Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people [La vitesse de marche comme critère de fragilité chez la personne âgée vivant au domicile]

Introduction: The use of a simple, safe and easy to perform assessment tool, like gait speed, to evaluate vulnerability to adverse outcomes in community-dwelling older people is appealing, but its predictive capacity is still questioned. The present manuscript summarises the conclusions of an expert panel (from International Academy on Nutrition and Aging) in the domain of physical performance measures and frailty in older people. Methods: A systematic review of literature was performed prior to the meeting (Medline search and additional pearling of reference lists and key-articles supplied by Task Force members). Manuscripts were retained for the present revision and reviewed and discussed during a 2-day meeting. Results: Gait speed at usual pace was found to be a consistent risk factor for disability, cognitive impairment, institutionalization, falls, and/or mortality. In predicting these adverse outcomes over time, gait speed was at least as sensible as composite tools (Fried's criteria, Short Physical Performance Battery). Conclusion: Although more specific surveys need to be performed, there is sufficient evidence to state that gait speed identifies nondisabled community-dwelling older people at risk of adverse outcomes and can be used as a single-item assessment tool. The assessment at usual pace over 4 m was the most often used method in literature and might represent a quick, safe, inexpensive, and highly reliable instrument to be implemented. © Springer-Verlag France 2009.