Dataset Information

Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults.

ABSTRACT: To determine the degree to which self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) are associated with fall status among community-dwelling older adults.WS and 1-year falls history data were collected on 217 community-dwelling older adults (median age = 82, range 65-93 years) at a local outpatient PT clinic and local retirement communities and senior centers. WSR was calculated as a difference (WSRdiff = MWS - SSWS) and ratio (WSRratio = MWS/SSWS).SSWS (P < 0.001), MWS (P < 0.001), and WSRdiff (P < 0.01) were associated with fall status. The cutpoints identified were 0.76 m/s for SSWS (65.4% sensitivity, 70.9% specificity), 1.13 m/s for MWS (76.6% sensitivity, 60.0% specificity), and 0.24 m/s for WSRdiff (56.1% sensitivity, 70.9% specificity). SSWS and MWS better discriminated between fallers and non-fallers (SSWS: AUC = 0.69, MWS: AUC = 0.71) than WSRdiff (AUC = 0.64).SSWS and MWS seem to be equally informative measures for assessing fall status in community-dwelling older adults. Older adults with SSWSs less than 0.76 m/s and those with MWSs less than 1.13 m/s may benefit from further fall risk assessment. Combining SSWS and MWS to calculate an individual's WSR does not provide additional insight into fall status in this population.Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Describe the different methods for calculating walking speed reserve and discuss the potential of the metric as an outcome measure; (2) Explain the degree to which self-selected walking speed, maximal walking speed, and walking speed reserve are associated with fall status among community-dwelling older adults; and (3) Discuss potential limitations to using walking speed reserve to identify fall status in populations without mobility restrictions.Advanced: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.

SUBMITTER: Middleton A

PROVIDER: S-EPMC4912425 | biostudies-literature | 2016 Jul

REPOSITORIES: biostudies-literature

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Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults.

Middleton Addie A Fulk George D GD Herter Troy M TM Beets Michael W MW Donley Jonathan J Fritz Stacy L SL

American journal of physical medicine & rehabilitation 20160701 7

<h4>Objective</h4>To determine the degree to which self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) are associated with fall status among community-dwelling older adults.<h4>Design</h4>WS and 1-year falls history data were collected on 217 community-dwelling older adults (median age = 82, range 65-93 years) at a local outpatient PT clinic and local retirement communities and senior centers. WSR was calculated as a difference (WSRdiff = MWS - SSWS) ...[more]

PMID: 27003205

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Project description:BackgroundA literature review reveals that studies on walking and fall occurrences in the context of cancer have predominantly centered on geriatric patients. Nonetheless, cancer patients of all ages are susceptible to such risks. Both cancer and its treatments contribute to significant risk factors for disturbances in walking and falls, encompassing muscle weakness, impaired balance, reduced proprioception, cognitive impairment, and functional limitations.Aimto assess walking speed and the risk of falls among patients undergoing surgery for the most common malignancies: breast (BU), lung (P), colorectal (DS), and reproductive organs (G).Material and methodsAn observational study was conducted using a cohort design. A total of 176 individuals participated in the study, including 139 cancer patients, who were divided into four groups: BU (N = 30), P (N = 35), DS (N = 35), and G (N = 39), as well as 37 healthy volunteers in the control group (C, N = 37). All participants underwent an assessment of walking speed using BTS G-WALK® and an evaluation of the number of falls and the risk of falling using a Fall Control Card.ResultsThere was a significant decrease in walking speed after surgery compared to the time before surgery, from 2.7% in the BU group, through 9.3% in the P group, and 19.2% in the DS group, to 30.0% in the G group. At the same time, for groups G and DS, the average walking speed fell below 1.0 m/s, amounting to 0.84 m/s and 0.97 m/s, respectively, in the measurement after the surgery and 0.95 m/s and 1.0 m/s in the follow-up measurement. Falling occurred in all the groups except for the BU group. The created logistic regression model showed that increasing the walking speed measured after the procedure (study 2) by 1 m/s reduces the risk of falling by approximately 500 times (OR = 0.002). Limitations in daily activity were observed in the follow-up examination (study 3) in 75% of patients.ConclusionsSurgical intervention has an impact on walking speed, and being part of the study group influences the risk of falling. Further research is needed to determine the precise risk of falls in cancer patients.

Project description:BackgroundMaintaining both walking speed and cognitive function is essential for active, healthy aging. This study investigated age-related differences in walking speed and global cognitive function with aging and the association between them among older adults residing in the developing country of China.MethodsThis cross-sectional study measured usual (UWS) and maximal walking speed (MWS) of participants for six meters. The Chinese version of the Montreal Cognitive Assessment was used to evaluate global cognition through in-person interviews. Analyses of variance were used to compare the differences in UWS, MWS, and global cognition between genders and age groups. Multiple linear regression models were used to determine the association between walking speed and global cognitive function.ResultsIn total, 791 Chinese adults (252 men and 539 women) aged 60-89 years were included in this study. Markedly slowed UWS and worse global cognitive function scores were observed for both genders among adults ≥80 years of age. MWS slowed considerably in men ≥85 years of age and in women ≥80 years of age. There was a significant gender difference in MWS-with men walking faster than women-but not in UWS. Linear regression analysis adjusted for the confounding factors of gender, height, weight, years of education, and chronic disease indicated that MWS, but not UWS, was significantly associated with global cognitive function (β = 0.086, [0.177, 1.657], P = 0.015) such that slower maximal walking speed was associated with poorer cognitive performance. This association was statistically significant only for adults aged 75-79 years (β = 0.261 [0.647, 4.592], P = 0.010).ConclusionWalking speed was slower in the older age groups. Global cognitive function deteriorated markedly after 80 years of age. After controlling for confounding variables, slower MWS, but not UWS, was associated with poorer global cognitive function. MWS may serve as a potential indicator for earlier identification of poor cognition and motoric cognitive risk syndrome in an older Chinese population.

Dataset Information

Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults.

Publications

Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults.

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