Gait Speed as a Biomarker of Cognitive Vulnerability: A Population-Based Study with Cognitively Normal Older Adults

Gait speed according to cognitive status in older adults: a cross-sectional study in a resource-limited country

OBJECTIVE

We aimed to investigate the association between gait speed and cognitive status in outpatient older adults from a resource-limited setting in Peru.

METHODS

We performed a cross-sectional study including older adults aged ≥60 years attending a geriatrics outpatient clinic between July 2017 and February 2020. Gait speed was measured over a 10-meters distance without considering the first and last meter traveled. Cognitive status was assessed through the Short Portable Mental Status Questionnaire (SPMSQ) and the Mini-Mental State Examination (MMSE). We used a multivariate binomial logistic regression to conduct both an epidemiological and fully adjusted models.

RESULTS

We included 519 older adults (mean age: 75 years; IQR = 10), of whom 95 (18.3%) and 151 (31.5%) were cognitively impaired according to the SPMSQ and MMSE, respectively. Gait speed was slower among patients with poorer cognitive status as assessed by both tools (p < 0.001). Malnutrition (PR: 1.74; CI: 1.45-2.08) and functional dependency (PR: 4.35; CI: 2.68-7.08) were associated with a greater prevalence of cognitive impairment according to the SPMSQ, whereas a faster gait speed (PR: 0.27, CI: 0.14-0.52) and longer years of education (PR: 0.83, CI: 0.77-0.88) were associated with a less prevalence.

CONCLUSIONS

Slower gait speed was associated with poorer cognitive status in outpatient older adults. Gait speed may be a complementary tool in the cognitive assessment of older adults from resource-limited settings.

Associations of Gait Speed, Cadence, Gait Stability Ratio, and Body Balance with Falls in Older Adults

To investigate the association between gait speed (GS), cadence (CAD), gait stability ratio (GSR), and body balance (BB) with falls in a large sample of older adults. The analysis included 619 individuals-305 men and 314 women (69.50 ± 5.62 years)-residing in the Autonomous Region of Madeira, Portugal. Mobility in GS, CAD, and GSR was assessed using the 50-foot walk test and BB by the Fullerton Advanced Balance scale. The frequency of falls was obtained by self-report. Linear regression analysis showed that higher performance in GS and BB was able to reduce the risk of falling by up to 0.34 and 0.44 times, respectively. An increase in the GSR value enhanced the risk of falling by up to 0.10 times. Multinomial analysis indicated that, in relation to the highest tertile (reference), older adults classified with GS and BB performance in the lowest tertile (lowest) had an increased chance (OR) of falling by up to 149.3% and 48.8%, respectively. Moreover, in relation to the highest tertile, the performance of the GSR classified in the lowest and medium tercile showed an increase in the chance of falling by up to 57.4% and 56.4%, respectively.

Evaluation of the Suitability of Smart Health Products for Aging Based on the IIVAHP-CRITIC Model: A Case Study of Smart Health Kiosk

In the global situation of an aging population, the evaluation of the suitability of smart health products for aging is very important in order to achieve sustainable development goals. However, few evaluation methods have been adopted for smart health products for older individuals. An objective and comprehensive evaluation system and evaluation methods need to be established to guide the design of smart health products. In this study, a Smart Health Kiosk (SHK) was used as an example, and an index system was established for the evaluation of the suitability for aging based on the influencing factors from four dimensions. To address the problem that it is difficult to quantify the subjective and objective weights in the evaluation, this study proposes a method of evaluating suitability for aging based on the combination of the Improved Interval-Valued Analytic Hierarchy Process and the Criteria Importance Though Intercrieria Correlation (IIVAHP-CRITIC) method. The results show that the method integrates the influence of subjective and objective weights on the evaluation and avoids the limitations of a single evaluation. It takes into account the relationship between the various levels of indicators and the subjective and objective indicators. Weights calculated by the IIVAHP-CRITIC method help to better assess the objectivity and validity of the design solutions. This evaluation method can effectively reflect the related attributes of each element in the aging-suitability design stage of smart health products. The evaluation results help to improve the quality and ergonomic comfort of aging products, and can effectively reduce the occurrence of design problems.