居家步态速度评估：老年人的常模数据和种族/民族相关性。
Home-Based Gait Speed Assessment: Normative Data and Racial/Ethnic Correlates Among Older Adults.
机构信息
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY.
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY.
出版信息
J Am Med Dir Assoc. 2019 Oct;20(10):1224-1229. doi: 10.1016/j.jamda.2019.06.002. Epub 2019 Aug 5.
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.
目的
确定老年人的家庭步行速度表现及其与社会人口统计学和健康相关因素的关系。
设计
对具有全国代表性的美国人群样本进行的横断面分析。
地点和参与者
健康与退休研究（HRS）参与者的家庭。
方法
汇总了来自 HRS 2006 年和 2008 年两个波次的 6983 名年龄≥65 岁（平均年龄 74.8±6.9 岁，54.2%为女性）个体的家庭行走测试数据。根据人口统计学和临床分组确定正常步伐的步行速度平均值；研究了步行速度与人口统计学、社会经济地位和健康因素的关系。使用基于人口统计学的截定点评分以及常用的推荐截定点评分（100 或 60cm/s）来定义基线时的缓慢步态状况，预测 4 年死亡率。
结果
女性的家庭步行速度（cm/s）平均值低于男性（差异为 9.6%），年龄较大者低于年龄较小者（差异为 18.0%），非裔美国人低于白人（差异为 20.5%），西班牙裔低于非西班牙裔（差异为 10.3%）。在性别内部，按年龄组、种族和民族划分的差异仍然显著（P<0.001）。速度较慢与非裔美国人种族和所有健康问题有关；速度较快与较高的社会经济地位和饮酒有关。缓慢的步态状态可预测 4 年死亡率。总体而言，基于人口统计学特征定义的缓慢步态截定点具有更高的预测准确性。
结论和意义
在家中测量的平均步行速度在按性别、年龄、种族、民族、健康状况以及这些因素的组合定义的美国老年（年龄≥65 岁）居民人群组之间存在差异，并且当速度明显慢于基于人群的标准时可预测 4 年死亡率。这些发现可能有助于研究人员和临床医生确定社区环境中老年人的正常和异常步态表现。
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