Home-Based Gait Speed Assessment: Normative Data and Racial/Ethnic Correlates Among Older Adults

Objectives: To determine home-based gait speed performance and its associations with sociodemographic and health-related factors among older adults. Design: Cross-sectional analysis of a nationally representative US population sample. Setting and participants: Homes of Health and Retirement Study (HRS) participants. Methods: Walk test data measured at home over 2.5 m were aggregated for 6983 individuals, aged >= 65 years (mean age 74.8 +/- 6.9 years, 54.2% women), from the 2006 and 2008 HRS waves. Means for gait speed at normal pace were determined for demographic and clinical groupings; association of gait speed with demographic, socioeconomic status, and health factors were examined. Four-year mortality was predicted from baseline slow gait status defined using demographic-based cutoff scores as well as commonly recommended cutoff scores (100 or 60 cm/s). Results: Home-based gait speed (cm/s) means were lower for female than male (9.6% difference), older than younger (18.0% difference), African American than white (20.5% difference), and Hispanic than Non-Hispanic (10.3% difference) participants. Differences by age group, race, and ethnicity remained significant within sexes (P < .001). Lower speed was associated with African American race and all health problems; higher speed was associated with higher socioeconomic status and alcohol consumption. Four-year mortality was predicted by slow gait status. Predictive validity was, in general, higher for slow gait cutoff scores defined by demographic characteristics. Conclusions and implications: Mean gait speed measured at home differs among older (aged >= 65 years) US resident population groups defined by sex, age, race, ethnicity, health status, and combinations of these factors, and predicts 4-year mortality when substantially slower than group-based norms. These findings may assist researchers and clinicians in determining normal and abnormal gait performance in older adults in community settings. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.