Lower Extremity Function Original Study| Volume 20, ISSUE 10, P1224-1229, October 2019

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

Published:August 05, 2019DOI:



      To determine home-based gait speed performance and its associations with sociodemographic and health-related factors among older adults.


      Cross-sectional analysis of a nationally representative US population sample.

      Setting and participants

      Homes of Health and Retirement Study (HRS) participants.


      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).


      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.


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        • Abellan van Kan G.
        • Rolland Y.
        • Andrieu S.
        • et al.
        Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force.
        J Nutr Health Aging. 2009; 13: 881-889
      1. Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention.
        J Am Geriatr Soc. 2001; 49: 664-672
        • Kikkert L.H.J.
        • Vuillerme N.
        • van Campen J.P.
        • et al.
        Walking ability to predict future cognitive decline in old adults: A scoping review.
        Ageing Res Rev. 2016; 27: 1-14
        • Montero-Odasso M.
        • Schapira M.
        • Soriano E.R.
        • et al.
        Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older.
        J Gerontol A Biol Sci Med Sci. 2005; 60: 1304-1309
        • Pamoukdjian F.
        • Paillaud E.
        • Zelek L.
        • et al.
        Measurement of gait speed in older adults to identify complications associated with frailty: A systematic review.
        J Geriatr Oncol. 2015; 6: 484-496
        • Studenski S.
        • Perera S.
        • Wallace D.
        • et al.
        Physical performance measures in the clinical setting.
        J Am Geriatr Soc. 2003; 51: 314-322
        • Bohannon R.W.
        • Williams Andrews A.
        Normal walking speed: A descriptive meta-analysis.
        Physiotherapy. 2011; 97: 182-189
        • Graham J.E.
        • Ostir G.V.
        • Fisher S.R.
        • et al.
        Assessing walking speed in clinical research: A systematic review.
        J Eval Clin Pract. 2008; 14: 552-562
        • Graham J.E.
        • Ostir G.V.
        • Kuo Y.F.
        • et al.
        Relationship between test methodology and mean velocity in timed walk tests: A review.
        Arch Phys Med Rehabil. 2008; 89: 865-872
        • Peel N.M.
        • Kuys S.S.
        • Klein K.
        Gait speed as a measure in geriatric assessment in clinical settings: A systematic review.
        J Gerontol A Biol Sci Med Sci. 2013; 68: 39-46
        • Blanco I.
        • Verghese J.
        • Lipton R.B.
        • et al.
        Racial differences in gait velocity in an urban elderly cohort.
        J Am Geriatr Soc. 2012; 60: 922-926
        • Kirkness C.S.
        • Ren J.
        Race differences: Use of walking speed to identify community-dwelling women at risk for poor health outcomes—Osteoarthritis Initiative Study.
        Phys Ther. 2015; 95: 955-965
        • Thorpe Jr., R.J.
        • Koster A.
        • Kritchevsky S.B.
        • et al.
        Race, socioeconomic resources, and late-life mobility and decline: Findings from the Health, Aging, and Body Composition study.
        J Gerontol A Biol Sci Med Sci. 2011; 66: 1114-1123
        • Guralnik J.M.
        • Ferrucci L.
        • Pieper C.F.
        • et al.
        Lower extremity function and subsequent disability: Consistency across studies, predictive models, and value of gait speed alone compared with the Short Physical Performance Battery.
        J Gerontol A Biol Sci Med Sci. 2000; 55: M221-M231
        • Simonsick E.M.
        • Maffeo C.E.
        • Rogers S.K.
        • et al.
        Methodology and feasibility of a home-based examination in disabled older women: The Women's Health and Aging Study.
        J Gerontol A Biol Sci Med Sci. 1997; 52: M264-M274
        • Guralnik J.M.
        • Simonsick E.M.
        • Ferrucci L.
        • et al.
        A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission.
        J Gerontol. 1994; 49: M85-M94
        • Youdas J.W.
        • Childs K.B.
        • McNeil M.L.
        • et al.
        Responsiveness of 2 procedures for measurement of temporal and spatial gait parameters in older adults.
        PM R. 2010; 2: 537-543
        • Guralnik J.M.
        • Branch L.G.
