步态速度的最佳切点是什么，能最好地区分有行动不便抱怨的社区居住的老年人和没有这些抱怨的老年人？肌少症定义和结局联盟的汇总分析。
What Cut-Point in Gait Speed Best Discriminates Community-Dwelling Older Adults With Mobility Complaints From Those Without? A Pooled Analysis From the Sarcopenia Definitions and Outcomes Consortium.
机构信息
California Pacific Medical Center Research Institute, San Francisco, USA.
Department of Epidemiology and Biostatistics, University of California San Francisco, USA.
出版信息
J Gerontol A Biol Sci Med Sci. 2021 Sep 13;76(10):e321-e327. doi: 10.1093/gerona/glab183.
BACKGROUND
Cut-points to define slow walking speed have largely been derived from expert opinion.
METHODS
Study participants (13 589 men and 5043 women aged ≥65years) had walking speed (m/s) measured over 4-6 m (mean ± SD: 1.20 ± 0.27 m/s in men and 0.94 ± 0.24 m/s in women.) Mobility limitation was defined as any self-reported difficulty with walking approximately 1/4 mile (prevalence: 12.6% men, 26.4% women). Sex-stratified classification and regression tree (CART) models with 10-fold cross-validation identified walking speed cut-points that optimally discriminated those who reported mobility limitation from those who did not.
RESULTS
Among 5043 women, CART analysis identified 2 cut-points, classifying 4144 (82.2%) with walking speed ≥0.75 m/s, which we labeled as "fast"; 478 (9.5%) as "intermediate" (walking speed ≥0.62 m/s but <0.75 m/s); and 421 (8.3%) as "slow" (walking speed <0.62 m/s). Among 13 589 men, CART analysis identified 3 cut-points, classifying 10 001 (73.6%) with walking speed ≥1.00 m/s ("very fast"); 2901 (21.3%) as "fast" (walking speed ≥0.74 m/s but <1.00 m/s); 497 (3.7%) as "intermediate" (walking speed ≥0.57 m/s but <0.74 m/s); and 190 (1.4%) as "slow" (walking speed <0.57 m/s). Prevalence of self-reported mobility limitation was lowest in the "fast" or "very fast" (11% for men and 19% for women) and highest in the "slow" (60.5% in men and 71.0% in women). Rounding the 2 slower cut-points to 0.60 m/s and 0.75 m/s reclassified very few participants.
CONCLUSIONS
Cut-points in walking speed of approximately 0.60 m/s and 0.75 m/s discriminate those with self-reported mobility limitation from those without.
背景
界定缓慢步行速度的切点主要源自专家意见。
方法
研究参与者（13589 名男性和 5043 名≥65 岁的女性）的步行速度（m/s）在 4-6m 范围内进行测量（男性的平均值±标准差为 1.20±0.27m/s，女性为 0.94±0.24m/s）。行动受限定义为任何自我报告的行走约 1/4 英里的困难（患病率：男性为 12.6%，女性为 26.4%）。性别分层分类和回归树（CART）模型与 10 倍交叉验证相结合，确定了最佳区分报告有行动受限和没有行动受限的步行速度切点。
结果
在 5043 名女性中，CART 分析确定了 2 个切点，将 4144 名（82.2%）行走速度≥0.75m/s 的女性归类为“快速”；478 名（9.5%）归类为“中等”（行走速度≥0.62m/s 但<0.75m/s）；421 名（8.3%）归类为“缓慢”（行走速度<0.62m/s）。在 13589 名男性中，CART 分析确定了 3 个切点，将 10001 名（73.6%）行走速度≥1.00m/s 的男性归类为“非常快”；2901 名（21.3%）归类为“快速”（行走速度≥0.74m/s 但<1.00m/s）；497 名（3.7%）归类为“中等”（行走速度≥0.57m/s 但<0.74m/s）；190 名（1.4%）归类为“缓慢”（行走速度<0.57m/s）。报告有行动受限的患病率在“快速”或“非常快”的人群中最低（男性为 11%，女性为 19%），而在“缓慢”的人群中最高（男性为 60.5%，女性为 71.0%）。将 2 个较慢的切点四舍五入至 0.60m/s 和 0.75m/s，重新分类的参与者很少。
结论
大约 0.60m/s 和 0.75m/s 的步行速度切点可区分有自我报告的行动受限者和无行动受限者。
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