Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, Kresge Building, Room K201, London, ON, N6A 5C1, Canada; Gait and Brain Laboratory, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada.
Gait and Brain Laboratory, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada; Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, N6C 0A7, Canada.
Ageing Res Rev. 2021 Mar;66:101253. doi: 10.1016/j.arr.2020.101253. Epub 2021 Jan 8.
Slow gait speed in older adults is associated with increased risk for falls and fractures, functional dependence, multimorbidity, and even mortality. The risk of these adverse outcomes can be reduced by intervening on potentially modifiable risk factors. The purpose of this systematic review was to identify potentially modifiable risk factors associated with slow gait speed and clinically meaningful gait speed decline in older community-dwelling adults.
Literature searches were conducted in MEDLINE, EMBASE, and CINAHL, Google Scholar, and in the bibliographies of retrieved articles.
Forty studies met the inclusion criteria for qualitative review. Study designs were cross-sectional and longitudinal. Operational definitions of 'slow gait' and 'meaningful gait speed decline' were variable and based on sample distributions (e.g. quartiles), external criteria (e.g. < 0.8 m/s), and dynamic changes over time (e.g. ≥ 0.05 m/s decline per year). Twenty-six potentially modifiable risk factors were assessed in at least two studies. The risk factors most commonly investigated and that showed significant associations with slow gait and/or meaningful gait speed decline include physical activity, education, body mass index-obesity, pain, and depression/depressive symptoms.
Our results suggest that there are modifiable targets to maintain gait speed that are amenable to potential treatment.
老年人步速缓慢与跌倒和骨折、功能依赖、多种疾病甚至死亡的风险增加有关。通过干预潜在的可改变的危险因素，可以降低这些不良后果的风险。本系统评价的目的是确定与老年人社区居住者步速缓慢和有临床意义的步速下降相关的潜在可改变的危险因素。
在 MEDLINE、EMBASE 和 CINAHL、Google Scholar 以及检索到的文章的参考文献中进行文献检索。
40 项研究符合定性综述的纳入标准。研究设计为横断面和纵向研究。“缓慢步态”和“有临床意义的步速下降”的操作定义是可变的，基于样本分布（例如四分位数）、外部标准（例如 < 0.8 m/s）和随时间的动态变化（例如每年下降≥0.05 m/s）。至少有两项研究评估了 26 个潜在可改变的危险因素。最常被调查的危险因素，以及与步速缓慢和/或有临床意义的步速下降有显著关联的危险因素，包括身体活动、教育、身体质量指数肥胖、疼痛和抑郁/抑郁症状。
我们的结果表明，有可改变的目标来维持步态速度，这是可以治疗的。
