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Yang M, Leung LY, Lim ZY, Ang RW, Ip HM, Lee XQ, Lim KY, Teoh LC, Yeung MT. Reference Values for Habitual and Fast Gait Speed in Singapore Adults Aged 21 to 80. J Clin Med 2024; 13:3507. [PMID: 38930036 PMCID: PMC11205154 DOI: 10.3390/jcm13123507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/10/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Objectives: Gait speed indicates the individual's functional status and predicts overall health. This study aims to determine (1) the intra- and inter-rater and test-retest reliability of the dynamic 4 m gait speed test protocol; (2) establish the normative reference values of habitual and fast gait speeds in community-dwelling healthy Singaporean adults aged 21 to 80; and (3) explore the association of age, gender, height, weight, and body mass index (BMI) on gait speed. Methods: This prospective cross-sectional study recruited healthy ambulatory community-dwelling Singaporeans aged 21 to 80 who could ambulate independently without aid. Participants were excluded if they required walking aids; were pregnant; or had physical, medical, or cognitive conditions that may affect gait. Each participant completed at least two habitual and fast gait speed test trials via a 4 m walkway with a dynamic start. The data were analysed by descriptive statistics, the Mann-Whitney test, the Spearman coefficient, and the interclass correlation coefficient (ICC). Results: In total, 178 males and 201 females were included in the data analysis. The median age was 45.0 years [interquartile range (IQR) 26.2-59.0], and the median height was 1.64 metres (m) (IQR 1.58-1.70). The median habitual gait speed was 1.08 metre/second (m/s) (IQR 0.97-1.22), and the fast gait speed was 1.55 m/s (IQR 1.40-1.70). The ICC for reliability ranged from 0.84 to 0.99, indicating that the 4 m gait speed test had good-to-excellent reliability. Conclusions: Gait speeds were not influenced by gender but declined with age advancement. Age and height and age and BMI were weakly correlated to habitual and fast gait speed, respectively. We established the norm values for the 4 m gait speeds in Singapore and proved it to be a reliable gait speed assessment ready for immediate community applications.
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Affiliation(s)
- Mingxing Yang
- Allied Health, Singhealth Polyclinic, Singapore 150167, Singapore;
| | - Leik Yu Leung
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Zhi Yan Lim
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Richmond W. Ang
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Ho Man Ip
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Xin Qian Lee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Kellee Y. Lim
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Li Ching Teoh
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Meredith T. Yeung
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
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Kramer PA, Coen PM, Cawthon PM, Distefano G, Cummings SR, Goodpaster BH, Hepple RT, Kritchevsky SB, Shankland EG, Marcinek DJ, Toledo FGS, Duchowny KA, Ramos SV, Harrison S, Newman AB, Molina AJA. Skeletal Muscle Energetics Explain the Sex Disparity in Mobility Impairment in the Study of Muscle, Mobility and Aging. J Gerontol A Biol Sci Med Sci 2024; 79:glad283. [PMID: 38150179 PMCID: PMC10960628 DOI: 10.1093/gerona/glad283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Indexed: 12/28/2023] Open
Abstract
The age-related decline in muscle mitochondrial energetics contributes to the loss of mobility in older adults. Women experience a higher prevalence of mobility impairment compared to men, but it is unknown whether sex-specific differences in muscle energetics underlie this disparity. In the Study of Muscle, Mobility and Aging (SOMMA), muscle energetics were characterized using in vivo phosphorus-31 magnetic resonance spectroscopy and high-resolution respirometry of vastus lateralis biopsies in 773 participants (56.4% women, age 70-94 years). A Short Physical Performance Battery (SPPB) score ≤8 was used to define lower-extremity mobility impairment. Muscle mitochondrial energetics were lower in women compared to men (eg, Maximal Complex I&II OXPHOS: Women = 55.06 ± 15.95; Men = 65.80 ± 19.74; p < .001) and in individuals with mobility impairment compared to those without (eg, Maximal Complex I&II OXPHOS in women: SPPB ≥ 9 = 56.59 ± 16.22; SPPB ≤ 8 = 47.37 ± 11.85; p < .001). Muscle energetics were negatively associated with age only in men (eg, Maximal ETS capacity: R = -0.15, p = .02; age/sex interaction, p = .04), resulting in muscle energetics measures that were significantly lower in women than men in the 70-79 age group but not the 80+ age group. Similarly, the odds of mobility impairment were greater in women than men only in the 70-79 age group (70-79 age group, odds ratio [OR]age-adjusted = 1.78, 95% confidence interval [CI] = 1.03, 3.08, p = .038; 80+ age group, ORage-adjusted = 1.05, 95% CI = 0.52, 2.15, p = .89). Accounting for muscle energetics attenuated up to 75% of the greater odds of mobility impairment in women. Women had lower muscle mitochondrial energetics compared to men, which largely explain their greater odds of lower-extremity mobility impairment.
