National Research Council, Neuroscience Institute-Aging Branch, Padova, Italy; Geriatrics Unit, Department of Geriatric Care, OrthoGeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, National Relevance and High Specialization Hospital, Genova, Italy.
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, King's College London, De Crespigny Park, London, United Kingdom; Anglia Ruskin University, Bishop Hall Lane, Chelmsford, United Kingdom.
J Am Med Dir Assoc. 2018 Nov;19(11):981-988.e7. doi: 10.1016/j.jamda.2018.06.007. Epub 2018 Jul 25.
Slow gait speed may be associated with premature mortality, cardiovascular disease (CVD), and cancer, although a comprehensive meta-analysis is lacking. In this systematic review and meta-analysis, we explored potential associations between gait speed and mortality, incident CVD, and cancer.
A systematic search in major databases was undertaken from inception until March 15, 2018 for prospective cohort studies reporting data on gait speed and mortality, incident CVD, and cancer.
All available.
The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs), based on the model with the maximum number of covariates for each study between gait speed (categorized as decrease in 0.1 m/s) and mortality, incident CVD, and cancer, were meta-analyzed with a random effects model.
Among 7026 articles, 44 articles corresponding to 48 independent cohorts were eligible. The studies followed up on a total of 101,945 participants (mean age 72.2 years; 55% women) for a median of 5.4 years. After adjusting for a median of 9 potential confounders and the presence of publication bias, each reduction of 0.1 m/s in gait speed was associated with a 12% increased risk of earlier mortality (45 studies; HR = 1.12, 95% CI: 1.09-1.14; I = 90%) and 8% increased risk of CVD (13 studies; HR = 1.08, 95% CI: 1.03-1.13; I = 81%), but no relationship with cancer was observed (HR = 1.00, 95% CI: 0.97-1.04; I = 15%).
CONCLUSION/IMPLICATIONS: Slow gait speed may be a predictor of mortality and CVD in older adults. Because gait speed is a quick and inexpensive measure to obtain, our study suggests that it should be routinely used and may help identify people at risk of premature mortality and CVD.
虽然目前缺乏全面的荟萃分析,但缓慢的步速可能与过早死亡、心血管疾病 (CVD) 和癌症有关。在这项系统评价和荟萃分析中,我们探讨了步速与死亡率、新发 CVD 和癌症之间的潜在关联。
从数据库建立之初到 2018 年 3 月 15 日,对前瞻性队列研究进行系统检索,这些研究报告了步速与死亡率、新发 CVD 和癌症的数据。
所有参与者。
根据每个研究中包含最多协变量的模型,使用随机效应模型对基于步速(分类为 0.1 m/s 下降)与死亡率、新发 CVD 和癌症之间的调整后的危险比 (HR) 和 95%置信区间 (CI) 进行荟萃分析。
在 7026 篇文章中,有 44 篇文章对应 48 个独立队列符合纳入标准。这些研究共随访了 101945 名参与者(平均年龄 72.2 岁;55%为女性),中位随访时间为 5.4 年。在调整了中位数为 9 个潜在混杂因素和发表偏倚后,步速每降低 0.1 m/s,与更早的死亡率风险增加 12%相关(45 项研究;HR = 1.12,95%CI:1.09-1.14;I² = 90%)和 CVD 风险增加 8%相关(13 项研究;HR = 1.08,95%CI:1.03-1.13;I² = 81%),但与癌症无关(HR = 1.00,95%CI:0.97-1.04;I² = 15%)。
结论/意义:缓慢的步速可能是老年人死亡和 CVD 的预测指标。由于步速是一种快速且廉价的测量方法,我们的研究表明,它应该被常规使用,并可能有助于识别有过早死亡和 CVD 风险的人。