Results: Home-based gait speed (cm/s) means were lower for female than male (9.6{\%} difference), older than younger (18.0{\%} difference), African American than white (20.5{\%} difference), and Hispanic than Non-Hispanic (10.3{\%} difference) participants. Differences by age group, race, and ethnicity remained significant within sexes (P <.001). Lower speed was associated with African American race and all health problems; higher speed was associated with higher socioeconomic status and alcohol consumption. Four-year mortality was predicted by slow gait status. Predictive validity was, in general, higher for slow gait cutoff scores defined by demographic characteristics. Conclusions and implications: Mean gait speed measured at home differs among older (aged ≥65 years) US resident population groups defined by sex, age, race, ethnicity, health status, and combinations of these factors, and predicts 4-year mortality when substantially slower than group-based norms. These findings may assist researchers and clinicians in determining normal and abnormal gait performance in older adults in community settings.",
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N2 - Objectives: To determine home-based gait speed performance and its associations with sociodemographic and health-related factors among older adults. Design: Cross-sectional analysis of a nationally representative US population sample. Setting and participants: Homes of Health and Retirement Study (HRS) participants. Methods: Walk test data measured at home over 2.5 m were aggregated for 6983 individuals, aged ≥65 years (mean age 74.8 ± 6.9 years, 54.2% women), from the 2006 and 2008 HRS waves. Means for gait speed at normal pace were determined for demographic and clinical groupings; association of gait speed with demographic, socioeconomic status, and health factors were examined. Four-year mortality was predicted from baseline slow gait status defined using demographic-based cutoff scores as well as commonly recommended cutoff scores (100 or 60 cm/s). Results: Home-based gait speed (cm/s) means were lower for female than male (9.6% difference), older than younger (18.0% difference), African American than white (20.5% difference), and Hispanic than Non-Hispanic (10.3% difference) participants. Differences by age group, race, and ethnicity remained significant within sexes (P <.001). Lower speed was associated with African American race and all health problems; higher speed was associated with higher socioeconomic status and alcohol consumption. Four-year mortality was predicted by slow gait status. Predictive validity was, in general, higher for slow gait cutoff scores defined by demographic characteristics. Conclusions and implications: Mean gait speed measured at home differs among older (aged ≥65 years) US resident population groups defined by sex, age, race, ethnicity, health status, and combinations of these factors, and predicts 4-year mortality when substantially slower than group-based norms. These findings may assist researchers and clinicians in determining normal and abnormal gait performance in older adults in community settings.

AB - Objectives: To determine home-based gait speed performance and its associations with sociodemographic and health-related factors among older adults. Design: Cross-sectional analysis of a nationally representative US population sample. Setting and participants: Homes of Health and Retirement Study (HRS) participants. Methods: Walk test data measured at home over 2.5 m were aggregated for 6983 individuals, aged ≥65 years (mean age 74.8 ± 6.9 years, 54.2% women), from the 2006 and 2008 HRS waves. Means for gait speed at normal pace were determined for demographic and clinical groupings; association of gait speed with demographic, socioeconomic status, and health factors were examined. Four-year mortality was predicted from baseline slow gait status defined using demographic-based cutoff scores as well as commonly recommended cutoff scores (100 or 60 cm/s). Results: Home-based gait speed (cm/s) means were lower for female than male (9.6% difference), older than younger (18.0% difference), African American than white (20.5% difference), and Hispanic than Non-Hispanic (10.3% difference) participants. Differences by age group, race, and ethnicity remained significant within sexes (P <.001). Lower speed was associated with African American race and all health problems; higher speed was associated with higher socioeconomic status and alcohol consumption. Four-year mortality was predicted by slow gait status. Predictive validity was, in general, higher for slow gait cutoff scores defined by demographic characteristics. Conclusions and implications: Mean gait speed measured at home differs among older (aged ≥65 years) US resident population groups defined by sex, age, race, ethnicity, health status, and combinations of these factors, and predicts 4-year mortality when substantially slower than group-based norms. These findings may assist researchers and clinicians in determining normal and abnormal gait performance in older adults in community settings.

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