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Affiliation(s)
- Philip A Kramer
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Paul M Coen
- AdventHealth, Translational Research Institute, Orlando, Florida, USA
| | - Peggy M Cawthon
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | | | - Steven R Cummings
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Bret H Goodpaster
- AdventHealth, Translational Research Institute, Orlando, Florida, USA
| | - Russell T Hepple
- Department of Physical Therapy, University of Florida, Gainesville, Florida, USA
| | - Stephen B Kritchevsky
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Eric G Shankland
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - David J Marcinek
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Frederico G S Toledo
- Department of Medicine-Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kate A Duchowny
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Sofhia V Ramos
- AdventHealth, Translational Research Institute, Orlando, Florida, USA
| | - Stephanie Harrison
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anthony J A Molina
- Department of Medicine-Division of Geriatrics, Gerontology, and Palliative Care, University of California San Diego School of Medicine, La Jolla, California, USA
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Santos F, Renuy A, Ozguler A, Ribet C, Goldberg M, Zins M, Artaud F, Elbaz A. Norms for Usual and Fast Walking Speed in Adults 45-69 Years Old From the French General Population: Constances Study. J Am Med Dir Assoc 2024; 25:266-274. [PMID: 37944906 DOI: 10.1016/j.jamda.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/25/2023] [Accepted: 10/01/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES Walking speed (WS) represents an objective measure of motor function and health. We aimed to develop usual (UWS) and fast WS (FWS) norms for the general population using a regression-based approach, while considering age, sex, height, and education. DESIGN Cross-sectional analysis of a population-based study. SETTING AND PARTICIPANTS French Constances study (45-69 years). METHODS UWS/FWS were measured over 3 m (dynamic start) using photoelectric cells. We addressed selection effects (related to survey sampling and nonresponse) and missing data using a combination of inverse probability weighting (IPW) and multiple imputation (MI). Norms by sex, age, height, and education ( RESULTS Analyses are based on 44,772 participants (51.2% women) with a mean age of 56.8 years (SE = 0.2) for women and 57.3 years (SE = 0.2) for men, and a mean height of 161.4 cm (SE = 0.1) for women and 174.2 cm (SE = 0.1) for men after IPW/MI. WS estimates decreased after IPW/MI. The mean UWS was 116.9 cm/s (SE = 0.8) in women and 120.7 cm/s (SE = 0.8) in men, and the mean FWS was 168.7 cm/s (SE = 1.0) in women and 182.8 cm/s (SE = 1.2) in men. In the multiadjusted model, UWS/FWS decreased with age and increased with height and education. Men had faster FWS than women; they had slightly slower UWS than women in the low-education group, but there were no sex differences in the high-education group. CONCLUSIONS AND IMPLICATIONS We developed UWS/FWS norms by age, sex, height, and education for the French general population (45-69 years) that are available through a web app (https://cesp-proxy2.vjf.inserm.fr/NORMES-VM-EN/). These norms can be used to identify in midlife persons with lower motor performances than the general population, given their age, sex, height, and education, who are at higher risk of adverse outcomes.
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Affiliation(s)
- Félicia Santos
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805, Villejuif, France
| | - Adeline Renuy
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Anna Ozguler
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Céline Ribet
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Marcel Goldberg
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Marie Zins
- Inserm, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), UMS 011 « Population-based cohorts unit », Villejuif, France
| | - Fanny Artaud
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805, Villejuif, France
| | - Alexis Elbaz
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805, Villejuif, France.
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Sprague B, Zhu X, Rosso A, Verghese J, Delbaere K, Lipnicki D, Sachdev P, Ng T, Gwee X, Yap K, Kim KW, Han J, Oh D, Narazaki K, Chen T, Chen S, Brodaty H, Numbers K, Kochan N, Walker R, Paddick SM, Gureje O, Ojagbemi A, Bello T, Rosano C. Correlates of Gait Speed Among Older Adults From 6 Countries: Findings From the COSMIC Collaboration. J Gerontol A Biol Sci Med Sci 2023; 78:2396-2406. [PMID: 36975099 PMCID: PMC10692426 DOI: 10.1093/gerona/glad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Few studies have compared gait speed and its correlates among different ethnogeographic regions. The goals of this study were to describe usual and rapid gait speed, and identify their correlates across Australian, Asian, and African countries. METHODS We used data from 6 population-based cohorts of adults aged 65+ from 6 countries and 3 continents (N = 6 472), with samples ranging from 231 to 1 913. All cohorts are members of the Cohort Studies of Memory in an International Consortium collaboration. We investigated whether clinical (body mass index [BMI], hypertension, stroke, apolipoprotein status), psychological (cognition, mood, general health), and behavioral factors (smoking, drinking, physical activity) correlated with usual (N = 4 cohorts) and rapid gait speed (N = 3 cohorts) similarly across cohorts. Regression models were controlled for age, sex, and education, and were sex-stratified. RESULTS Age- and sex-standardized usual gait speed means ranged from 0.61 to 1.06 m/s and rapid gait speed means ranged from 1.16 to 1.64 m/s. Lower BMI and better cognitive function consistently correlated with faster gait speed in all cohorts. Less consistently, not having hypertension and greater physical activity engagement were associated with faster gait speed. Associations with mood, smoking, and drinking were largely nonsignificant. These patterns were not attenuated by demographics. There was limited evidence that the associations differed by sex, except physical activity, where the greater intensity was associated with usual gait among men but not women. CONCLUSIONS This study is among the first to describe the usual and rapid gait speeds across older adults in Africa, Asia, and Australia.
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Affiliation(s)
- Briana N Sprague
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
| | - Xiaonan Zhu
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, USA
- Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Tze Pin Ng
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Keng Bee Yap
- Department of Geriatric Medicine, Ng Teng Fong Hospital, Singapore, Singapore
| | - Ki-Woong Kim
- Department of Neuropsychiatry, Seoul National University, Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University, Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Dae Jong Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, Fukuoka, Japan
| | - Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai, China
| | - Sanmei Chen
- Department of Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Richard W Walker
- Department of Medicine, North Tyneside General Hospital, North Shields, UK
| | - Stella-Maria Paddick
- Translational and Clinical Research Institute; Newcastle University, Newcastle upon Tyne, UK
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Akin Ojagbemi
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Toyin Bello
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,USA
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Kramer PA, Coen PM, Cawthon PM, Distefano G, Cummings SR, Goodpaster BH, Hepple RT, Kritchevsky SB, Shankland EG, Marcinek DJ, Toledo FGS, Duchowny KA, Ramos SV, Harrison S, Newman AB, Molina AJA. Skeletal muscle energetics explain the sex disparity in mobility impairment in the Study of Muscle, Mobility and Aging (SOMMA). MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.08.23298271. [PMID: 37987007 PMCID: PMC10659490 DOI: 10.1101/2023.11.08.23298271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
The age-related decline in muscle mitochondrial energetics contributes to the loss of mobility in older adults. Women experience a higher prevalence of mobility impairment compared to men, but it is unknown whether sex-specific differences in muscle energetics underlie this disparity. In the Study of Muscle, Mobility and Aging (SOMMA), muscle energetics were characterized using in vivo phosphorus-31 magnetic resonance spectroscopy and high-resolution respirometry of vastus lateralis biopsies in 773 participants (56.4% women, age 70-94 years). A Short Physical Performance Battery score ≤ 8 was used to define lower-extremity mobility impairment. Muscle mitochondrial energetics were lower in women compared to men (e.g. Maximal Complex I&II OXPHOS: Women=55.06 +/- 15.95; Men=65.80 +/- 19.74; p<0.001) and in individuals with mobility impairment compared to those without (e.g., Maximal Complex I&II OXPHOS in women: SPPB≥9=56.59 +/- 16.22; SPPB≤8=47.37 +/- 11.85; p<0.001). Muscle energetics were negatively associated with age only in men (e.g., Maximal ETS capacity: R=-0.15, p=0.02; age/sex interaction, p=0.04), resulting in muscle energetics measures that were significantly lower in women than men in the 70-79 age group but not the 80+ age group. Similarly, the odds of mobility impairment were greater in women than men only in the 70-79 age group (70-79 age group, OR age-adjusted =1.78, 95% CI=1.03, 3.08, p=0.038; 80+ age group, OR age-adjusted =1.05, 95% CI=0.52, 2.15, p=0.89). Accounting for muscle energetics attenuated up to 75% of the greater odds of mobility impairment in women. Women had lower muscle mitochondrial energetics compared to men, which largely explain their greater odds of lower-extremity mobility impairment.
