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Published in: European Review of Aging and Physical Activity 1/2019

Open Access 01-12-2019 | Research article

The association between motor capacity and mobility performance: frailty as a moderator

Authors: Carl-Philipp Jansen, Nima Toosizadeh, M. Jane Mohler, Bijan Najafi, Christopher Wendel, Michael Schwenk

Published in: European Review of Aging and Physical Activity | Issue 1/2019

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Abstract

Background

In older adults, the linkage between laboratory-assessed ‘motor capacity’ and ‘mobility performance’ during daily routine is controversial. Understanding factors moderating this relationship could help developing more valid assessment as well as intervention approaches. We investigated whether the association between capacity and performance becomes evident with transition into frailty, that is, whether frailty status moderates their association.

Methods

We conducted a cross-sectional analysis of the observational Arizona Frailty Cohort Study (ClinicalTrials.gov identifier: NCT01880229) in a community-dwelling cohort in Tucson, Arizona. Participants were N = 112 older adults aged 65 years or older who were categorized as non-frail (n = 40), pre-frail (n = 53) or frail (n = 19) based on the Fried frailty index.
Motor capacity was quantified as normal (NWS) and fast walking speed (FWS). Mobility performance was quantified as 1) cumulated physical activity (PA) time and 2) everyday walking performance (average steps per walking bout; maximal number of steps in one walking bout), measured by a motion sensor over a 48 h period. Hierarchical linear regression analyses were performed to evaluate moderation effects.

Results

Unlike in non-frail persons, the relationship between motor capacity and mobility performance was evident in pre-frail and frail persons, confirming our hypothesis. A moderating effect of frailty status was found for 1) the relationship between both NWS and FWS and maximal number of steps in one bout and 2) NWS and the average steps per bout. No moderation was found for the association between NWS and FWS with cumulated PA.

