Pasma Jantsje H, Stijntjes Marjon, Ou Shan Shan, Blauw Gerard J, Meskers Carel G M, Maier Andrea B
Department of Rehabilitation Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Age (Dordr). 2014;36(6):9736. doi: 10.1007/s11357-014-9736-y. Epub 2014 Dec 6.
Walking speed is shown to be an important indicator of the health status and function in older adults and part of the comprehensive geriatric assessment in clinical practice. The present study aimed to assess the influence of different assessment methods on walking speed and its association with the key aspects of poor health status, i.e., the presence of low cognitive performance and cardiopulmonary disease. In 288 community-dwelling elderly (mean age 82.2 ± 7.1 years) referred to a geriatric outpatient clinic, walking speed was assessed with the 4-m, 10-m, and 6-min walking tests. The mean walking speed assessed with the 10-m walking test was higher compared to the 4-m and 6-min walking tests (mean difference (95% CI) 0.11 m/s (0.10; 0.13) and 0.08 m/s (0.04; 0.13), respectively). No significant difference was found in the walking speed assessed with the 4-m compared to the 6-min walking test (mean difference (95% CI) -0.03 m/s (-0.08; 0.03)). ICCs showed excellent agreement of the 4-m with the 10-m walking test and fair to good agreement of the 6-min with the 4-m as well as 10-m walking test. The presence of low cognitive performance was negatively associated with walking speed, with the highest effect size for the 4-m walking test. The presence of cardiopulmonary disease was negatively associated with walking speed as well, with the highest effect size for the 6-min walking test. In conclusion, in the clinically relevant population of elderly outpatients, walking speed and its interpretation depends on the assessment method, which therefore cannot be used interchangeably in clinical practice.
步行速度被证明是老年人健康状况和功能的重要指标,也是临床实践中综合老年评估的一部分。本研究旨在评估不同评估方法对步行速度的影响及其与健康状况不佳的关键方面(即认知功能低下和心肺疾病的存在)的关联。在转诊至老年门诊的288名社区居住老年人(平均年龄82.2±7.1岁)中,采用4米、10米和6分钟步行测试评估步行速度。与4米和6分钟步行测试相比,10米步行测试评估的平均步行速度更高(平均差异(95%CI)分别为0.11米/秒(0.10;0.13)和0.08米/秒(0.04;0.13))。4米步行测试与6分钟步行测试评估的步行速度无显著差异(平均差异(95%CI)为-0.03米/秒(-0.08;0.03))。组内相关系数显示,4米步行测试与10米步行测试具有极好的一致性,6分钟步行测试与4米以及10米步行测试具有中等至良好的一致性。认知功能低下与步行速度呈负相关,4米步行测试的效应量最高。心肺疾病的存在也与步行速度呈负相关,6分钟步行测试的效应量最高。总之,在临床相关的老年门诊患者群体中,步行速度及其解读取决于评估方法,因此在临床实践中不能互换使用。