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Kittelson AJ, Loyd BJ. Personalized Reference Values for the Two-Minute Walk Test: An Analysis of Cross-Sectional Data From the National Institutes of Health Toolbox Study. Arch Phys Med Rehabil 2023; 104:1418-1424.e1. [PMID: 37037295 PMCID: PMC10524757 DOI: 10.1016/j.apmr.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 03/09/2023] [Accepted: 03/24/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVES To develop reference values for the Two-Minute Walk Test (TMWT) via 2 previously untested methods: (1) smooth age-based statistical models and (2) a neighbors-based approach accounting for age, sex, and height. DESIGN Cross-sectional observational study. SETTING National Institutes of Health Toolbox study sites across the United States. PARTICIPANTS A total of 1385 healthy, community dwelling adult participants (age 18-85 years) in the National Institutes of Health Toolbox study were included in this analysis. INTERVENTION None. MAIN OUTCOME MEASURES Reference values for TMWT were generated using 2 approaches: (1) Generalized Additive Models for Location Scale and Shape, wherein TMWT values were modeled as a smooth function of age, and (2) a semiparametric neighbors-based approach. The performance of references values was then adjudicated by examining precision (ie, the average interquartile or interdecile range of reference values), and coverage (ie, the proportion of realized values included within a given inter-percentile interval). Agreement between methods was examined by intraclass correlation coefficient. RESULTS Neighbors-based reference values demonstrated a smaller average interquartile range (149 ft; 95% confidence interval [CI], 146-152 ft), compared with age-based reference values (158 ft; 95% CI, 155-162 ft), but similar average interdecile range (neighbors-based: 369 ft; 95% CI, 360-377 ft; age-based: 374 ft; 95% CI, 366-383 ft). Coverage appeared accurate via both approaches. Agreement between approaches was high (intraclass correlation coefficient=0.96), although differences were apparent on a case-by-case basis. CONCLUSIONS Both age-based and neighbors-based reference values offer viable options for interpreting a person's TMWT performance. In this analysis, the neighbors-based approach (adjusting for height) yielded potentially clinically relevant differences in reference values for persons at extremes of height.
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Affiliation(s)
- Andrew J Kittelson
- School of Physical Therapy and Rehabilitation Science, The University of Montana - Missoula, MT
| | - Brian J Loyd
- School of Physical Therapy and Rehabilitation Science, The University of Montana - Missoula, MT.
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Le Noan-Lainé M, Artaud F, Ndoadoumgue AL, Ozguler A, Cœuret-Pellicer M, Ringa V, Elbaz A, Canonico M. Characteristics of reproductive history, use of exogenous hormones and walking speed among women: Data from the CONSTANCES French Cohort Study. Maturitas 2023; 170:42-50. [PMID: 36773499 DOI: 10.1016/j.maturitas.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/15/2022] [Accepted: 01/09/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVE To investigate the cross-sectional associations of reproductive history and use of exogenous hormones with fast walking speed (WS) in women. STUDY DESIGN Between 2012 and 2020, 33,892 French women aged 45 years or more, recruited at health centers, underwent physical function tests and self-reported information on reproductive history and use of exogenous hormones. Linear mixed models with the center as random intercept were used to estimate the association of exposures with WS. MAIN OUTCOME MEASURES Fast WS. RESULTS Mean WS was 172.2 cm/s. WS increased with age at menarche (β+1y = 0.23, 95 % confidence interval = 0.05 to 0.40), age at first birth (β+1y = 0.20, 95 % CI = 0.13 to 0.27) and duration of breastfeeding (βfor ≥10 vs ≤5months = 1.38; 95 % CI = 0.39 to 2.36). In addition, parity was quadratically associated with WS, with women with 3 children having the highest WS (p for U-shaped relationship < 0.01). Menopausal status had no impact on WS but age at menopause was positively associated with WS (β+5y = 0.52, 95 % CI = 0.17 to 0.87) and partly explained the deleterious impact of artificial menopause on WS. WS increased with reproductive lifetime duration (β+5y = 0.49, 95 % CI = 0.16 to 0.83) and decreased with time since onset of menopause (β+5y = -0.65, 95 % CI = -0.99 to -0.31). By contrast, there was no association of WS with oral contraception and postmenopausal hormone therapy. CONCLUSION Our findings suggest that reproductive life characteristics may be associated with WS and timing of exposure could play a role.
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Affiliation(s)
- Maryline Le Noan-Lainé
- Université Paris-Saclay, UVSQ, Inserm UMR1018, Équipe "Exposome, hérédité, cancer et santé", CESP, 94807 Villejuif, France
| | - Fanny Artaud
- Université Paris-Saclay, UVSQ, Inserm UMR1018, Équipe "Exposome, hérédité, cancer et santé", CESP, 94807 Villejuif, France
| | - Aude Laetitia Ndoadoumgue
- Université Paris-Saclay, UVSQ, Inserm UMR1018, Équipe "Exposome, hérédité, cancer et santé", CESP, 94807 Villejuif, France
| | - Anna Ozguler
- Inserm, UMS011, Population-Based Epidemiologic Cohorts, 94807 Villejuif, France
| | | | - Virginie Ringa
- Université Paris-Saclay, UVSQ, Inserm UMR1018, Équipe "Soins primaires et prévention", CESP, 94807 Villejuif, France
| | - Alexis Elbaz
- Université Paris-Saclay, UVSQ, Inserm UMR1018, Équipe "Exposome, hérédité, cancer et santé", CESP, 94807 Villejuif, France
| | - Marianne Canonico
- Université Paris-Saclay, UVSQ, Inserm UMR1018, Équipe "Exposome, hérédité, cancer et santé", CESP, 94807 Villejuif, France.
