title: Gait shows a sex-specific pattern of associations with daily functioning in a community-dwelling population of older people.
abstract: BACKGROUND
  Gait is increasingly considered an important indicator of health. Yet, little is known on the relation of gait with established health indicators, e.g. daily functioning. Although gait differs by sex, it is unknown whether different gait domains provide different health indicators in men or women. We investigated how gait associates with basic and instrumental activities of daily living (BADL and IADL) in community-dwelling persons.
  
  
  METHODS
  In 2500 participants of the population-based Rotterdam Study (aged ≥ 50 yrs), gait was assessed by electronic walkway and summarized into seven independent gait domains: Pace, Rhythm, Phases, Tandem, Turning, Variability, Base of Support, which were averaged into Global Gait. We assessed BADL with the disability index of the Stanford Health Assessment Questionnaire and IADL with the Instrumental Activities of Daily Living scale. BADL and IADL were analyzed as continuous scores, and dichotomised: with impairment defined as moderate to very severe disability.
  
  
  RESULTS
  In men, Global Gait, Pace, and Rhythm associated with BADL in linear analyses. In contrast, all domains except Base of Support associated with BADL or IADL in women. Associations of Global Gait and Phases with BADL were significantly stronger in women (p-interaction < 0.05). Similarly, associations of Global Gait, Rhythm, and Phases with IADL were stronger in women (p-interaction < 0.05). For dichotomised analyses, higher Global Gait, Pace, and Rhythm associated with less BADL-impairment in men, while Global Gait associated with less BADL and IADL-impairment in women.
  
  
  CONCLUSIONS
  In men, Pace and Rhythm may suffice as health indicators, while women may require comprehensive gait assessment to better estimate their health status.
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Department of Radiology, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: v.verlinden@erasmusmc.nl.
authors.forename: Vincentius J A
authors.initials: VJ
authors.lastname: Verlinden
authors.affiliation: Department of Neuroscience, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: j.vandergeest@erasmusmc.nl.
authors.forename: Jos N
authors.initials: JN
authors.lastname: van der Geest
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: j.heeringa@erasmusmc.nl.
authors.forename: Jan
authors.initials: J
authors.lastname: Heeringa
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: a.hofman@erasmusmc.nl.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Department of Radiology, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Department of Neurology, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: m.a.ikram@erasmusmc.nl.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D005684:Gait / Q000502:physiology*; D006305:Health Status Indicators; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
keywords: Activities of daily living; Aging; Gait; Sex; Walking