Abstract :
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 in the domain
of physical performance measures and frailty in older people, who reviewed and discussed the existing literature
in a 2-day meeting held in Toulouse, France on March 12-13, 2009. The aim of the IANA Task Force was to
state if, in the light of actual scientific evidence, gait speed assessed at usual pace had the capacity to identify
community-dwelling older people at risk of adverse outcomes, and if gait speed could be used as a single-item
tool instead of more comprehensive but more time-consuming assessment instruments. 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 only when
a high level of evidence was present following 4 pre-selected criteria: a) gait speed, at usual pace, had to be
specifically assessed as a single-item tool, b) gait speed should be measured over a short distance, c) at baseline,
participants had to be autonomous, community-dwelling older people, and d) the evaluation of onset of adverse
outcomes (i.e. disability, cognitive impairment, institutionalisation, falls, and/or mortality) had to be assessed
longitudinally over time. Based on the prior criteria, a final selection of 27 articles was used for the present
manuscript. Results: Gait speed at usual pace was found to be a consistent risk factor for disability, cognitive
impairment, institutionalisation, falls, and/or mortality. In predicting these adverse outcomes over time, gait
speed was at least as sensible as composite tools. Conclusions: Although more specific surveys needs to be
performed, there is sufficient evidence to state that gait speed identifies autonomous 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 meters was the most often used method in literature and might represent a quick, safe, inexpensive
and highly reliable instrument to be implemented.