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Andrews AW, Vallabhajosula S, Boise S, Bohannon RW. Normal gait speed varies by age and sex but not by geographical region: a systematic review. J Physiother 2023; 69:47-52. [PMID: 36528509 DOI: 10.1016/j.jphys.2022.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/02/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022] Open
Abstract
QUESTIONS What are comfortable gait speed values for apparently healthy adults? How do these differ by age group, sex and geographical region? DESIGN Systematic review of observational studies with meta-analysis. PARTICIPANTS Apparently healthy, community-dwelling adults who have undergone measurement of comfortable gait speed. SEARCH METHOD Potentially relevant studies were identified in four databases. Extracted data from studies that satisfied the eligibility criteria were added to a database containing the same information from a meta-analysis published a decade ago. OUTCOME MEASURES The weighted mean comfortable gait speed was calculated along with the 95% confidence interval for each stratum of age/sex using a random-effects model. Mean gait speeds were further stratified by the continent where the study took place. Tests of homogeneity included I2 and prediction intervals. RESULTS Meta-analysis of data from 51,248 apparently healthy adults was stratified by age (in decades) and sex. Male gait speed slowed beyond age 50 years whereas female gait speed slowed beyond age 30 years. The weighted mean gait speed ranged from 97 cm/s (females aged ≥ 80 years) to 140 cm/s (males aged 40 to 49 years). The I2 values ranged from 0 to 34.07; prediction interval ranges varied from a low of 30 (125 to 155 cm/s; males aged 40 to 49 years) to a high of 77 (83 to 160 cm/s; females aged 60 to 69 years). There was considerable overlap in confidence intervals between continents for each sex/age group. CONCLUSIONS Comfortable gait speed slowed through the adult years, but males maintained a faster walking speed than females. Further stratification of comfortable gait speed by geographical region is not warranted.
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Affiliation(s)
| | | | - Sarah Boise
- Department of Physical Therapy Education, Elon University, Elon, USA
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Donatoni da Silva L, Shiel A, McIntosh C. Effects of Pilates on the risk of falls, gait, balance and functional mobility in healthy older adults: A randomised controlled trial. J Bodyw Mov Ther 2022; 30:30-41. [DOI: 10.1016/j.jbmt.2022.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 02/04/2022] [Indexed: 10/19/2022]
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Gait speed reference values in community-dwelling older adults - Cross-sectional analysis from the Rotterdam Study. Exp Gerontol 2021; 158:111646. [PMID: 34861357 DOI: 10.1016/j.exger.2021.111646] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Gait speed is a simple, inexpensive and clinically useful marker of physical function in older adults. We aimed to establish gait speed reference values for community-dwelling older adults. To this end, we further explored the association of age, sex and height with gait speed. METHODS This study included community-dwelling participants aged 50 years and over enrolled in the Rotterdam Study. Participants completed the gait protocol between 2009 and 2016. The mean gait speed was calculated for age and height groups, stratified by sex. Reference values for gait speed were calculated using a quantile regression model adjusted for sex, the non-linear effects of age and height, as well as the interaction between age and sex plus the interaction between age and height. RESULTS The study population included 4656 Dutch participants with a mean (standard deviation) age of 67.7 (9.5) years, comprising 2569 (55.2%) women. The mean height of the participants was 1.69 (0.10) meters and the mean gait speed was 1.20 (0.20) m/s. Gait speed was lower with older age and greater with taller stature, but the effect of height disappeared above the age of 80 years. Sex did not affect gait speed after accounting for age and height. Age-, sex-, and height-specific reference values for gait speed are available for use at https://emcbiostatistics.shinyapps.io/GaitSpeedReferenceValues/. CONCLUSIONS We found that height explains the commonly noted difference in usual gait speed between sexes and that neither height nor sex impacts gait speed in the very oldest adults. We developed reference values for usual gait speed in Western European community-dwelling older adults.
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A Clinically Interpretable Computer-Vision Based Method for Quantifying Gait in Parkinson's Disease. SENSORS 2021; 21:s21165437. [PMID: 34450879 PMCID: PMC8399017 DOI: 10.3390/s21165437] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/04/2021] [Accepted: 08/08/2021] [Indexed: 12/20/2022]
Abstract
Gait is a core motor function and is impaired in numerous neurological diseases, including Parkinson's disease (PD). Treatment changes in PD are frequently driven by gait assessments in the clinic, commonly rated as part of the Movement Disorder Society (MDS) Unified PD Rating Scale (UPDRS) assessment (item 3.10). We proposed and evaluated a novel approach for estimating severity of gait impairment in Parkinson's disease using a computer vision-based methodology. The system we developed can be used to obtain an estimate for a rating to catch potential errors, or to gain an initial rating in the absence of a trained clinician-for example, during remote home assessments. Videos (n=729) were collected as part of routine MDS-UPDRS gait assessments of Parkinson's patients, and a deep learning library was used to extract body key-point coordinates for each frame. Data were recorded at five clinical sites using commercially available mobile phones or tablets, and had an associated severity rating from a trained clinician. Six features were calculated from time-series signals of the extracted key-points. These features characterized key aspects of the movement including speed (step frequency, estimated using a novel Gamma-Poisson Bayesian model), arm swing, postural control and smoothness (or roughness) of movement. An ordinal random forest classification model (with one class for each of the possible ratings) was trained and evaluated using 10-fold cross validation. Step frequency point estimates from the Bayesian model were highly correlated with manually labelled step frequencies of 606 video clips showing patients walking towards or away from the camera (Pearson's r=0.80, p<0.001). Our classifier achieved a balanced accuracy of 50% (chance = 25%). Estimated UPDRS ratings were within one of the clinicians' ratings in 95% of cases. There was a significant correlation between clinician labels and model estimates (Spearman's ρ=0.52, p<0.001). We show how the interpretability of the feature values could be used by clinicians to support their decision-making and provide insight into the model's objective UPDRS rating estimation. The severity of gait impairment in Parkinson's disease can be estimated using a single patient video, recorded using a consumer mobile device and within standard clinical settings; i.e., videos were recorded in various hospital hallways and offices rather than gait laboratories. This approach can support clinicians during routine assessments by providing an objective rating (or second opinion), and has the potential to be used for remote home assessments, which would allow for more frequent monitoring.
