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What Cut-Point in Gait Speed Best Discriminates Community-Dwelling Older Adults With Mobility Complaints From Those Without? A Pooled Analysis From the Sarcopenia Definitions and Outcomes Consortium.

  • Author(s): Cawthon, Peggy M
  • Patel, Sheena M
  • Kritchevsky, Stephen B
  • Newman, Anne B
  • Santanasto, Adam
  • Kiel, Douglas P
  • Travison, Thomas G
  • Lane, Nancy
  • Cummings, Steven R
  • Orwoll, Eric S
  • Duchowny, Kate A
  • Kwok, Timothy
  • Hirani, Vasant
  • Schousboe, John
  • Karlsson, Magnus K
  • Mellström, Dan
  • Ohlsson, Claes
  • Ljunggren, Östen
  • Xue, Qian-Li
  • Shardell, Michelle
  • Jordan, Joanne M
  • Pencina, Karol M
  • Fielding, Roger A
  • Magaziner, Jay
  • Correa-de-Araujo, Rosaly
  • Bhasin, Shalender
  • Manini, Todd M
  • et al.
Abstract

Background

Cut-points to define slow walking speed have largely been derived from expert opinion.

Methods

Study participants (13 589 men and 5043 women aged ≥65years) had walking speed (m/s) measured over 4-6 m (mean ± SD: 1.20 ± 0.27 m/s in men and 0.94 ± 0.24 m/s in women.) Mobility limitation was defined as any self-reported difficulty with walking approximately 1/4 mile (prevalence: 12.6% men, 26.4% women). Sex-stratified classification and regression tree (CART) models with 10-fold cross-validation identified walking speed cut-points that optimally discriminated those who reported mobility limitation from those who did not.

Results

Among 5043 women, CART analysis identified 2 cut-points, classifying 4144 (82.2%) with walking speed ≥0.75 m/s, which we labeled as "fast"; 478 (9.5%) as "intermediate" (walking speed ≥0.62 m/s but <0.75 m/s); and 421 (8.3%) as "slow" (walking speed <0.62 m/s). Among 13 589 men, CART analysis identified 3 cut-points, classifying 10 001 (73.6%) with walking speed ≥1.00 m/s ("very fast"); 2901 (21.3%) as "fast" (walking speed ≥0.74 m/s but <1.00 m/s); 497 (3.7%) as "intermediate" (walking speed ≥0.57 m/s but <0.74 m/s); and 190 (1.4%) as "slow" (walking speed <0.57 m/s). Prevalence of self-reported mobility limitation was lowest in the "fast" or "very fast" (11% for men and 19% for women) and highest in the "slow" (60.5% in men and 71.0% in women). Rounding the 2 slower cut-points to 0.60 m/s and 0.75 m/s reclassified very few participants.

Conclusions

Cut-points in walking speed of approximately 0.60 m/s and 0.75 m/s discriminate those with self-reported mobility limitation from those without.

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