Gait speed and dependence in activities of daily living in older adults with severe aortic stenosis

Philip Green, Abigail E. Woglom, Philippe Genereux, Mathew S. Maurer, Ajay J. Kirtane, Marian Hawkey, Susan Schnell, Jeanie Sohn, Jeffrey W. Moses, Martin B. Leon, Craig R. Smith, Mathew Williams, Susheel Kodali

Research output: Contribution to journalArticle

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Abstract

Background In the transcatheter aortic valve replacement era, characterization of functional status in older adults with aortic stenosis (AS) is essential. Gait speed (GS) is emerging as a marker of frailty and predictor of outcomes in older adults undergoing cardiovascular intervention. The objective of this study was to delineate the prevalence of slow GS, evaluate the association of GS with factors used in standard cardiovascular assessments, and evaluate the association of GS with dependence in activities of daily living (ADLs) in older adults with AS. Hypothesis We hypothesized that gait speed would not be associated with clinical factors, but would be associated with ADLs. Methods We evaluated GS, ADLs dependence, and Society of Thoracic Surgery score along with clinical and functional assessments in 102 older adults with AS being evaluated for transcatheter valve. Gait speed <0.5 m/s was considered slow, and GS ≥0.5 m/s was considered preserved. We assessed the association of covariates with GS as well as with ADLs dependence. Results Median GS was 0.37 m/s (interquartile range, 0.0-0.65 m/s). Sixty-four (63%) subjects had slow GS. Of commonly employed clinical covariates, only prior coronary intervention and serum albumin were weakly associated with GS. However, GS was independently associated with ADLs dependence (Odds ratio: 1.52 [1.21-1.91] for every 0.1 m/s decrease in GS; P = 0.0003). Conclusions Although the prevalence of slow GS in a population of elderly patients with severe AS being screened for transcatheter valve was high, there were only weak associations between GS and other risk stratifying tools. The strong association between GS and dependent functional status suggests that assessment of gait speed is a useful, objectively measurable, risk stratification tool in this population. Dr. Maurer is supported by a grant from the NIH/NIA AG036778-02. The other authors have no funding, financial relationships, or conflicts of interest to disclose.

Original languageEnglish (US)
Pages (from-to)307-314
Number of pages8
JournalClinical Cardiology
Volume35
Issue number5
DOIs
StatePublished - May 1 2012
Externally publishedYes

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Aortic Valve Stenosis
Activities of Daily Living
Walking Speed
Conflict of Interest
Organized Financing

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Green, P., Woglom, A. E., Genereux, P., Maurer, M. S., Kirtane, A. J., Hawkey, M., ... Kodali, S. (2012). Gait speed and dependence in activities of daily living in older adults with severe aortic stenosis. Clinical Cardiology, 35(5), 307-314. https://doi.org/10.1002/clc.21974
Green, Philip ; Woglom, Abigail E. ; Genereux, Philippe ; Maurer, Mathew S. ; Kirtane, Ajay J. ; Hawkey, Marian ; Schnell, Susan ; Sohn, Jeanie ; Moses, Jeffrey W. ; Leon, Martin B. ; Smith, Craig R. ; Williams, Mathew ; Kodali, Susheel. / Gait speed and dependence in activities of daily living in older adults with severe aortic stenosis. In: Clinical Cardiology. 2012 ; Vol. 35, No. 5. pp. 307-314.
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abstract = "Background In the transcatheter aortic valve replacement era, characterization of functional status in older adults with aortic stenosis (AS) is essential. Gait speed (GS) is emerging as a marker of frailty and predictor of outcomes in older adults undergoing cardiovascular intervention. The objective of this study was to delineate the prevalence of slow GS, evaluate the association of GS with factors used in standard cardiovascular assessments, and evaluate the association of GS with dependence in activities of daily living (ADLs) in older adults with AS. Hypothesis We hypothesized that gait speed would not be associated with clinical factors, but would be associated with ADLs. Methods We evaluated GS, ADLs dependence, and Society of Thoracic Surgery score along with clinical and functional assessments in 102 older adults with AS being evaluated for transcatheter valve. Gait speed <0.5 m/s was considered slow, and GS ≥0.5 m/s was considered preserved. We assessed the association of covariates with GS as well as with ADLs dependence. Results Median GS was 0.37 m/s (interquartile range, 0.0-0.65 m/s). Sixty-four (63{\%}) subjects had slow GS. Of commonly employed clinical covariates, only prior coronary intervention and serum albumin were weakly associated with GS. However, GS was independently associated with ADLs dependence (Odds ratio: 1.52 [1.21-1.91] for every 0.1 m/s decrease in GS; P = 0.0003). Conclusions Although the prevalence of slow GS in a population of elderly patients with severe AS being screened for transcatheter valve was high, there were only weak associations between GS and other risk stratifying tools. The strong association between GS and dependent functional status suggests that assessment of gait speed is a useful, objectively measurable, risk stratification tool in this population. Dr. Maurer is supported by a grant from the NIH/NIA AG036778-02. The other authors have no funding, financial relationships, or conflicts of interest to disclose.",
author = "Philip Green and Woglom, {Abigail E.} and Philippe Genereux and Maurer, {Mathew S.} and Kirtane, {Ajay J.} and Marian Hawkey and Susan Schnell and Jeanie Sohn and Moses, {Jeffrey W.} and Leon, {Martin B.} and Smith, {Craig R.} and Mathew Williams and Susheel Kodali",
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Green, P, Woglom, AE, Genereux, P, Maurer, MS, Kirtane, AJ, Hawkey, M, Schnell, S, Sohn, J, Moses, JW, Leon, MB, Smith, CR, Williams, M & Kodali, S 2012, 'Gait speed and dependence in activities of daily living in older adults with severe aortic stenosis', Clinical Cardiology, vol. 35, no. 5, pp. 307-314. https://doi.org/10.1002/clc.21974

