Get access

Incidence of Loss of Ability to Walk 400 Meters in a Functionally Limited Older Population

Authors

  • Milan Chang PhD,

    1. From the *Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, MarylandResearch Institute on Aging, Hebrew Home of Greater Washington Research Institute, Rockville, MarylandGeorge Washington University Medical Center, Washington, DC§Hebrew Rehabilitation Center for Aged, Research and Training Institute, Boston, MassachusettsDepartment of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy.
    Search for more papers by this author
  • Jiska Cohen-Mansfield PhD,

    1. From the *Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, MarylandResearch Institute on Aging, Hebrew Home of Greater Washington Research Institute, Rockville, MarylandGeorge Washington University Medical Center, Washington, DC§Hebrew Rehabilitation Center for Aged, Research and Training Institute, Boston, MassachusettsDepartment of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy.
    Search for more papers by this author
  • Luigi Ferrucci MD, PhD,

    1. From the *Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, MarylandResearch Institute on Aging, Hebrew Home of Greater Washington Research Institute, Rockville, MarylandGeorge Washington University Medical Center, Washington, DC§Hebrew Rehabilitation Center for Aged, Research and Training Institute, Boston, MassachusettsDepartment of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy.
    Search for more papers by this author
  • Suzanne Leveille PhD,

    1. From the *Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, MarylandResearch Institute on Aging, Hebrew Home of Greater Washington Research Institute, Rockville, MarylandGeorge Washington University Medical Center, Washington, DC§Hebrew Rehabilitation Center for Aged, Research and Training Institute, Boston, MassachusettsDepartment of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy.
    Search for more papers by this author
  • Stefano Volpato MD, MPH,

    1. From the *Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, MarylandResearch Institute on Aging, Hebrew Home of Greater Washington Research Institute, Rockville, MarylandGeorge Washington University Medical Center, Washington, DC§Hebrew Rehabilitation Center for Aged, Research and Training Institute, Boston, MassachusettsDepartment of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy.
    Search for more papers by this author
  • Nathalie De Rekeneire MD,

    1. From the *Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, MarylandResearch Institute on Aging, Hebrew Home of Greater Washington Research Institute, Rockville, MarylandGeorge Washington University Medical Center, Washington, DC§Hebrew Rehabilitation Center for Aged, Research and Training Institute, Boston, MassachusettsDepartment of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy.
    Search for more papers by this author
  • Jack M. Guralnik MD, PhD

    1. From the *Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, MarylandResearch Institute on Aging, Hebrew Home of Greater Washington Research Institute, Rockville, MarylandGeorge Washington University Medical Center, Washington, DC§Hebrew Rehabilitation Center for Aged, Research and Training Institute, Boston, MassachusettsDepartment of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy.
    Search for more papers by this author

Miran (Milan) Chang, PhD, Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, 7201 Wisconsin Ave, Gateway Building, Suite 3C-309, Bethesda, MD, 20892. E-mail: changmi@hjarta.is

Abstract

Objectives: To assess the incidence of and factors related to nondisabled but functionally limited older adults aged 75 to 85 years losing the ability to walk 400 m.

Design: Observational study with average follow-up of 21 months.

Setting: Community.

Participants: At baseline, 101 persons with objective signs of functional limitations and intact cognitive function agreed to participate in the study. Of these, 81 were able to walk 400 m at baseline, and 62 participated in the follow-up examination.

Measurements: Mobility disability was defined as an inability to complete a 400-m walk test. At baseline, eligible participants (n=81) had the ability to walk 400 m, scored between 4 and 9 on the Short Physical Performance Battery (SPPB; range 0–12), and scored 18 or more on the Mini-Mental State Examination. Demographics, difficulty in daily activities, disease status, behavioral risk factors, and muscle strength were assessed at baseline and follow-up.

Results: Of 62 persons at follow-up, 21 (33.9%) developed incident mobility disability. The strongest predictors of loss of mobility were the time to complete the 400-m walk at baseline (odds ratio (OR)=1.6 per 1-minute difference, 95% confidence interval (CI)=1.04–2.45), and decline in SPPB score over the follow-up (OR=1.4 per 1-point difference, 95% CI=1.01–1.92).

Conclusion: Older persons with functional limitations have a high rate of loss of ability to walk 400 m. The 400-m walk test is a highly relevant, discrete outcome that is an ideal target for testing preventive interventions in vulnerable older populations.

Get access to the full text of this article

Ancillary