title: Gait speed and dependence in activities of daily living in older adults with severe aortic stenosis.
abstract: BACKGROUND
  In the transcatheter aortic valve replacement era, characterization of functional status in older adults with aortic stenosis (AS) is essential. Gait speed (GS) is emerging as a marker of frailty and predictor of outcomes in older adults undergoing cardiovascular intervention. The objective of this study was to delineate the prevalence of slow GS, evaluate the association of GS with factors used in standard cardiovascular assessments, and evaluate the association of GS with dependence in activities of daily living (ADLs) in older adults with AS.
  
  
  OBJECTIVE
  We hypothesized that gait speed would not be associated with clinical factors, but would be associated with ADLs.
  
  
  METHODS
  We evaluated GS, ADLs dependence, and Society of Thoracic Surgery score along with clinical and functional assessments in 102 older adults with AS being evaluated for transcatheter valve. Gait speed <0.5 m/s was considered slow, and GS ≥0.5 m/s was considered preserved. We assessed the association of covariates with GS as well as with ADLs dependence.
  
  
  RESULTS
  Median GS was 0.37 m/s (interquartile range, 0.0-0.65 m/s). Sixty-four (63%) subjects had slow GS. Of commonly employed clinical covariates, only prior coronary intervention and serum albumin were weakly associated with GS. However, GS was independently associated with ADLs dependence (Odds ratio: 1.52 [1.21-1.91] for every 0.1 m/s decrease in GS; P = 0.0003).
  
  
  CONCLUSIONS
  Although the prevalence of slow GS in a population of elderly patients with severe AS being screened for transcatheter valve was high, there were only weak associations between GS and other risk stratifying tools. The strong association between GS and dependent functional status suggests that assessment of gait speed is a useful, objectively measurable, risk stratification tool in this population.
authors.affiliation: Department of Medicine Columbia University Medical Center, 173 Fort Washington Ave, New York, NY 10032, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Green
authors.forename: Abigail E
authors.initials: AE
authors.lastname: Woglom
authors.forename: Philippe
authors.initials: P
authors.lastname: Genereux
authors.forename: Mathew S
authors.initials: MS
authors.lastname: Maurer
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Kirtane
authors.forename: Marian
authors.initials: M
authors.lastname: Hawkey
authors.forename: Susan
authors.initials: S
authors.lastname: Schnell
authors.forename: Jeanie
authors.initials: J
authors.lastname: Sohn
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Moses
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
authors.forename: Craig R
authors.initials: CR
authors.lastname: Smith
authors.forename: Mathew
authors.initials: M
authors.lastname: Williams
authors.forename: Susheel
authors.initials: S
authors.lastname: Kodali
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000503:physiopathology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies