Incidence of loss of ability to walk 400 meters in a functionally limited older population

OBJECTIVES: To assess the incidence of and factors related to nondisabled but functionally limited older adults aged 75 to 85 years losing the ability to walk 400 m. DESIGN: Observational study with average follow-up of 21 months. SETTING: Community. PARTICIPANTS: At baseline, 101 persons with objective signs of functional limitations and intact cognitive function agreed to participate in the study. Of these, 81 were able to walk 400 m at baseline, and 62 participated in the follow-up examination. MEASUREMENTS: Mobility disability was defined as an inability to complete a 400-m walk test. At baseline, eligible participants (n = 81) had the ability to walk 400 m, scored between 4 and 9 on the Short Physical Performance Battery (SPPB; range 0-12), and scored 18 or more on the Mini-Mental State Examination. Demographics, difficulty in daily activities, disease status, behavioral risk factors, and muscle strength were assessed at baseline and follow-up. RESULTS: Of 62 persons at follow-up, 21 (33.9%) developed incident mobility disability. The strongest predictors of loss of mobility were the time to complete the 400-m walk at baseline (odds ratio (OR) = 1.6 per 1-minute difference, 95% confidence interval (CI) = 1.04-2.45), and decline in SPPB score over the follow-up (OR =1.4 per 1-point difference, 95% CI = 1.01-1.92). CONCLUSION: Older persons with functional limitations have a high rate of loss of ability to walk 400 m. The 400-m walk test is a highly relevant, discrete outcome that is an ideal target for testing preventive interventions in vulnerable older populations.