Conclusion

In pre-frail and frail persons, motor capacity is associated with everyday walking performance, indicating that functional capacity seems to better represent mobility performance in this impaired population. The limited relationship found in non-frail persons suggests that other factors account for their mobility performance. Our findings may help to inform tailored assessment approaches and interventions taking into consideration a person’s frailty status.
Literature
1.
go back to reference World Health Organization. International classification of functioning, disability, and health. Geneva: World Health Organization; 2005. World Health Organization. International classification of functioning, disability, and health. Geneva: World Health Organization; 2005.
2.
go back to reference Van Ancum JM, van Schooten KS, Jonkman NH, Huijben B, van Lummel RC, Meskers CGM, et al. Gait speed assessed by a 4-m walk test is not representative of daily-life gait speed in community-dwelling adults. Maturitas. 2019;121:28–34.CrossRef Van Ancum JM, van Schooten KS, Jonkman NH, Huijben B, van Lummel RC, Meskers CGM, et al. Gait speed assessed by a 4-m walk test is not representative of daily-life gait speed in community-dwelling adults. Maturitas. 2019;121:28–34.CrossRef
3.
go back to reference Giannouli E, Bock O, Mellone S, Zijlstra W. Mobility in old age: capacity is not performance. Biomed Res Int. 2016;2016:3261567.CrossRef Giannouli E, Bock O, Mellone S, Zijlstra W. Mobility in old age: capacity is not performance. Biomed Res Int. 2016;2016:3261567.CrossRef
4.
go back to reference Rapp K, Klenk J, Benzinger P, Franke S, Denkinger MD, Peter R. Physical performance and daily walking duration: associations in 1271 women and men aged 65-90 years. Aging Clin Exp Res. 2012;24(5):455–60.PubMed Rapp K, Klenk J, Benzinger P, Franke S, Denkinger MD, Peter R. Physical performance and daily walking duration: associations in 1271 women and men aged 65-90 years. Aging Clin Exp Res. 2012;24(5):455–60.PubMed
5.
go back to reference Hillel I, Gazit E, Nieuwboer A, Avanzino L, Rochester L, Cereatti A, et al. Is every-day walking in older adults more analogous to dual-task walking or to usual walking? Elucidating the gaps between gait performance in the lab and during 24/7 monitoring. Eur Rev Aging Phys Act. 2019;16(1):6.CrossRef Hillel I, Gazit E, Nieuwboer A, Avanzino L, Rochester L, Cereatti A, et al. Is every-day walking in older adults more analogous to dual-task walking or to usual walking? Elucidating the gaps between gait performance in the lab and during 24/7 monitoring. Eur Rev Aging Phys Act. 2019;16(1):6.CrossRef
6.
go back to reference Stellmann JP, Neuhaus A, Götze N, Briken S, Lederer C, Schimpl M, et al. Ecological validity of walking capacity tests in multiple sclerosis. PLoS One. 2015;10(4):e0123822.CrossRef Stellmann JP, Neuhaus A, Götze N, Briken S, Lederer C, Schimpl M, et al. Ecological validity of walking capacity tests in multiple sclerosis. PLoS One. 2015;10(4):e0123822.CrossRef
7.
go back to reference Suominen H. Ageing and maximal physical performance. Eur Rev Aging Phys Act. 2011;8(1):37–42.CrossRef Suominen H. Ageing and maximal physical performance. Eur Rev Aging Phys Act. 2011;8(1):37–42.CrossRef
8.
go back to reference Hortobagyi T, Mizelle C, Beam S, DeVita P. Old adults perform activities of daily living near their maximal capabilities. J Gerontol A Biol Sci Med Sci. 2003;58(5):M453–60.CrossRef Hortobagyi T, Mizelle C, Beam S, DeVita P. Old adults perform activities of daily living near their maximal capabilities. J Gerontol A Biol Sci Med Sci. 2003;58(5):M453–60.CrossRef
9.
go back to reference Pincheira PA, Stenroth L, Avela J, Cronin NJ. Individual leg muscle contributions to the cost of walking: effects of age and walking speed. J Aging Phys Act. 2017;25(2):295–304.CrossRef Pincheira PA, Stenroth L, Avela J, Cronin NJ. Individual leg muscle contributions to the cost of walking: effects of age and walking speed. J Aging Phys Act. 2017;25(2):295–304.CrossRef
10.
go back to reference Rockwood K. Frailty and its definition: a worthy challenge. J Am Geriatr Soc. 2005;53(6):1069–70.CrossRef Rockwood K. Frailty and its definition: a worthy challenge. J Am Geriatr Soc. 2005;53(6):1069–70.CrossRef
11.
go back to reference Ferrucci L, Guralnik JM, Studenski S, Fried LP, Cutler GB Jr, Walston JD, et al. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report. J Am Geriatr Soc. 2004;52(4):625–34.CrossRef Ferrucci L, Guralnik JM, Studenski S, Fried LP, Cutler GB Jr, Walston JD, et al. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report. J Am Geriatr Soc. 2004;52(4):625–34.CrossRef
12.
go back to reference Schwenk M, Mohler J, Wendel C, D'Huyvetter K, Fain M, Taylor-Piliae R, et al. Wearable sensor-based in-home assessment of gait, balance, and physical activity for discrimination of frailty status: baseline results of the Arizona frailty cohort study. Gerontology. 2015;61(3):258–67.CrossRef Schwenk M, Mohler J, Wendel C, D'Huyvetter K, Fain M, Taylor-Piliae R, et al. Wearable sensor-based in-home assessment of gait, balance, and physical activity for discrimination of frailty status: baseline results of the Arizona frailty cohort study. Gerontology. 2015;61(3):258–67.CrossRef
