Gait speed correlated with expected years of life remaining to people aged 65 years and older, with increased walking speed predicting longer life expectancy....
Dr. Stephanie Studenski of the division of geriatric medicine at the University of Pittsburgh, and her associates, stated that, for both sexes and at any age older than 65 years, a gait speed of 0.8 meters per second correlated with the median life expectancy for a person's age and sex. Faster walking speeds consistently correlated with extended survival, they said.
They assessed the relationship between gait speed and survival in a pooled analysis using data from nine cohort studies of community-dwelling adults. Each study included at least 400 people, gait speed data at baseline, and follow-up for at least 5 years. All of the studies measured gait speed by having subjects walk at their usual pace from a standing start for 6-8 feet indoors.
There were 34,485 study subjects, including "substantial" numbers of African American and Hispanic patients, as well as 1,765 who were older than 85 years. Follow-up ranged from 6 to 21 years, with a median of 14 years. Gait speed ranged widely, from less than 0.4 meters per second (in 1,247 people) to more than 1.4 meters per second (in 1,491 people). There were 17,528 deaths during follow-up.
Predicted years of life remaining correlated with gait speed for patients of both sexes and all ages.
A walking speed of approximately 0.8 meters per second was associated with the predicted median life expectancy for a subject's age and sex. Gait speeds faster than that rate predicted longer-than-average life expectancy, while slower gait speeds predicted shorter-than-average life expectancy. Gait speeds of 1.2 meters per second and faster predicted "exceptional" life expectancy, the investigators said
Gait speed "was especially informative after age 75 years" in patients who had no, or only minor, functional limitations. It may be less helpful in predicting life expectancy for patients who already report functional impairments and dependency on others for performing the activities of daily living, the investigators noted.
The data allowed Dr. Studenski and her colleagues to calculate survival estimates for a broad range of gait speeds, and to calculate absolute rates and median years of survival. "Compared with prior studies that were too small to assess potential effect modification by age, sex, race/ethnicity, and other subgroups, we were able to assess multiple subgroup effects with substantial power," the researchers said.
"Because gait speed can be assessed by nonprofessional staff using a 4-meter walkway and a stopwatch, it is relatively simple to measure compared with many medical assessments," they added.
In practice, gait speed can be used to identify elderly patients with a high probability of living 5-10 more years, who can then be targeted for preventive interventions that require a long time before benefits are realized. It can also identify patients at increased risk for early mortality, who can then be targeted for interventions to maximize health and survival, the researchers explained.
If gait speed is tracked over time, it can serve as an indicator that new health problems have arisen. It can also be helpful in stratifying risks from surgery or chemotherapy, the investigators said.
Showing posts with label seniors. Show all posts
Showing posts with label seniors. Show all posts
Tuesday, January 18, 2011
Friday, July 2, 2010
Body Fat Linked to Diabetes Risk in Older People
To avoid Type 2 diabetes, seniors may need to watch their weight just as closely as younger individuals do, a prospective cohort study showed....
Among individuals 65 and older, several measures of adiposity and weight gain were associated with a greater risk of developing Type 2 diabetes during follow-up, according to Mary Biggs, PhD, of the University of Washington School of Public Health and Community Medicine in Seattle, and colleagues.
The hazard ratios ranged from 1.9 to 6.0 when broken down by sex.
Self-reported body mass index at age 50 and weight gain from age 50 to study baseline were both also associated with risk of incident diabetes. "We found it surprising that the relationship between adiposity or body fat and diabetes was so strong among older adults," Biggs said.
"I think the results affirm the importance of weight control during middle age and suggest that weight control remains important into older ages in terms of reducing diabetes risks."
Although overweight and obesity are well-recognized risk factors for Type 2 diabetes among young and middle-age individuals, the relationship has not been well studied in older adults, according to the researchers.
So they turned to the Cardiovascular Health Study, which prospectively followed 4,193 men and women who were at least 65 and free of diabetes at baseline from 1989 to 2007. The participants came from four counties in North Carolina, Maryland, California, and Pennsylvania.
At baseline, mean age of participants was 72 and their mean BMI was 26 kg/m2 for both men and women; 45% had prediabetes (fasting glucose of 100 to 125 mg/dL).