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O’Connell ML, Coppinger T, Lacey S, Arsenic T, McCarthy AL. The Gender-Specific Relationship between Nutritional Status, Physical Activity and Functional Mobility in Irish Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168427. [PMID: 34444176 PMCID: PMC8392852 DOI: 10.3390/ijerph18168427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/04/2021] [Accepted: 08/08/2021] [Indexed: 11/16/2022]
Abstract
Research suggests that both nutrition and physical activity can protect mobility in older adults, but it is yet to be determined whether these relationships are affected by gender. Thus, we investigated the gender-specific relationship between nutritional status, physical activity level and functional mobility in Irish older adults. A cross-sectional study was undertaken in 176 community-dwelling older adults (73.6 ± 6.61 years) living in Cork, Ireland. Nutritional status was measured using the Mini Nutritional Assessment-Short Form (MNA-SF) and physical activity was assessed via the Physical Activity Scale for the Elderly (PASE). Functional mobility was measured using the Timed Up and Go (TUG) test. The gender-stratified relationship between variables was assessed using Pearson's correlations and multiple linear regression. Partial correlations (p < 0.05) were observed for TUG with PASE score in both genders, and with MNA-SF score in females, only. Multiple regression showed that physical activity was a predictor of TUG in both genders (β = 0.257 for males, β = 0.209 for females, p < 0.05), while nutritional status was a predictor of TUG in females, only (β = -0.168, p = 0.030). Our results suggest that physical activity is associated with functional mobility in both genders, while the relationship between nutritional status and mobility may be specific to older females. These findings may be of interest for the design of functional preservation strategies.
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Affiliation(s)
- Maeve Lorraine O’Connell
- Department of Biological Sciences, Munster Technological University, Rossa Avenue, T12 P928 Cork, Ireland; (T.A.); (A.L.M.)
- Correspondence:
| | - Tara Coppinger
- Department of Sport, Leisure and Childhood Studies, Munster Technological University, Rossa Avenue, T12 P928 Cork, Ireland;
| | - Seán Lacey
- Department of Mathematics, Munster Technological University, Rossa Avenue, T12 P928 Cork, Ireland;
| | - Tijana Arsenic
- Department of Biological Sciences, Munster Technological University, Rossa Avenue, T12 P928 Cork, Ireland; (T.A.); (A.L.M.)
| | - Aoife Louise McCarthy
- Department of Biological Sciences, Munster Technological University, Rossa Avenue, T12 P928 Cork, Ireland; (T.A.); (A.L.M.)
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Vive S, Elam C, Bunketorp-Käll L. Comfortable and Maximum Gait Speed in Individuals with Chronic Stroke and Community-Dwelling Controls. J Stroke Cerebrovasc Dis 2021; 30:106023. [PMID: 34375858 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/02/2021] [Accepted: 07/20/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The relationship between maximum and comfortable gait speed in individuals with mild to moderate disability in the chronic phase of stroke is unknown. OBJECTIVE This study examines the relationship between comfortable and maximum gait speed in individuals with chronic stroke and whether the relationship differ from that seen in a community-dwelling elderly population. Further, we investigate the influence of age, gender, time post-stroke and degree of disability on gait speed. MATERIALS AND METHODS Gait speed was measured using the 10-meter walk test (10MWT) and the 30-meter walk test (30MWT) in 104 older individuals with chronic stroke and 154 community-dwelling controls, respectively. RESULTS We found that the maximum gait speed in individuals with stroke could be estimated by multiplying the comfortable speed by 1.41. This relationship differed significantly from that of the control group, for which the corresponding factor was 1.20. In the stroke group, age, gender and time post-stroke did not affect the relationship, whereas the degree of disability was negatively correlated with maximum speed - but not when included in the multiple analysis. In the community-dwelling population, higher age and female gender had a negative relationship with maximum gait speed. When correcting for those parameters, the coefficient was 1.07. CONCLUSIONS The maximum gait speed in the chronic phase of stroke can be estimated by multiplying the individual's comfortable gait speed by 1.41. This estimation is not impacted by age, gender, degree of disability and time since stroke. A similar but weaker relationship can be seen in the community-dwelling controls.
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Affiliation(s)
- Sara Vive
- Section for Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Neurocampus, Sophiahemmet Hospital, Box 5605, 114 86, Stockholm, Sweden.
| | - Cecilia Elam
- Section for Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Lina Bunketorp-Käll
- Section for Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Centre for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital, Mölndal, Sweden.
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Kulkarni S, Nagarkar A. Basic gait pattern and impact of fall risk factors on gait among older adults in India. Gait Posture 2021; 88:16-21. [PMID: 33951574 DOI: 10.1016/j.gaitpost.2021.04.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/21/2021] [Accepted: 04/24/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND An unstable gait pattern is an indicator of an increased risk of falls among older adults. Data on basic gait parameters is useful in the early identification of gait impairment. However, reference gait measurements are not available in low- and middle-income countries. RESEARCH QUESTION What are the normative reference values of gait parameters and do fall risk factors such as impaired balance, functional difficulty, and multimorbidity affect the gait patterns of older adults in India? METHODS A cross-sectional data of 659 older adults were collected using a semi-structured schedule. Gait parameters were measured using wearable sensors. Descriptive statistics, independent t-test, and one-way ANCOVA were used to determine the significant difference (p < 0.05) in gait parameters across the risk factors. RESULTS A mean stride length of 123.00 ± 15.19 cm, stride velocity of 110.57 ± 17.57 cm/s, and a cadence of 106.14 ± 11.44 steps/minute were reported in the study. Functional difficulties and balance impairment were the two major risk factors that affected stride velocity, stride length, and cadence after adjusting for age and height. No difference in gait parameters was observed among participants with and without multimorbidity. SIGNIFICANCE This study provides a baseline or reference values of various gait parameters measured on a large sample of population aged 60 and above from India. Assessment of gait patterns and associated risk factors in a clinical setup will help identify the older adults at risk of falls and reduce the enormous burden of fall injuries. Since gait parameters show a large variation across geographical regions, it is important to have region-specific reference values.
