Gait speed as a test for monitoring frailty in community-dwelling older people has the highest diagnostic value compared to step length and chair rise time

Abstract

Background: Frailty reflects a state of increased risk of negative health outcomes, such as falls and mortality. Self-management in recognition and monitoring of frailty is a prerequisite for effective and efficient care for the elderly. Mobility may be self-monitored with simple reliable tests, such as maximum step length (MSL) test, gait speed (GS) test, or chair rise test (CR).

Aim: The aim was to investigate whether a complex frailty assessment may be replaced by simple stand alone mobility tests as a prerequisite for self-monitoring of frailty.

Design: This was an observational cross-sectional study.

Setting: The study was performed in an outpatient clinic.

Population: The study subjects were community-dwelling older people aged 70 years or older.

Methods: In all subjects, frailty status was assessed using a standardised geriatric assessment that included Fried's frailty phenotype and the Frailty Index (FI). Mobility was assessed with the MSL, GS and CR.

Results: A total of 593 subjects with mean age of 76.8 years (±4.8 [SD]), 56% female, participated in the study. GS showed a correlation of r=-0.60 with both the Fried score and the FI. The MSL correlated best with the Fried score: r=-0.52, and the CR correlated best with the FI: r=0.51. The GS had an area under the curve of 0.92 for assessing the dichotomised frailty state.

Conclusion: Compared with step length and chair rise time, gait speed has the strongest correlation with frailty, the highest diagnostic value, and it is the simplest single measure that can replace the complex frailty assessment as a self-test for monitoring frailty at home.

Clinical rehabilitation impact: THE self-monitoring of frailty is likely to be possible with GS, which may be a valuable tool for empowering older individuals.