Comparative study of young-old and old-old people using functional evaluation, gait characteristics, and cardiopulmonary metabolic energy consumption

Abstract

Background Walking is an important factor in daily life. Among older adults, gait function declines with age. In contrast to the many studies revealing gait differences between young adults and older adults, few studies have further divided older adults into groups. The purpose of this study was to subdivide an older adult population by age to identify age-related differences in functional evaluation, gait characteristics and cardiopulmonary metabolic energy consumption while walking. Methods This was a cross-sectional study of 62 old adult participants who were classified into two age groups of 31 participants each as follows: young-old (65–74 years) and old-old (75–84 years) group. Physical functions, activities of daily living, mood state, cognitive function, quality of life, and fall efficacy were evaluated using the Short Physical Performance Battery (SPPB), Four-square Step Test (FSST), Timed Up and Go Test (TUG), Korean Version of the Modified Barthel Index, Geriatric Depression Scale (GDS), Korean Mini-mental State Examination, EuroQol-5 Dimensions (EQ-5D) questionnaire, and the Korean version of the Fall Efficacy Scale. A three-dimensional motion capture system (Kestrel Digital RealTime System®; Motion Analysis Corporation, Santa Rosa, CA, USA) and two force plates (TF-4060-B; Tec Gihan, Kyoto, Japan) were used to investigate spatiotemporal gait parameters (velocity, cadence, stride length, stride width, step length, single support, stance phase, and swing phase), kinematic variables (hip, knee, and ankle joint angles), and kinetic variables (hip, knee, and ankle joint moment and power) of gait. A portable cardiopulmonary metabolic system (K5; Cosmed, Rome, Italy) was used to measure cardiopulmonary energy consumption. Results The old-old group showed significantly lower SPPB, FSST, TUG, GDS-SF, and EQ-5D scores (p < 0.05). Among spatiotemporal gait parameters, velocity, stride length, and step length were significantly lower in the old-old group than in the young-old group (p < 0.05). Among the kinematic variables, the knee joint flexion angles during initial contact and terminal swing phase were significantly higher in the old-old than the young-old group (P < 0.05). The old-old group also showed a significantly lower ankle joint plantarflexion angle during the pre- and initial swing phases (P < 0.05). Among the kinetic variables, the hip joint flexion moment and knee joint absorption power in the pre-swing phase were significantly lower in the old-old than the young-old group (P < 0.05). Conclusion This study demonstrated that participants 75–84 years of age had less functional gaits than their young-old counterparts (65–74 years old). As the walking pace of old-old people diminishes, driving strength to move ahead and pressure on the knee joint also tend to decrease together with stride length. These differences in gait characteristics according to age among older adults could improve our understanding of how aging causes variations in gait that increase the risk of falls. Older adults of different ages may require customized intervention plans, such as gait training methods, to prevent age-related falls. Trial registration Clinical trials registration information: ClinicalTrials.gov Identifier: NCT04723927 (26/01/2021).

Does Old Age Comprise Distinct Subphases? Evidence from an Analysis of the Relationship between Age and Activities of Daily Living, Comorbidities, and Geriatric Syndromes

“…Some authors 1,3,4) concur with this age limit; others have reported a cutoff of 75 years. [5][6][7][8] This observation is clinically significant. The difficulty of treating older individuals as a homog-enous group is reflected in the Australian clinical guidelines.…”

“…Furthermore, other studies have suggested that the 65–74 and ≥75 years of age groups differ in mental and physical health. 6 , 7 ) The analysis of the surveys in these previous studies, initially divided the participants into age groups to explore age-related differences. In contrast, based on similarities in disease profiles and using clustering techniques, Geifman et al 8 ) investigated the feasibility of redefining age ranges and concluded that the 76–98 years of age group was distinct in terms of age-related diseases including Alzheimer disease, dementia, cataracts, and Parkinson disease.…”

A Comparison of Dynamic Gait Stability between the Young and Elderly Female Populations Using the Zero-Moment Point Method

“…This is a novel study that involves a comparison of gait stability between the young and elderly populations in their habitual walking speed using the ZMP method. Most previous studies for understanding gait stability in the elderly focused on gait characteristics, such as walking speed, stride length, and the time for double-limb support [31]. In this study, the dynamic stability of habitual walking was assessed to investigate the gait of the elderly compared to the young.…”

The Association of Body Mass Index on Falls Risk and Mortality in Hospitalized Patients of Different Old-Age Categories Requiring Nutritional Support

“…In the 2017 National Survey of Older Koreans, the proportions of older adults aged 65−74 and over 75 years were reported to be about 57% and 43%, respectively; the proportion of those aged 75 years or more has been confirmed to be increasing continuously [ 31 ]. In addition, recent nutrition related studies have reported comparable clinical outcomes for groups classified into 65–74 years (young-old) and 75 or older (old-old) [ 32 33 ]. Therefore, in this study, based on age, participants were categorized into 2 groups: 1) 65−74 years old and 2) ≥ 75 years old.…”