Walking Speed, Risk Factors, and Cardiovascular Events in Older Adults—Systematic Review

Abstract

Fonseca Alves, DJ, Bartholomeu-Neto, J, Júnior, ER, Ribeiro Zarricueta, BS, Nóbrega, OT, and Córdova, C. Walking speed, risk factors, and cardiovascular events in older adults-systematic review. J Strength Cond Res 31(11): 3235-3244, 2017-It is important that new clinical measures can identify risk factors and predict cardiovascular events. Although the walking speed (WS) test is a potential candidate, consolidating data from multiple studies is required to determine comparative references. We examined the associations of WS measures with markers of cardiovascular risk and with cardiovascular events in noninstitutionalized subjects older than 60 years. A systematic review of observational studies was conducted using MEDLINE and SCOPUS from inception of the databases to December 2014, aiming at studies that evaluated WS as the primary outcome (usual or maximal pace) within a distance ≤20 m associated with cardiovascular health. All 15 included studies (29,845 subjects) reported significant associations of WS with different cardiovascular risk factors (coronary artery calcification, C-reactive protein, hypertension, diabetes, and intima-media thickness) and occurrence of cardiovascular events (peripheral artery disease, stroke, and mortality). Approximately 80% of the studies used a distance ≤6 m and WS at usual pace. There was high heterogeneity in the risk thresholds established by different studies. Our results suggest usefulness of the WS test as a tool for cardiovascular risk stratification in older adults. However, the variation in speed thresholds and diversity of protocols among studies suggest caution when generalizing results to different older adult populations. Because the WS test is a simple, cheap, and safe tool to administer, we make suggestions for its standardization in future studies.

<p>Gait Speed at Discharge and Risk for Readmission or Death: A Prospective Study of an Emergency Ward Population</p>

“…8 There has been a growing interest in measuring gait speed for assessing motor function and long-term mortality. 9 It is thought to be a surrogate marker for frailty, and has even been called a new vital sign. 10,11 Information about the association between gait speed and risk of hospital readmission is scarce; only two studies have suggested such an association.…”

Association between Walking Pace and Diabetes: Findings from the Chilean National Health Survey 2016–2017

“…The associations found between walking pace and T2D agree with international existing evidence [ 25 , 26 , 27 , 28 , 29 , 30 ]. However, other studies have shown that walking pace is also a strong predictor of cardiovascular disease, cancer, and premature mortality in middle age [ 7 , 8 , 9 , 31 ] as well as cardiovascular risk, cardiovascular events, and risk of death in older adults [ 32 , 33 , 34 ]. In addition, walking pace has been used to estimate years of physical functioning lost in older adults and has been associated with both low socioeconomic status and risk factors for non-communicable diseases (among them T2D) [ 35 ].…”

“…If causal, the early assessment of walking pace could help as a cardiovascular and metabolic risk assessment in older adults [34]. More specifically, as a tool to identify individuals who have a high diabetic risk.…”

Small Steps in Fitness, Major Leaps in Health for Adults With Intellectual Disabilities

“…As CVD is the leading cause for mortality in the general population [17], and CVD risk factors are highly prevalent in individuals with intellectual disabilities [18], we will specifically focus on CVD morbidity and on all-cause mortality. Several physical fitness components strongly predict CVD morbidity and mortality in the general population, with the strongest evidence for cardiorespiratory fitness [19,20], gait speed [21,22] and grip strength [23].…”

“…In older adults, a comfortable gait speed below 1.0 m/s and below 0.8 m/s is often used as a cut-off for an increased all-cause mortality risk [22,[27][28][29]. Cut-off values between 0.8 -1.3 m/s were identified for CVD morbidity risk in older adults (60 years and over) [21]. This range in cut-off values suggest that there may be an 'area of risk' instead of a single cut-off value, with a gait speed of 0.8 m/s seen as the lower end.…”