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Affiliation(s)
- Snehal Kulkarni
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India.
| | - Aarti Nagarkar
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India.
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15
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Sialino LD, Schaap LA, van Oostrom SH, Picavet HSJ, Twisk JWR, Verschuren WMM, Visser M, Wijnhoven HAH. The sex difference in gait speed among older adults: how do sociodemographic, lifestyle, social and health determinants contribute? BMC Geriatr 2021; 21:340. [PMID: 34078276 PMCID: PMC8173843 DOI: 10.1186/s12877-021-02279-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/04/2021] [Indexed: 12/25/2022] Open
Abstract
Background This study explores whether a sex difference in sensitivity to (strength of the association) and/or in exposure to (prevalence) determinants of gait speed contributes to the observed lower gait speed among older women compared to men. Methods Data from the Longitudinal Aging Study Amsterdam (LASA) were used. In total 2407 men and women aged 55–81 years were included, with baseline measurements in 1992/2002 and follow-up measurements every 3–4 years for 15/25 years. Multivariable mixed model analysis was used to investigate sex differences in sensitivity (interaction term with sex) and in exposure to (change of the sex difference when adjusted) socio-demographic, lifestyle, social and health determinants of gait speed. Results Women had a 0.054 m/s (95 % CI: 0.076 − 0.033, adjusted for height and age) lower mean gait speed compared to men. In general, men and women had similar determinants of gait speed. However, higher BMI and lower physical activity were more strongly associated with lower gait speed in women compared to men (i.e. higher sensitivity). More often having a lower educational level, living alone and having more chronic diseases, pain and depressive symptoms among women compared to men also contributed to observed lower gait speed in women (i.e. higher exposure). In contrast, men more often being a smoker, having a lower physical activity and a smaller personal network size compared to women contributed to a lower gait speed among men (i.e. higher exposure). Conclusions Both a higher sensitivity and higher exposure to determinants of gait speed among women compared to men contributes to the observed lower gait speed among older women. The identified (modifiable) contributing factors should be taken into account when developing prevention and/or treatment strategies aimed to enhance healthy physical aging. This might require a sex-specific approach in both research and clinical practice, which is currently often lacking. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02279-7.
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Affiliation(s)
- Lena D Sialino
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Laura A Schaap
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sandra H van Oostrom
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - H Susan J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Johannes W R Twisk
- Department of Clinical Epidemiology and Biostatistics, Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Khan H, Naseer N, Yazidi A, Eide PK, Hassan HW, Mirtaheri P. Analysis of Human Gait Using Hybrid EEG-fNIRS-Based BCI System: A Review. Front Hum Neurosci 2021; 14:613254. [PMID: 33568979 PMCID: PMC7868344 DOI: 10.3389/fnhum.2020.613254] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/15/2020] [Indexed: 11/21/2022] Open
Abstract
Human gait is a complex activity that requires high coordination between the central nervous system, the limb, and the musculoskeletal system. More research is needed to understand the latter coordination's complexity in designing better and more effective rehabilitation strategies for gait disorders. Electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) are among the most used technologies for monitoring brain activities due to portability, non-invasiveness, and relatively low cost compared to others. Fusing EEG and fNIRS is a well-known and established methodology proven to enhance brain-computer interface (BCI) performance in terms of classification accuracy, number of control commands, and response time. Although there has been significant research exploring hybrid BCI (hBCI) involving both EEG and fNIRS for different types of tasks and human activities, human gait remains still underinvestigated. In this article, we aim to shed light on the recent development in the analysis of human gait using a hybrid EEG-fNIRS-based BCI system. The current review has followed guidelines of preferred reporting items for systematic reviews and meta-Analyses (PRISMA) during the data collection and selection phase. In this review, we put a particular focus on the commonly used signal processing and machine learning algorithms, as well as survey the potential applications of gait analysis. We distill some of the critical findings of this survey as follows. First, hardware specifications and experimental paradigms should be carefully considered because of their direct impact on the quality of gait assessment. Second, since both modalities, EEG and fNIRS, are sensitive to motion artifacts, instrumental, and physiological noises, there is a quest for more robust and sophisticated signal processing algorithms. Third, hybrid temporal and spatial features, obtained by virtue of fusing EEG and fNIRS and associated with cortical activation, can help better identify the correlation between brain activation and gait. In conclusion, hBCI (EEG + fNIRS) system is not yet much explored for the lower limb due to its complexity compared to the higher limb. Existing BCI systems for gait monitoring tend to only focus on one modality. We foresee a vast potential in adopting hBCI in gait analysis. Imminent technical breakthroughs are expected using hybrid EEG-fNIRS-based BCI for gait to control assistive devices and Monitor neuro-plasticity in neuro-rehabilitation. However, although those hybrid systems perform well in a controlled experimental environment when it comes to adopting them as a certified medical device in real-life clinical applications, there is still a long way to go.
