Home-Based Gait Speed Assessment: Normative Data and Racial/Ethnic Correlates Among Older Adults.
David A Boulifard, Emmeline Ayers, Joe Verghese
PMID 31395494WHAT IT FOUND
Older adults walking at normal pace at home had lower gait speed with age, female sex, African-American or Hispanic status, and more health problems; slow speed predicted four-year death, so use group-specific norms rather than one universal cutoff.
Key findings
01Home normal-pace gait speed means were lower for female than male participants (75.6 vs. 83.2), older than younger participants (71.2 vs. 85.3), African-American than Caucasian participants (65.2 vs. 80.1), and Hispanic than non-Hispanic participants (71.6 vs. 79.4).
02After adjustment for risk factors, African-American participants still had lower gait speed than Caucasian participants, with the difference reduced from -14.9 to -9.6.
03Slow-gait cuts defined by race and ethnicity had the highest specificity and positive predictive value for four-year mortality, while standard 60 cm/s and 100 cm/s cuts had the lowest.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The normative sample excluded participants who used walking aids, so the speed values do not describe older adults who need a cane or walker. Race was limited to African-American and Caucasian groups, and other racial groups were excluded, so the norms do not cover all older adults. Health and behaviour factors were mostly self-reported, and the available survey variables may miss milder or undetected disease. The home walk course was only 2.5 m because homes often lack space, which is shorter than preferred for reliable gait measurement. The study is observational, so associations between slow gait and mortality do not show that improving gait speed will reduce death. Mortality vital status was reported by spouse, family member, or friend, not necessarily by medical records.
Declared interests
The analysis used Health and Retirement Study data sponsored by the National Institute on Aging and the Social Security Administration and conducted by the University of Michigan. The article does not report author conflicts of interest.
The easy way to misread this
Do not treat these home-based gait speed norms as universal clinical cutoffs or proof that slow walking causes death. The sample excluded people who used walking aids, and the study was observational.