Gait speed and dependence in activities of daily living in older adults with severe aortic stenosis. / Green, Philip; Woglom, Abigail E.; Genereux, Philippe; Maurer, Mathew S.; Kirtane, Ajay J.; Hawkey, Marian; Schnell, Susan; Sohn, Jeanie; Moses, Jeffrey W.; Leon, Martin B.; Smith, Craig R.; Williams, Mathew; Kodali, Susheel.

In: Clinical Cardiology, Vol. 35, No. 5, 01.05.2012, p. 307-314.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Gait speed and dependence in activities of daily living in older adults with severe aortic stenosis

AU - Green, Philip

AU - Woglom, Abigail E.

AU - Genereux, Philippe

AU - Maurer, Mathew S.

AU - Kirtane, Ajay J.

AU - Hawkey, Marian

AU - Schnell, Susan

AU - Sohn, Jeanie

AU - Moses, Jeffrey W.

AU - Leon, Martin B.

AU - Smith, Craig R.

AU - Williams, Mathew

AU - Kodali, Susheel

PY - 2012/5/1

Y1 - 2012/5/1

N2 - Background In the transcatheter aortic valve replacement era, characterization of functional status in older adults with aortic stenosis (AS) is essential. Gait speed (GS) is emerging as a marker of frailty and predictor of outcomes in older adults undergoing cardiovascular intervention. The objective of this study was to delineate the prevalence of slow GS, evaluate the association of GS with factors used in standard cardiovascular assessments, and evaluate the association of GS with dependence in activities of daily living (ADLs) in older adults with AS. Hypothesis We hypothesized that gait speed would not be associated with clinical factors, but would be associated with ADLs. Methods We evaluated GS, ADLs dependence, and Society of Thoracic Surgery score along with clinical and functional assessments in 102 older adults with AS being evaluated for transcatheter valve. Gait speed <0.5 m/s was considered slow, and GS ≥0.5 m/s was considered preserved. We assessed the association of covariates with GS as well as with ADLs dependence. Results Median GS was 0.37 m/s (interquartile range, 0.0-0.65 m/s). Sixty-four (63%) subjects had slow GS. Of commonly employed clinical covariates, only prior coronary intervention and serum albumin were weakly associated with GS. However, GS was independently associated with ADLs dependence (Odds ratio: 1.52 [1.21-1.91] for every 0.1 m/s decrease in GS; P = 0.0003). Conclusions Although the prevalence of slow GS in a population of elderly patients with severe AS being screened for transcatheter valve was high, there were only weak associations between GS and other risk stratifying tools. The strong association between GS and dependent functional status suggests that assessment of gait speed is a useful, objectively measurable, risk stratification tool in this population. Dr. Maurer is supported by a grant from the NIH/NIA AG036778-02. The other authors have no funding, financial relationships, or conflicts of interest to disclose.

AB - Background In the transcatheter aortic valve replacement era, characterization of functional status in older adults with aortic stenosis (AS) is essential. Gait speed (GS) is emerging as a marker of frailty and predictor of outcomes in older adults undergoing cardiovascular intervention. The objective of this study was to delineate the prevalence of slow GS, evaluate the association of GS with factors used in standard cardiovascular assessments, and evaluate the association of GS with dependence in activities of daily living (ADLs) in older adults with AS. Hypothesis We hypothesized that gait speed would not be associated with clinical factors, but would be associated with ADLs. Methods We evaluated GS, ADLs dependence, and Society of Thoracic Surgery score along with clinical and functional assessments in 102 older adults with AS being evaluated for transcatheter valve. Gait speed <0.5 m/s was considered slow, and GS ≥0.5 m/s was considered preserved. We assessed the association of covariates with GS as well as with ADLs dependence. Results Median GS was 0.37 m/s (interquartile range, 0.0-0.65 m/s). Sixty-four (63%) subjects had slow GS. Of commonly employed clinical covariates, only prior coronary intervention and serum albumin were weakly associated with GS. However, GS was independently associated with ADLs dependence (Odds ratio: 1.52 [1.21-1.91] for every 0.1 m/s decrease in GS; P = 0.0003). Conclusions Although the prevalence of slow GS in a population of elderly patients with severe AS being screened for transcatheter valve was high, there were only weak associations between GS and other risk stratifying tools. The strong association between GS and dependent functional status suggests that assessment of gait speed is a useful, objectively measurable, risk stratification tool in this population. Dr. Maurer is supported by a grant from the NIH/NIA AG036778-02. The other authors have no funding, financial relationships, or conflicts of interest to disclose.

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