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Affiliation(s)
- Haroon Khan
- Department of Mechanical, Electronics and Chemical Engineering, OsloMet—Oslo Metropolitan University, Oslo, Norway
| | - Noman Naseer
- Department of Mechatronics and Biomedical Engineering, Air University, Islamabad, Pakistan
| | - Anis Yazidi
- Department of Computer Science, OsloMet—Oslo Metropolitan University, Oslo, Norway
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Hafiz Wajahat Hassan
- Department of Mechanical, Electronics and Chemical Engineering, OsloMet—Oslo Metropolitan University, Oslo, Norway
| | - Peyman Mirtaheri
- Department of Mechanical, Electronics and Chemical Engineering, OsloMet—Oslo Metropolitan University, Oslo, Norway
- Department of Biomedical Engineering, Michigan Technological University, Michigan, MI, United States
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Figgins E, Choi YH, Speechley M, Montero-Odasso M. Associations Between Potentially Modifiable and Nonmodifiable Risk Factors and Gait Speed in Middle- and Older-Aged Adults: Results From the Canadian Longitudinal Study on Aging. J Gerontol A Biol Sci Med Sci 2021; 76:e253-e263. [PMID: 33420785 DOI: 10.1093/gerona/glab008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Gait speed is a strong predictor of morbidity and mortality in older adults. Understanding the factors associated with gait speed and the associated adverse outcomes will inform mitigation strategies. We assessed the potentially modifiable and nonmodifiable factors associated with gait speed in a large national cohort of middle and older-aged Canadian adults. METHODS We examined cross-sectional baseline data from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive cohort. The study sample included 20 201 community-dwelling adults aged 45-85 years. The associations between sociodemographic and anthropometric factors, chronic conditions, and cognitive, clinical, and lifestyle factors and 4-m usual gait speed (m/s) were estimated using hierarchical multivariable linear regression. RESULTS The coefficient of determination, R 2, of the final regression model was 19.7%, with 12.9% of gait speed variability explained by sociodemographic and anthropometric factors, and nonmodifiable chronic conditions and 6.8% explained by potentially modifiable chronic conditions, cognitive, clinical, and lifestyle factors. Potentially modifiable factors significantly associated with gait speed include cardiovascular conditions (unstandardized regression coefficient, B = -0.018; p < .001), stroke (B = -0.025; p = .003), hypertension (B = -0.007; p = .026), serum Vitamin D (B = 0.004; p < .001), C-reactive protein (B = -0.005; p = .005), depressive symptoms (B = -0.003; p < .001), physical activity (B = 0.0001; p < .001), grip strength (B = 0.003; p < .001), current smoking (B = -0.026; p < .001), severe obesity (B = -0.086; p < .001), and chronic pain (B = -0.008; p = .018). CONCLUSIONS The correlates of gait speed in adulthood are multifactorial, with many being potentially modifiable through interventions and education. Our results provide a life-course-perspective framework for future longitudinal assessments risk factors affecting gait speed.
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Affiliation(s)
- Erica Figgins
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
| | - Yun-Hee Choi
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
| | - Mark Speechley
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.,Schulich Interfaculty Program in Public Health, University of Western Ontario, London, Canada
| | - Manuel Montero-Odasso
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.,Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada
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Álvarez I, Latorre J, Aguilar M, Pastor P, Llorens R. Validity and sensitivity of instrumented postural and gait assessment using low-cost devices in Parkinson's disease. J Neuroeng Rehabil 2020; 17:149. [PMID: 33176833 PMCID: PMC7656721 DOI: 10.1186/s12984-020-00770-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accurate assessment of balance and gait is necessary to monitor the clinical progress of Parkinson's disease (PD). Conventional clinical scales can be biased and have limited accuracy. Novel interactive devices are potentially useful to detect subtle posture or gait-related impairments. METHODS Posturographic and single and dual-task gait assessments were performed to 54 individuals with PD and 43 healthy controls with the Wii Balance Board and the Kinect v2 and the, respectively. Individuals with PD were also assessed with the Tinetti Performance Oriented Mobility Assessment, the Functional Gait Assessment and the 10-m Walking Test. The influence of demographic and clinical variables on the performance in the instrumented posturographic and gait tests, the sensitivity of these tests to the clinical condition and phenotypes, and their convergent validity with clinical scales were investigated. RESULTS Individuals with PD in H&Y I and I.5 stages showed similar performance to controls. The greatest differences in posture and gait were found between subjects in H&Y II.5 and H&Y I-I.5 stage, as well as controls. Dual-tasking enhanced the differences among all groups in gait parameters. Akinetic/rigid phenotype showed worse postural control and gait than other phenotypes. High significant correlations were found between the limits of stability and most of gait parameters with the clinical scales. CONCLUSIONS Low-cost devices showed potential to objectively quantify posture and gait in established PD (H&Y ≥ II). Dual-tasking gait evaluation was more sensitive to detect differences among PD stages and compared to controls than free gait. Gait and posture were more impaired in akinetic/rigid PD.
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Affiliation(s)
- Ignacio Álvarez
- Fundació Docència i Recerca Mútua de Terrassa, Terrassa, Barcelona, Spain
- Movement disorders Unit, Department of Neurology, Memory Disorders Unit, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Jorge Latorre
- Neurorehabilitation and Brain Research Group, Instituto Interuniversitario de Investigación en Bioingeniería, Universitat Politècnica de València, Ciudad Politécnica de la Innovación-Building 8B-Access M-Floor 0, Camino de Vera s/n, 46022, Valencia, Spain
- NEURORHB. Servicio de Neurorrehabilitación de Hospitales Vithas, Río Tajo 1, 46011, Valencia, Spain
| | - Miquel Aguilar
- Fundació Docència i Recerca Mútua de Terrassa, Terrassa, Barcelona, Spain
- Movement disorders Unit, Department of Neurology, Memory Disorders Unit, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Pau Pastor
- Fundació Docència i Recerca Mútua de Terrassa, Terrassa, Barcelona, Spain
- Movement disorders Unit, Department of Neurology, Memory Disorders Unit, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Roberto Llorens
- Neurorehabilitation and Brain Research Group, Instituto Interuniversitario de Investigación en Bioingeniería, Universitat Politècnica de València, Ciudad Politécnica de la Innovación-Building 8B-Access M-Floor 0, Camino de Vera s/n, 46022, Valencia, Spain.
- NEURORHB. Servicio de Neurorrehabilitación de Hospitales Vithas, Río Tajo 1, 46011, Valencia, Spain.
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Artaud F, Lee PC, Mangone G, Vidailhet M, Corvol JC, Elbaz A. Longitudinal association between dopamine agonists and weight in Parkinson's disease. Parkinsonism Relat Disord 2020; 80:158-164. [PMID: 33011605 DOI: 10.1016/j.parkreldis.2020.09.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/17/2020] [Accepted: 09/23/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the longitudinal relation of dopamine agonists (DA) use with body mass index (BMI) change and weight gain in Parkinson's disease (PD). METHODS In a cohort of 356 patients with PD annually followed up to 6 years, BMI, antiparkinsonian drugs use, and impulse control disorders (ICDs) were assessed at each visit. DA dose trajectories were estimated using latent class mixed models. The association of DA use with BMI change and weight gain was examined using latent-process mixed models and time-dependent Cox models respectively, while adjusting for disease severity and levodopa (LD) use. RESULTS In the mixed model, BMI (kg/m2) increased over the follow-up in DA users (betaDA×time = 0.13, 95% CI = 0.02, 0.24) compared to non-users, while it decreased in LD users (betaLD×time = -0.26, 95% CI = -0.38, -0.13). We identified three trajectories of average daily DA dose over the follow-up. Patients in the high trajectory gained more weight than patients who never used DA (P = .001) and in the low (P = .02) or moderate (P = .04) trajectories. The incidence of weight gain of ≥6 kg was 2.10-fold (95% CI = 1.03, 4.28) higher in DA users compared to non-users, while LD users were less likely to gain weight (HR = 0.60, 95% CI = 0.33, 1.11). Associations decreased in analyses adjusted for compulsive eating or ICDs. CONCLUSION Weight increased in DA users over 6 years, and DA use was associated with increased incidence of weight gain. These associations were partially explained by compulsive eating. Alternatively, weight decreased in LD users. These findings warrant careful monitoring of compulsive eating and weight in PD patients.
