Potentially modifiable risk factors for slow gait in community-dwelling older adults: A systematic review

Erica Figgins; Frederico Pieruccini-Faria; Mark Speechley; Manuel Montero-Odasso

doi:10.1016/j.arr.2020.101253

Potentially modifiable risk factors for slow gait in community-dwelling older adults: A systematic review

Ageing Res Rev. 2021 Mar:66:101253. doi: 10.1016/j.arr.2020.101253. Epub 2021 Jan 8.

Authors

Erica Figgins¹, Frederico Pieruccini-Faria², Mark Speechley³, Manuel Montero-Odasso⁴

Affiliations

¹ 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. Electronic address: efiggins@uwo.ca.
² 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. Electronic address: Frederico.Faria@sjhc.london.on.ca.
³ 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; Schulich Interfaculty Program in Public Health, The University of Western Ontario, London, ON, N6G 2M1, Canada. Electronic address: speechly@uwo.ca.
⁴ 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; Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, N6C 0A7, Canada. Electronic address: mmontero@uwo.ca.

PMID: 33429086
DOI: 10.1016/j.arr.2020.101253

Abstract

Purpose: 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.

Methods: Literature searches were conducted in MEDLINE, EMBASE, and CINAHL, Google Scholar, and in the bibliographies of retrieved articles.

Results: 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.

Conclusion: Our results suggest that there are modifiable targets to maintain gait speed that are amenable to potential treatment.

Keywords: Aging; Epidemiology; Gait speed; Risk factors; Systematic review.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Aged
Cross-Sectional Studies
Gait
Humans
Independent Living*
Risk Factors
Walking Speed*

Grants and funding

PJT 153100/CIHR/Canada