        • Cummings S.R.
        • et al.
        Physical performance measures in aging research.
        J Gerontol. 1989; 44: M141-M146
        • Guralnik J.M.
        • Ferrucci L.
        • Simonsick E.M.
        • et al.
        Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability.
        N Engl J Med. 1995; 332: 556-561
        • Hayes K.W.
        • Johnson M.E.
        Measures of adult general performance tests: The Berg Balance Scale, Dynamic Gait Index (DGI), Gait Velocity, Physical Performance Test (PPT), Timed Chair Stand Test, Timed Up and Go, and Tinetti Performance-Oriented Mobility Assessment (POMA).
        Arthritis Care Res. 2003; 49: S28-S42
        • Markides K.S.
        • Black S.A.
        • Ostir G.V.
        • et al.
        Lower body function and mortality in Mexican American elderly people.
        J Gerontol A Biol Sci Med Sci. 2001; 56: M243-M247
        • Juster F.T.
        • Suzman R.
        An overview of the health and retirement study.
        J Hum Resour. 1995; 30: S7-S56
        • Fisher G.G.
        • Ryan L.H.
        Overview of the Health and Retirement Study and introduction to the special issue.
        Work Aging Retire. 2018; 4: 1-9
        • Health and Retirement Study
        Cross-Wave Tracker 2014 File (v.1.0), Cross-Wave Census Region/Division and Mobility File (v.6.1), RAND HRS Longitudinal File 2014 (v.2), 2006 RAND HRS Fat File (v.3A), 2008 RAND HRS Fat File (v.3A) public use dataset.
        University of Michigan, National Institute on Aging, Ann Arbor, MI2018
        • Kim J.
        • Richardson V.
        The impact of socioeconomic inequalities and lack of health insurance on physical functioning among middle-aged and older adults in the United States.
        Health Soc Care Community. 2012; 20: 42-51
        • Verghese J.
        • Wang C.
        • Allali G.
        • et al.
        Modifiable risk factors for new-onset slow gait in older adults.
        J Am Med Dir Assoc. 2016; 17: 421-425
        • Verghese J.
        • Annweiler C.
        • Ayers E.
        • et al.
        Motoric cognitive risk syndrome: Multicountry prevalence and dementia risk.
        Neurology. 2014; 83: 718-726
        • Zivin K.
        • Llewellyn D.J.
        • Lang I.A.
        • et al.
        Depression among older adults in the United States and England.
        Am J Geriatr Psychiatry. 2010; 18: 1036-1044
        • Cummings S.R.
        • Studenski S.
        • Ferrucci L.
        A diagnosis of dismobility—Giving mobility clinical visibility: A Mobility Working Group recommendation.
        JAMA. 2014; 311: 2061-2062
        • Fielding R.A.
        • Vellas B.
        • Evans W.J.
        • et al.
        Sarcopenia: An undiagnosed condition in older adults. Current consensus definition: Prevalence, etiology, and consequences. International Working Group on Sarcopenia.
        J Am Med Dir Assoc. 2011; 12: 249-256
        • Studenski S.
        • Perera S.
        • Patel K.
        • et al.
        Gait speed and survival in older adults.
        JAMA. 2011; 305: 50-58
        • Berglund P.A.
        Getting the MOST out of the SAS® survey procedures: Repeated replication methods, subpopulation analysis, and missing data options in SAS® v9.2.
        SAS Global Forum, 2009
        • Benjamini Y.
        • Hochberg Y.
        Controlling the false discovery rate: A new and powerful approach to multiple testing.
        J R Stat Soc Series B. 1995; 57: 1289-1300
        • Black S.A.
        • Markides K.S.
        • Miller T.Q.
        Correlates of depressive symptomatology among older community-dwelling Mexican Americans: The Hispanic EPESE.
        J Gerontol B Psychol Sci Soc Sci. 1998; 53: S198-S208
        • Cornoni-Huntley J.
        • Ostfeld A.M.
        • Taylor J.O.
        • et al.
        Established populations for epidemiologic studies of the elderly: Study design and methodology.
        Aging (Milano). 1993; 5: 27-37
        • Stephan Y.
        • Sutin A.R.
        • Terracciano A.
        “Feeling younger, walking faster”: Subjective age and walking speed in older adults.
        Age (Dordr). 2015; 37: 86
        • Bohannon R.W.
        Population representative gait speed and its determinants.
        J Geriatr Phys Ther. 2008; 31: 49-52
        • Middleton A.
        • Fritz S.L.
        • Lusardi M.
        Walking speed: The functional vital sign.
        J Aging Phys Act. 2015; 23: 314-322