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Affiliation(s)
- Fanny Artaud
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe « Exposome, Hérédité, Cancer et Santé », CESP, 94807, Villejuif, France.
| | - Pei-Chen Lee
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taiwan
| | - Graziella Mangone
- Assistance Publique Hôpitaux de Paris; and Sorbonne Université; and INSERM; and CNRS; Institut du Cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Department of Neurology, F-75013, Paris, France
| | - Marie Vidailhet
- Assistance Publique Hôpitaux de Paris; and Sorbonne Université; and INSERM; and CNRS; Institut du Cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Department of Neurology, F-75013, Paris, France
| | - Jean-Christophe Corvol
- Assistance Publique Hôpitaux de Paris; and Sorbonne Université; and INSERM; and CNRS; Institut du Cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, Hôpital Pitié-Salpêtrière, Department of Neurology, F-75013, Paris, France
| | - Alexis Elbaz
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe « Exposome, Hérédité, Cancer et Santé », CESP, 94807, Villejuif, France
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Lee PC, Artaud F, Cormier-Dequaire F, Rascol O, Durif F, Derkinderen P, Marques AR, Bourdain F, Brandel JP, Pico F, Lacomblez L, Bonnet C, Brefel-Courbon C, Ory-Magne F, Grabli D, Klebe S, Mangone G, You H, Mesnage V, Brice A, Vidailhet M, Corvol JC, Elbaz A. Examining the Reserve Hypothesis in Parkinson's Disease: A Longitudinal Study. Mov Disord 2019; 34:1663-1671. [PMID: 31518456 DOI: 10.1002/mds.27854] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 08/13/2019] [Accepted: 08/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whether reserve plays a role in Parkinson's disease (PD) patients has received less attention than in dementia and has been mainly examined in relation with cognitive function. OBJECTIVE To investigate whether reserve plays a role in the severity and progression of motor, cognitive, and nonmotor PD symptoms by examining whether education level (proxy of reserve) is associated with baseline performance and rate of progression. METHODS We used data from a longitudinal cohort of PD patients (≤5-year disease duration at baseline) annually followed up to 5 years (n = 393; 41% women; mean age = 62.3 years, standard deviation = 10.0; mean disease duration = 2.6 years, standard deviation = 1.5). We examined the relationship of education with time to reach Hoehn and Yahr stage ≥3 using Cox regression and with baseline severity and progression of motor (Movement Disorder Society-Unified Parkinson's Disease Rating Scale parts II and III, gait speed), cognitive (Mini-Mental State Examination), and nonmotor (depression, anxiety, nonmotor symptoms scale, quality of life) symptoms using mixed models. RESULTS Education level was not associated with age at onset or diagnosis. Compared with the low-education group, the incidence of Hoehn and Yahr ≥3.0 was 0.42 times lower (95% confidence interval, 0.22-0.82, P = 0.012) in the high-education group. Higher education was associated with better baseline motor function (P < 0.001), but not with the rate of motor decline (P > 0.15). Similar results were observed for cognition. Education was not associated with nonmotor symptoms. CONCLUSIONS Higher education is associated with better baseline motor/cognitive function in PD, but not with rate of decline, and with a lower risk of reaching Hoehn and Yahr ≥3 during the follow-up. Our observations are consistent with a passive reserve hypothesis for motor/cognitive symptoms. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Pei-Chen Lee
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,Preventive Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.,Taipei City Hospital, Taipei, Taiwan
| | - Fanny Artaud
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
| | - Florence Cormier-Dequaire
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Olivier Rascol
- NS-PARK/FCRIN Network, Paris, France.,Universityof Toulouse 3, Centre Hospitalo-Universitaire de Toulouse and INSERM; Centre d'Investigation Clinique CIC1436, Départements de Neurosciences et de Pharmacologie Clinique, NeuroToul COEN center, Toulouse, France
| | - Franck Durif
- NS-PARK/FCRIN Network, Paris, France.,Department of Neurology, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Pascal Derkinderen
- NS-PARK/FCRIN Network, Paris, France.,Department of Neurology, Centre Hospitalo-Universitaire de Nantes, Nantes, France
| | - Ana-Raquel Marques
- NS-PARK/FCRIN Network, Paris, France.,Department of Neurology, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | | | | | - Fernando Pico
- Department of Neurology, Centre Hospitalier de Versailles; and Université Versailles Saint Quentin en Yvelines et Paris Saclay, Versailles, France
| | - Lucette Lacomblez
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Cecilia Bonnet
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Christine Brefel-Courbon
- NS-PARK/FCRIN Network, Paris, France.,Universityof Toulouse 3, Centre Hospitalo-Universitaire de Toulouse and INSERM; Centre d'Investigation Clinique CIC1436, Départements de Neurosciences et de Pharmacologie Clinique, NeuroToul COEN center, Toulouse, France
| | - Fabienne Ory-Magne
- NS-PARK/FCRIN Network, Paris, France.,Universityof Toulouse 3, Centre Hospitalo-Universitaire de Toulouse and INSERM; Centre d'Investigation Clinique CIC1436, Départements de Neurosciences et de Pharmacologie Clinique, NeuroToul COEN center, Toulouse, France
| | - David Grabli
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Stephan Klebe
- Department of Neurology, University Hospital Essen, Essen, Germany
| | - Graziella Mangone
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Hana You
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Valérie Mesnage
- Department of Neurology, Centre Hospitalo-Universitaire Saint-Antoine, Paris, France
| | - Alexis Brice
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Marie Vidailhet
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Jean-Christophe Corvol
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Alexis Elbaz
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
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