title: Gait speed in ambulant older people in long term care: a systematic review and meta-analysis.
abstract: BACKGROUND
  Gait speed, recently proposed as the sixth vital sign of geriatric assessment, is a strong predictor of adverse outcomes. Walking faster than 1.0 m/s is associated with better survival in community-dwelling older adults, and a recent meta-analysis of older adults in clinical settings estimated usual gait speed to be 0.58 m/s. Here, we aimed to review gait speed values for long term care residents.
  
  
  METHODS
  Relevant databases were systematically searched for original research studies published prior to December 2012. Inclusion criteria were participants living in long term care, mean age >70 years, and gait speed measured over a short distance. Meta-analysis determined gait speed data adjusting for covariates including age, sex, and cognition.
  
  
  RESULTS
  Final data included 2888 participants from 34 studies. The percentage of residents ineligible because of inability to mobilize was stated in only 1 study. Of the 34 studies, 22 reported cognitive status using the Mini-Mental State Examination. Usual pace and maximal pace gait speeds were determined separately using a random effects model. No association between gait speed and covariates was found. Usual pace gait speed was 0.475 m/s (95% confidence interval 0.396-0.554) and maximal pace was 0.672 m/s (95% confidence interval 0.532-0.811).
  
  
  CONCLUSIONS
  In ambulant older people in long term care, gait speed is slow but remains functional. However, since many residents are likely to have been ineligible to participate in assessments, these results cannot be generalized to the long term care population as a whole.
authors.affiliation: Allied Health Research Collaborative, Metro North Health Service District, Queensland Health, Queensland, Australia; School of Rehabilitation Science, Griffith Health Institute, Griffith University, Australia. Electronic address: s.kuys@griffith.edu.au.
authors.forename: Suzanne S
authors.initials: SS
authors.lastname: Kuys
authors.affiliation: Center for Research in Geriatric Medicine, School of Medicine, The University of Queensland, Queensland, Australia.
authors.forename: Nancye M
authors.initials: NM
authors.lastname: Peel
authors.affiliation: Queensland Clinical Trials & Biostatistics, School of Population Health, The University of Queensland, Queensland, Australia.
authors.forename: Kerenaftali
authors.initials: K
authors.lastname: Klein
authors.affiliation: Center for Research in Geriatric Medicine, School of Medicine, The University of Queensland, Queensland, Australia.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Slater
authors.affiliation: Center for Research in Geriatric Medicine, School of Medicine, The University of Queensland, Queensland, Australia.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Hubbard
mesh_terms: D000054:Acceleration; D000368:Aged; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008134:Long-Term Care; D009735:Nursing Homes
keywords: Gait speed; long term care; meta-analysis