13.
go back to reference Mohler MJ, Wendel CS, Taylor-Piliae RE, Toosizadeh N, Najafi B. Motor performance and physical activity as predictors of prospective falls in community-dwelling older adults by frailty level: application of wearable technology. Gerontology. 2016;62(6):654–64.CrossRef Mohler MJ, Wendel CS, Taylor-Piliae RE, Toosizadeh N, Najafi B. Motor performance and physical activity as predictors of prospective falls in community-dwelling older adults by frailty level: application of wearable technology. Gerontology. 2016;62(6):654–64.CrossRef
14.
go back to reference Muchna A, Najafi B, Wendel CS, Schwenk M, Armstrong DG, Mohler J. Foot problems in older adults associations with incident falls, frailty syndrome, and sensor-derived gait, balance, and physical activity measures. J Am Podiatr Med Assoc. 2018;108(2):126–39.CrossRef Muchna A, Najafi B, Wendel CS, Schwenk M, Armstrong DG, Mohler J. Foot problems in older adults associations with incident falls, frailty syndrome, and sensor-derived gait, balance, and physical activity measures. J Am Podiatr Med Assoc. 2018;108(2):126–39.CrossRef
15.
go back to reference Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.CrossRef Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.CrossRef
16.
go back to reference Taylor HL, Jacobs DR Jr, Schucker B, Knudsen J, Leon AS, Debacker G. A questionnaire for the assessment of leisure time physical activities. J Chronic Dis. 1978;31(12):741–55.CrossRef Taylor HL, Jacobs DR Jr, Schucker B, Knudsen J, Leon AS, Debacker G. A questionnaire for the assessment of leisure time physical activities. J Chronic Dis. 1978;31(12):741–55.CrossRef
17.
go back to reference Eaton W, Smith C, Ybarra M, Muntaner C, Tien A. Center for epidemiologic studies depression scale: review and revision. In: Maruish M, editor. The use of psychological testing for treatment planning and outcomes assessment. 3rd ed. New Jersey: Lawrence Erlbaum Associates; 2004. p. 363–77. Eaton W, Smith C, Ybarra M, Muntaner C, Tien A. Center for epidemiologic studies depression scale: review and revision. In: Maruish M, editor. The use of psychological testing for treatment planning and outcomes assessment. 3rd ed. New Jersey: Lawrence Erlbaum Associates; 2004. p. 363–77.
18.
go back to reference Najafi B, Armstrong DG, Mohler J. Novel wearable technology for assessing spontaneous daily physical activity and risk of falling in older adults with diabetes. J Diabetes Sci Technol. 2013;7(5):1147–60.CrossRef Najafi B, Armstrong DG, Mohler J. Novel wearable technology for assessing spontaneous daily physical activity and risk of falling in older adults with diabetes. J Diabetes Sci Technol. 2013;7(5):1147–60.CrossRef
19.
go back to reference Najafi B, Aminian K, Paraschiv-Ionescu A, Loew F, Bula CJ, Robert P. Ambulatory system for human motion analysis using a kinematic sensor: monitoring of daily physical activity in the elderly. IEEE Trans Biomed Eng. 2003;50(6):711–23.CrossRef Najafi B, Aminian K, Paraschiv-Ionescu A, Loew F, Bula CJ, Robert P. Ambulatory system for human motion analysis using a kinematic sensor: monitoring of daily physical activity in the elderly. IEEE Trans Biomed Eng. 2003;50(6):711–23.CrossRef
20.
go back to reference Najafi B, Aminian K, Loew F, Blanc Y, Robert PA. Measurement of stand-sit and sit-stand transitions using a miniature gyroscope and its application in fall risk evaluation in the elderly. IEEE Trans Biomed Eng. 2002;49(8):843–51.CrossRef Najafi B, Aminian K, Loew F, Blanc Y, Robert PA. Measurement of stand-sit and sit-stand transitions using a miniature gyroscope and its application in fall risk evaluation in the elderly. IEEE Trans Biomed Eng. 2002;49(8):843–51.CrossRef
21.
go back to reference Cesari M, Kritchevsky SB, Penninx BW, Nicklas BJ, Simonsick EM, Newman AB, et al. Prognostic value of usual gait speed in well-functioning older people--results from the health, aging and body composition study. J Am Geriatr Soc. 2005;53(10):1675–80.CrossRef Cesari M, Kritchevsky SB, Penninx BW, Nicklas BJ, Simonsick EM, Newman AB, et al. Prognostic value of usual gait speed in well-functioning older people--results from the health, aging and body composition study. J Am Geriatr Soc. 2005;53(10):1675–80.CrossRef
22.
go back to reference Montero-Odasso M, Schapira M, Soriano ER, Varela M, Kaplan R, Camera LA, 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(10):1304–9.CrossRef Montero-Odasso M, Schapira M, Soriano ER, Varela M, Kaplan R, Camera LA, 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(10):1304–9.CrossRef
23.
