The Importance of Racially and Ethnically Inclusive Gait Speed Reference Values in Individuals 90 Years and Older: LifeAfter90.

BACKGROUND AND PURPOSE: Clinicians use reference values to contextualize physical performance scores, but data are sparse in individuals 90 years and older and racial/ethnic diversity is limited in existing studies. Gait speed provides valuable information about an individual's health status. Slow gait speed is associated with falls, cognitive decline, and mortality. Here, we report gait speed reference values in a racially/ethnically diverse oldest-old cohort. METHODS: LifeAfter90 is a multiethnic cohort study of individuals 90 years and older. Participants are long-term members of an integrated healthcare delivery system without a dementia diagnosis at enrollment. We assessed gait speed using the 4-m walk test and calculated means, standard deviations, and percentiles by age, sex, assistive device use, and device type. We used linear regression to compare means by sex, age, device use and type, living situation and arrangement, and race/ethnicity. RESULTS AND DISCUSSION: The mean age of the 502 participants was 92.9 (range 90.1-102.8) years. Of these, 62.6% were women, 34.7% were college educated, 90.8% lived in a private residence, 20.9% self-reported as Asian, 22.5% as Black, 11.8% as Hispanic, 35.7% as White, and 9.2% as multiple, "other," or declined to state. The overall mean gait speed was 0.54 m/s (women = 0.51 m/s, men = 0.58 m/s). Mean gait speeds were 0.58 m/s, 0.53 m/s, and 0.48 m/s in the 90 to 91, 92 to 93, and 94+ age categories, respectively. In those without a device, mean gait speed was 0.63 m/s compared to 0.40 m/s in those with a device (cane = 0.44 m/s, walker = 0.37 m/s). Mean gait speed was significantly slower in women compared to men, age category 94+ compared to 90 to 91, participants with a device compared to those without, participants with a walker compared to a cane, and Black participants compared to Asian and White participants. However, differences by race/ethnicity were attenuated when chronic health conditions were considered. CONCLUSIONS: Reference values developed from this multiethnic 90+ cohort will help clinicians interpret gait speed measures and tailor recommendations toward a 90+ population that is growing in number and in racial/ethnic diversity.

Gait Speed Reference Values for Adults Aged 90 and Older: The 90+ Study.

BACKGROUND AND PURPOSE: Slow gait speed has been associated with adverse outcomes in older adults, but little data exist for those 90 years and older, a group often referred to as the "oldest old." We aimed to establish reference values for gait speed in men and women 90 years and older. METHODS: The 90+ Study is a population-based longitudinal study of aging. Our analyses of gait speed included participants who were evaluated in person and were ambulatory. Gait speed was assessed using the 4-m walk test. We calculated means, standard deviations, and percentiles stratified by age, sex, and use of assistive device. RESULTS AND DISCUSSION: The 797 participants had a mean age of 93.5 years. Of these, 73.9% were women, 39.5% had a college education, and 98.6% were White. The overall mean gait speed was 0.58 m/s (women = 0.55 m/s, men = 0.65 m/s). In participants who did not use an assistive device, the overall mean gait speed was 0.66 m/s (women = 0.63 m/s, men = 0.71 m/s). In those who used a device, the overall mean gait speed was 0.38 m/s (women = 0.37 m/s, men = 0.43 m/s). Gait speed decreased with increasing age. Men had consistently higher average gait speeds compared with women across age categories. Men and women who used assistive devices had lower average gait speeds across age categories compared with men and women who ambulated with no device. Average gait speeds in our oldest-old cohort were slower than those of older adults younger than 90 years in previous studies. CONCLUSIONS: This study is the first to establish gait speed reference values specific to adults 90 years and older. Age-appropriate reference values are crucial to the accurate interpretation of clinical measures for patients in their 90s and above.