Racial Differences in Gait Velocity in an Urban Elderly Cohort

Abstract

Background/ Objectives Gait Velocity (GV) is predictive of hospitalizations and mortality in the elderly. In the US, elderly African Americans have higher rates of physical disability compared to Caucasians. Few studies have investigated if there are racial differences in GV in the elderly. Design We performed a cross sectional analysis to investigate racial differences in GV. Setting/Participants Participants were part of the Einstein Aging Study, a longitudinal study of community-residing elderly in the Bronx, NY. They were recruited using Medicare and voter registration records. Records of 213 participants were analyzed. Measurements Demographics, medical history, the Geriatric Depression Scale, the Blessed Information Memory Concentration Test, and the Total Pain Index (TPI) were collected. GV was measured using the GAITrite® mat. Results We included 157 Caucasians and 56 African Americans. Caucasians were older (median 79.9y v 75.5y, p<0.01), more educated (median 14y v 12y, p<0.01) and had lower BMIs (mean 26.9±4.3 v 28.9±6.4, p=0.03). African Americans had higher proportions of female participants (80.4% v 59.9%, p<0.01) and diabetes (28.6% v 13.4%, p=0.01). Neither group had significantly higher pain levels. African Americans had a significantly slower GV (mean 90.2±17.9 v 99.1±20.1 cm/sec, p<0.01). This difference persists despite adjusting for multiple covariates. A 7.79 cm /sec slower gait speed in African Americans versus Caucasians was not explained by differences in common factors known to influence gait. Conclusion Differences in GV persist between African Americans and Caucasians despite adjusting for many confounders. Increases of just 10cm/sec are associated with reduced mortality. Further studies are needed to evaluate if there are modifiable risk factors that potentially explain this difference and if an intervention could reduce the discrepancy between the groups.

Gait speed correlates in a multiracial population of community-dwelling older adults living in Brazil: a cross-sectional population-based study

“…We did not observe racial differences in gait speed. However, a recent study [21] that compared Caucasians and African Americans identified that gait speed was slower in African Americans, even when adjusting for multiple confounders and covariates, such as age, gender, education, comorbidities and pain. One possible explanation is that, in some multiracial samples, such as ours, the ambiguity in racial classification can be substantial [36], mainly in Brazil where race is based primarily on skin colour rather than ancestry.…”

“…Mean values for usual gait speed in community-dwelling older adults vary substantially; for example, from 0.56 m/s in a Hispanic American population to 1.19 m/s in a population of men (mainly White Americans) [2]. These differences in walking speed may reflect not only a multi-systemic impairment in health status, traduced by biological dysfunctions (for example, cognitive, musculoskeletal, neural) such as dynapenia [17], diminished cutaneous sensitivity and decreased nerve conduction velocity [18] and brain neuronal loss and presence of white matter lesions [19,20], but may be also influenced by racial differences [21], psychological and socioeconomic conditions such as a high concern about falling [22], low educational level [23] and low employment grade [24]. Therefore, social, biological or health factors might explain why certain groups tend to self-select their gait speed (e.g., usual or fast) in different patterns, but the significance of each factor within a multifactorial approach has not been fully explored.…”

Efeito agudo do alongamento na marcha de idosas em terreno inclinado

“…A velocidade de deslocamento tem sido descrita como um dos melhores indicadores de segurança na marcha. Incrementos em torno de 0,1 m.s -1 na velocidade de deslocamento de idosos estão diretamente associados com a redução do risco de acidentes durante a transposição de terrenos planos (41). Acredita-se que, de forma similar ao que acontece em terreno plano, incrementos na velocidade de deslocamento na rampa sejam reflexo de maior capacidade de controle.…”

Associations Between Inflammation and Physical Function in African Americans and European Americans with Prevalent Cardiovascular Risk Factors

“…Previous studies have also demonstrated lower physical function and greater disability in AA compared to EA. 32,33 Potentially, higher levels of inflammation among AA could contribute to disparities in physical function.…”