Gait velocity in senior people. An easy test for detecting mobility impairment in community elderly.
BACKGROUND
Functional assessment is an important part of the evaluation of elderly patients. Mobility problems detected by functional tests predict the development of more severe disability and injurious events such as falls and hip fractures. Several tests to evaluate mobility have been described, but most of them are difficult to perform by a primary care physicians or take much time in the ambulatory setting.


OBJECTIVE
To evaluate different mobility test to detect mobility impairment in community senior people. Select an easier test to perform on the ambulatory ward by a GP with the hypothesis that gait velocity could be an easier test to detect early mobility impairment.


METHODS
A cohort of 100 elderly subjects of 75 year and older were selected from our database and contacted by phone. The subjects were appointed and assessed by three geriatricians from January to May 2000. The measures including MMSE, Yesavage Test, ADL (Barhtel) and IADL (Lawton), the Get Up and Go test, the POMA, one leg balance test and the Gait Velocity (GV). A gait velocity of 0.8 m/s or lower was defined as a pathological gait velocity (PGV).


RESULTS
95 subjects, mean age 79.63 (+/- 4) ranged form 75 to 95. Women in 71.3%. The ADLs were normal on 85% of the patients and the MMSE was normal on 78%. There was a significant association between pathological gait velocity (<0.8m/sec) and impairment on Get up and Go (OR 2.20; 95% CI 1.44-3.34), incapacity to perform the one leg balance test (OR 2.20; 95%CI: 1.43 - 4.71) and abnormal POMA test (OR 4.60; 95 %CI 1.5-14.7). Only 15% of the subjects with normal gait velocity reported recurrent falls in the previous 6 months while 35% of subjects with pathological gait velocity did. (OR 0.32 CI95% 010-099 p < 0.044).


CONCLUSIONS
The pathological gait velocity (<0.8m/sec) correlates with a pathologic performance of Get Up and Go test and POMA and with the incapacity to perform the One Leg Balance test. Also correlate with previous repeated falls in the last 6 (p <0.04). The gait velocity could be a test easy to perform, no time consuming, and an operative tool to apply in the ambulatory care to detect elderly patients with mobility impairment.
Montero-Odasso
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Geriatric Medicine Program and Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires 1181(ACH), Argentina. manuel.montero@hospitalitaliano.org.ar
Schapira
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Varela
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Pitteri
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Soriano
E R
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Kaplan
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Camera
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Mayorga
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LM
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015331:Cohort Studies; D016001:Confidence Intervals; D005080:Exercise Test; D005260:Female; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008124:Locomotion / Q000502:physiology*; D008297:Male; D016017:Odds Ratio; D004856:Postural Balance / Q000502:physiology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity