Slowness when walking may indicate future problem in elderly people for daily activities

Researchers from the Federal University of São Carlos (UFSCar) and University College London (United Kingdom) found an efficient, simple and inexpensive way to predict the risk of loss of functional capacity in the elderly.

From the analysis of a database with more than 3,000 British elderly, they identified that slow gait can be considered, in isolation, an indicator of increased risk for the loss of the ability to perform daily activities – from the most basic ones, such as getting out of bed, showering and changing clothes, to the so-called instrumental activities, which include shopping, managing their own money, going to the bank and using public transport, for example.

“Our study showed that just measuring gait speed is enough to have an efficient predictor of loss of functional capacity in the elderly. Our research data show that slow gait precedes this loss by a few years. This is an important finding, because it facilitates the monitoring of the problem. In addition, the discovery makes it possible that, in addition to physical therapists, doctors and gerontologists, any health professional can detect the risk”, says Tiago da Silva Alexandre, professor at the Department of Gerontology at UFSCar and advisor of the search.

Published in the Journal of Cachexia, Sarcopenia and Muscle, the study analyzed data on the physical condition and gait speed of more than 3,000 individuals over the age of 60. Participants are part of the English Longitudinal Study of Aging (ELSA), a longitudinal study that tracks the health and well-being of older adults in the English community. The research was supported by Fapesp.

Fragility

Generally, the loss of ability to perform basic and instrumental activities can be simultaneous or precede the so-called frailty syndrome – a condition that affects a large part of the elderly population and can cause incapacity to perform daily activities, increasing the risk of falls, hospitalization and death. death.

To diagnose the problem, health professionals usually carry out a series of assessments to measure different parameters, such as walking speed, hand strength (palm grip), level of physical activity, exhaustion and weight loss in the last six months. months.

“Frailty is a risk factor for disability, but it is not synonymous. We use five elements to measure the syndrome. If a person has one or two of these elements, he is pre-frail. If he has three or more, he is fragile. The problem with this assessment is that it is more complex, it needs equipment and questionnaires. It is not possible to do it everywhere”, explains the researcher.

In the study, the researchers compared frailty as a whole with each of the five components, in order to see which one would best discriminate the disability process. And they concluded that gait slowness alone was the best component to indicate the risk of disability in daily activities in both sexes, rather than assessing frailty as a whole.

“It is an early indicator. It is worth mentioning that, with this discovery, it is possible to detect the problem more easily. The health professional can investigate in advance what is causing this slowness”, comments Dayane Capra de Oliveira, author of the study.

Alexandre points out that the faster the problem is identified, the more resources and approaches there are to deal with it. “It is very difficult to act when the individual is already having difficulty performing several daily activities. There are alternatives, but the result is not the same as when identified early. That is why it is so important to have a simpler, safer and cheaper way to predict risks of functional loss”, he says.

According to the research, women who became pre-frail were more incapable of performing daily activities. This did not happen to men. On the other hand, both men and women who became frail (a more serious condition) also became more dependent for day-to-day activities over the years.

This may have happened because, in men, problems such as stroke, cancer and lung disease, added to unhealthy behavioral habits, such as smoking, alcohol and heavy work, can influence frailty and disability with a faster evolution to death. Unlike women, who live longer with disabling diseases, such as osteoarthritis, depression and hypertension.

According to the researcher, previous studies have already shown a difference in this process between men and women over 60 years of age.

“From this perspective, our work also suggests that men go through a very short process of disability due to the burden of more serious diseases that can progress more quickly to death. While women go through a longer process of frailty and disability”, says Alexander.

For Capra, the study reveals an important shortcut for identifying the risk of incapacity to perform day-to-day activities in the elderly. “With this it is possible to implement quick interventions, before the problem sets in”, she says.