Through a median follow-up of 12.4 years, there were 339 incident cases of Type 2 diabetes, defined as use of diabetes medication or a fasting glucose of at least 126 mg/dL.
With increasing quintiles of various measures of adiposity, there was a corresponding greater risk of developing diabetes, with no significant differences by sex or race.
All multivariate models were adjusted for age, sex, race, smoking, alcohol consumption, physical activity, and dietary factors.
The magnitude of the increased risk associated with various measures appeared to fade with age, with about half the risk in individuals 75 and older compared with those 65 to 74. However, the interaction with age was significant only for BMI at age 50 and at baseline and for fat mass.
There are several possible reasons risk might be increased to a lesser extent in older individuals, according to the researchers.
"Among older adults, standard anthropometric measures may not adequately quantify body fat due to age-related changes in body composition, including decreases in skeletal muscle mass and height," they wrote.
In addition, among older individuals, regional fat distribution may be more important in the etiology of diabetes than absolute fat mass, the pathophysiology of diabetes may differ, and selective survival may be involved. Changes in body weight were also associated with diabetes risk.
Compared with individuals who had a weight fluctuation of no more than about 4 pounds, those who gained 20 or more pounds from age 50 to baseline or 13 pounds or more from baseline to the third follow-up visit had a two- to threefold increased risk of developing diabetes.
"Results of this study affirm the importance of maintaining optimal weight during middle age for prevention of diabetes and, while requiring confirmation, suggest that weight control remains important in reducing diabetes risk among adults 65 years of age and older," the researchers wrote.
Among individuals 65 and older, several measures of adiposity and weight gain were associated with a greater risk of developing Type 2 diabetes during follow-up, according to Mary Biggs, PhD, of the University of Washington School of Public Health and Community Medicine in Seattle, and colleagues.
The hazard ratios ranged from 1.9 to 6.0 when broken down by sex.
Self-reported body mass index at age 50 and weight gain from age 50 to study baseline were both also associated with risk of incident diabetes. "We found it surprising that the relationship between adiposity or body fat and diabetes was so strong among older adults," Biggs said.
"I think the results affirm the importance of weight control during middle age and suggest that weight control remains important into older ages in terms of reducing diabetes risks."
Although overweight and obesity are well-recognized risk factors for Type 2 diabetes among young and middle-age individuals, the relationship has not been well studied in older adults, according to the researchers.
So they turned to the Cardiovascular Health Study, which prospectively followed 4,193 men and women who were at least 65 and free of diabetes at baseline from 1989 to 2007. The participants came from four counties in North Carolina, Maryland, California, and Pennsylvania.
At baseline, mean age of participants was 72 and their mean BMI was 26 kg/m2 for both men and women; 45% had prediabetes (fasting glucose of 100 to 125 mg/dL).
Through a median follow-up of 12.4 years, there were 339 incident cases of Type 2 diabetes, defined as use of diabetes medication or a fasting glucose of at least 126 mg/dL.
With increasing quintiles of various measures of adiposity, there was a corresponding greater risk of developing diabetes, with no significant differences by sex or race.
All multivariate models were adjusted for age, sex, race, smoking, alcohol consumption, physical activity, and dietary factors.
The magnitude of the increased risk associated with various measures appeared to fade with age, with about half the risk in individuals 75 and older compared with those 65 to 74. However, the interaction with age was significant only for BMI at age 50 and at baseline and for fat mass.
There are several possible reasons risk might be increased to a lesser extent in older individuals, according to the researchers.
"Among older adults, standard anthropometric measures may not adequately quantify body fat due to age-related changes in body composition, including decreases in skeletal muscle mass and height," they wrote.
In addition, among older individuals, regional fat distribution may be more important in the etiology of diabetes than absolute fat mass, the pathophysiology of diabetes may differ, and selective survival may be involved. Changes in body weight were also associated with diabetes risk.
Compared with individuals who had a weight fluctuation of no more than about 4 pounds, those who gained 20 or more pounds from age 50 to baseline or 13 pounds or more from baseline to the third follow-up visit had a two- to threefold increased risk of developing diabetes.
"Results of this study affirm the importance of maintaining optimal weight during middle age for prevention of diabetes and, while requiring confirmation, suggest that weight control remains important in reducing diabetes risk among adults 65 years of age and older," the researchers wrote.
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