Department of Epidemiology and Biostatistics, University of California, Irvine, California.
Kaiser Permanente Division of Research Oakland, California.
J Geriatr Phys Ther. 2024;47(4):202-213. doi: 10.1519/JPT.0000000000000416. Epub 2024 Sep 18.
Clinicians use reference values to contextualize physical performance scores, but data are sparse in individuals 90 years and older and racial/ethnic diversity is limited in existing studies. Gait speed provides valuable information about an individual's health status. Slow gait speed is associated with falls, cognitive decline, and mortality. Here, we report gait speed reference values in a racially/ethnically diverse oldest-old cohort.
LifeAfter90 is a multiethnic cohort study of individuals 90 years and older. Participants are long-term members of an integrated healthcare delivery system without a dementia diagnosis at enrollment. We assessed gait speed using the 4-m walk test and calculated means, standard deviations, and percentiles by age, sex, assistive device use, and device type. We used linear regression to compare means by sex, age, device use and type, living situation and arrangement, and race/ethnicity.
The mean age of the 502 participants was 92.9 (range 90.1-102.8) years. Of these, 62.6% were women, 34.7% were college educated, 90.8% lived in a private residence, 20.9% self-reported as Asian, 22.5% as Black, 11.8% as Hispanic, 35.7% as White, and 9.2% as multiple, "other," or declined to state. The overall mean gait speed was 0.54 m/s (women = 0.51 m/s, men = 0.58 m/s). Mean gait speeds were 0.58 m/s, 0.53 m/s, and 0.48 m/s in the 90 to 91, 92 to 93, and 94+ age categories, respectively. In those without a device, mean gait speed was 0.63 m/s compared to 0.40 m/s in those with a device (cane = 0.44 m/s, walker = 0.37 m/s). Mean gait speed was significantly slower in women compared to men, age category 94+ compared to 90 to 91, participants with a device compared to those without, participants with a walker compared to a cane, and Black participants compared to Asian and White participants. However, differences by race/ethnicity were attenuated when chronic health conditions were considered.
Reference values developed from this multiethnic 90+ cohort will help clinicians interpret gait speed measures and tailor recommendations toward a 90+ population that is growing in number and in racial/ethnic diversity.
临床医生使用参考值来分析身体机能评分，但在 90 岁及以上人群中数据稀缺，而且现有研究的种族/民族多样性有限。步速提供了有关个体健康状况的有价值的信息。步速缓慢与跌倒、认知能力下降和死亡有关。在这里，我们报告了一个种族/民族多样化的最年长队列的步速参考值。
LifeAfter90 是一项针对 90 岁及以上人群的多民族队列研究。参与者是长期加入综合医疗服务系统的成员，在入组时没有痴呆症诊断。我们使用 4 米步行测试评估步速，并按年龄、性别、辅助设备使用情况和设备类型计算平均值、标准差和百分位数。我们使用线性回归比较性别、年龄、设备使用和类型、居住情况和安排以及种族/民族之间的平均值。
502 名参与者的平均年龄为 92.9（范围为 90.1-102.8）岁。其中，62.6%为女性，34.7%受过大学教育，90.8%居住在私人住宅中，20.9%自我报告为亚洲人，22.5%为黑人，11.8%为西班牙裔，35.7%为白人，9.2%为多种、“其他”或拒绝说明。总体平均步速为 0.54 m/s（女性为 0.51 m/s，男性为 0.58 m/s）。90 至 91 岁、92 至 93 岁和 94 岁以上年龄组的平均步速分别为 0.58 m/s、0.53 m/s 和 0.48 m/s。在没有设备的情况下，平均步速为 0.63 m/s，而使用设备的平均步速为 0.40 m/s（手杖为 0.44 m/s，助行器为 0.37 m/s）。与男性相比，女性的平均步速较慢，94 岁以上年龄组与 90 至 91 岁年龄组相比，使用设备的参与者与不使用设备的参与者相比，使用助行器的参与者与使用手杖的参与者相比，以及黑人参与者与亚洲人和白人参与者相比，平均步速均较慢。然而，当考虑慢性健康状况时，种族/民族差异会减弱。
从这个多民族 90 岁以上队列中得出的参考值将有助于临床医生解释步速测量值，并针对数量不断增加且种族/民族多样性不断增加的 90 岁以上人群提出建议。
