Verghese Joe, Wang Cuiling, Allali Gilles, Holtzer Roee, Ayers Emmeline
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.
Department of Epidemiology, Albert Einstein College of Medicine, Bronx, NY.
J Am Med Dir Assoc. 2016 May 1;17(5):421-5. doi: 10.1016/j.jamda.2016.01.017. Epub 2016 Feb 26.
Despite the growing importance of slow gait as a universal screen of health, systematic investigation of risk factors for incident slow gait is lacking. Our objective was to identify potentially modifiable risk factors for incident slow gait.
Prospective cohort study.
The Health and Retirement Study, a nationally representative US sample.
A total of 2306 individuals age 65 and older (56.5% women) from the 2008 wave with timed walks at baseline and 4 years later.
Incident slow gait (walking speed 1 SD below age and sex means) was the outcome. Fifteen potentially modifiable medical and lifestyle risk factors were examined as predictors.
Incident slow gait developed in 243 participants (11%) at 4 years. Physical inactivity (adjusted relative risk [aRR] 1.94), cognitive impairment (aRR 1.77), muscle weakness (aRR 1.48), pain (aRR 1.45), obesity (aRR 1.35), vision (aRR 1.36), and falls (aRR 1.32) predicted increased risk of developing incident slow gait. Together, these risk factors accounted for 77% (95% confidence interval 14-95) of the Population Attributable Risk for incident slow gait.
A limited set of potentially modifiable risk factors is associated with new-onset slow gait in older adults. These findings provide a foundation for developing clinical guidelines and preventive interventions for slow gait.
尽管步速缓慢作为一种通用的健康筛查指标日益重要，但对步速缓慢发生风险因素的系统研究仍很缺乏。我们的目的是确定步速缓慢发生的潜在可改变风险因素。
前瞻性队列研究。
健康与退休研究，这是一个具有全国代表性的美国样本。
来自2008年队列的2306名65岁及以上的个体（56.5%为女性），在基线和4年后进行了定时步行测试。
步速缓慢发生（步行速度低于年龄和性别均值1个标准差）为研究结果。研究了15个潜在可改变的医学和生活方式风险因素作为预测因素。
4年时，243名参与者（11%）出现了步速缓慢发生。身体活动不足（调整后相对风险[aRR]为1.94）、认知障碍（aRR为1.77）、肌肉无力（aRR为1.48）、疼痛（aRR为1.45）、肥胖（aRR为1.35）、视力（aRR为1.36）和跌倒（aRR为1.32）预测了步速缓慢发生风险的增加。这些风险因素共同占步速缓慢发生的人群归因风险的77%（95%置信区间14-95）。
一组有限的潜在可改变风险因素与老年人新发步速缓慢有关。这些发现为制定步速缓慢的临床指南和预防干预措施提供了基础。