go back to reference Rydwik E, Bergland A, Forsen L, Frandin K. Investigation into the reliability and validity of the measurement of elderly people's clinical walking speed: a systematic review. Physiother Theory Pract. 2012;28(3):238–56.CrossRef Rydwik E, Bergland A, Forsen L, Frandin K. Investigation into the reliability and validity of the measurement of elderly people's clinical walking speed: a systematic review. Physiother Theory Pract. 2012;28(3):238–56.CrossRef
24.
go back to reference Aminian K, Najafi B, Bula C, Leyvraz PF, Robert P. Spatio-temporal parameters of gait measured by an ambulatory system using miniature gyroscopes. J Biomech. 2002;35(5):689–99.CrossRef Aminian K, Najafi B, Bula C, Leyvraz PF, Robert P. Spatio-temporal parameters of gait measured by an ambulatory system using miniature gyroscopes. J Biomech. 2002;35(5):689–99.CrossRef
25.
go back to reference Aminian K, Trevisan C, Najafi B, Dejnabadi H, Frigo C, Pavan E, et al. Evaluation of an ambulatory system for gait analysis in hip osteoarthritis and after total hip replacement. Gait Posture. 2004;20(1):102–7.CrossRef Aminian K, Trevisan C, Najafi B, Dejnabadi H, Frigo C, Pavan E, et al. Evaluation of an ambulatory system for gait analysis in hip osteoarthritis and after total hip replacement. Gait Posture. 2004;20(1):102–7.CrossRef
26.
go back to reference Hayes AF, Rockwood NJ. Regression-based statistical mediation and moderation analysis in clinical research: observations, recommendations, and implementation. Behav Res Ther. 2017;98:39–57.CrossRef Hayes AF, Rockwood NJ. Regression-based statistical mediation and moderation analysis in clinical research: observations, recommendations, and implementation. Behav Res Ther. 2017;98:39–57.CrossRef
27.
go back to reference van Lummel RC, Walgaard S, Pijnappels M, Elders PJM, Garcia-Aymerich J, van Dieën JH, et al. Physical performance and physical activity in older adults: associated but separate domains of physical function in old age. PLoS One. 2015;10(12):e0144048.CrossRef van Lummel RC, Walgaard S, Pijnappels M, Elders PJM, Garcia-Aymerich J, van Dieën JH, et al. Physical performance and physical activity in older adults: associated but separate domains of physical function in old age. PLoS One. 2015;10(12):e0144048.CrossRef
28.
go back to reference Egerton T, Paterson K, Helbostad JL. The association between gait characteristics and ambulatory physical activity in older people: a cross-sectional and longitudinal observational study using generation 100 data. J Aging Phys Act. 2017;25(1):10–9.CrossRef Egerton T, Paterson K, Helbostad JL. The association between gait characteristics and ambulatory physical activity in older people: a cross-sectional and longitudinal observational study using generation 100 data. J Aging Phys Act. 2017;25(1):10–9.CrossRef
29.
go back to reference Umstattd Meyer MR, Janke MC, Beaujean AA. Predictors of older adults’ personal and community mobility: using a comprehensive theoretical mobility framework. Gerontologist. 2014;54(3):398–408.CrossRef Umstattd Meyer MR, Janke MC, Beaujean AA. Predictors of older adults’ personal and community mobility: using a comprehensive theoretical mobility framework. Gerontologist. 2014;54(3):398–408.CrossRef
30.
go back to reference Webber SC, Porter MM, Menec VH. Mobility in older adults: a comprehensive framework. Gerontologist. 2010;50(4):443–50.CrossRef Webber SC, Porter MM, Menec VH. Mobility in older adults: a comprehensive framework. Gerontologist. 2010;50(4):443–50.CrossRef
31.
go back to reference Blodgett J, Theou O, Kirkland S, Andreou P, Rockwood K. Frailty in NHANES: comparing the frailty index and phenotype. Arch Gerontol Geriatr. 2015;60(3):464–70.CrossRef Blodgett J, Theou O, Kirkland S, Andreou P, Rockwood K. Frailty in NHANES: comparing the frailty index and phenotype. Arch Gerontol Geriatr. 2015;60(3):464–70.CrossRef
32.
go back to reference Bowerman BL, O'Connel RT. Linear statistical models: an applied approach. 2nd ed. Belmont: Duxbury; 1990. Bowerman BL, O'Connel RT. Linear statistical models: an applied approach. 2nd ed. Belmont: Duxbury; 1990.
33.
go back to reference Rodriguez-Manas L, Feart C, Mann G, Vina J, Chatterji S, Chodzko-Zajko W, et al. Searching for an operational definition of frailty: a Delphi method based consensus statement: the frailty operative definition-consensus conference project. J Gerontol A Biol Sci Med Sci. 2013;68(1):62–7.CrossRef Rodriguez-Manas L, Feart C, Mann G, Vina J, Chatterji S, Chodzko-Zajko W, et al. Searching for an operational definition of frailty: a Delphi method based consensus statement: the frailty operative definition-consensus conference project. J Gerontol A Biol Sci Med Sci. 2013;68(1):62–7.CrossRef
Metadata
Title
The association between motor capacity and mobility performance: frailty as a moderator
Authors
Carl-Philipp Jansen
Nima Toosizadeh
M. Jane Mohler
Bijan Najafi
Christopher Wendel
Michael Schwenk
Publication date
01-12-2019
Publisher
BioMed Central
Published in
European Review of Aging and Physical Activity / Issue 1/2019
Print ISSN: 1813-7253
Electronic ISSN: 1861-6909
DOI
https://doi.org/10.1186/s11556-019-0223-4

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