title: Predictors of change in walking velocity in older adults.
abstract: OBJECTIVE
  To determine factors that predict change in walking velocity in older people using a multivariate model.
  
  
  METHODS
  Longitudinal observational study.
  
  
  METHODS
  A total of 588 persons older than age 60, including subjects residing in a continuing care retirement community (CCRC) (n = 248), and homebound (n = 79) and ambulatory (n = 261) subjects. Mean age at baseline = 77.
  
  
  METHODS
  Independent variables included demographics, physician measures of lower-extremity joint impairment and other musculoskeletal and neurological variables, comorbidities derived from physical examination and chart abstract, self-assessed arthritis pain, depression, and anxiety. The major dependent variables were 2- and 4-year decline in walking velocity below a threshold associated with nursing home placement.
  
  
  RESULTS
  From baseline to Year 4, median walking velocity declined from 61.8 to 53.0 m/min, and the proportion of subjects above a threshold value of 11.5 m/min declined from 95.3% to 80.4%. Age, joint impairment, and weakness of quadriceps, measured at baseline, predicted 2-year and 4-year decline in walking velocity.
  
  
  CONCLUSIONS
  The findings indicate that joint impairment and quadriceps strength contribute significantly to crossing a clinically significant threshold in walking velocity among older people over time. Future research is needed to determine whether these risk factors can be modified through preventive interventions such as muscle-strengthening exercises and pain medication.
authors.affiliation: Center for Health Services and Policy Research, Northwestern University, Evanston, IL 60208, USA.
authors.forename: J
authors.initials: J
authors.lastname: Gibbs
authors.forename: S
authors.initials: S
authors.lastname: Hughes
authors.forename: D
authors.initials: D
authors.lastname: Dunlop
authors.forename: R
authors.initials: R
authors.lastname: Singer
authors.forename: R W
authors.initials: RW
authors.lastname: Chang
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000502:physiology* / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D007592:Joint Diseases / Q000503:physiopathology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000503:physiopathology; D011237:Predictive Value of Tests; D012959:Socioeconomic Factors; D016138:Walking / Q000502:physiology*