WHAT IS THE EVIDENCE FOR ASSOCIATIONS BETWEEN GAIT SPEED AND GRIP STRENGTH WITH FRAILTY IN HEALTHY OLDER ADULTS? A SYSTEMATIC REVIEW
Background Frailty is a common age-related syndrome that is associated with an increased susceptibility to adverse health outcomes, which include disability, dependency, hospitalisations, requirement for long-term care, falls and death. The prevalence of these adverse outcomes are projected to increase with the increasing elderly population, which poses major problems to healthcare systems. There is a need for feasible screening tools that can identify elderly people at risk of frailty on a large scale so that targeted preventative interventions can be implemented. Objective To determine whether gait speed and grip strength are significant indicators of frailty and its associated adverse-health-related outcomes in healthy older adults. Search Strategy To identify studies the electronic databases MEDLINE, CINAHL, PubMed, PEDro and Cochrane Library were systematically searched under defined search terms and combinations. The reference lists of included studies were hand-searched to identify any more studies that may be relevant to the research question. Study Selection The search was limited to RCTs and cohort studies in the English language, and included publications between January 2000 and March 2018. Studies that examined the associations for gait speed and/or grip strength with frailty in relation to healthy adults over the age of 60 were included. Data collection and analysis The included studies were critically appraised using the CASP checklist for cohort studies, and data collection headings were adapted from a previous systematic review in this area by den Ouden et al. (2011). Main Results The key findings of this review were that gait speed was associated with an increased risk of future disability, hospitalisations, mortality, requirement for care and falls, and the majority of evidence reported that grip strength was associated with an increased risk of future disability. The associations between gait speed and an increased risk of future disability also appeared to be stronger and more consistent than that of grip strength Conclusion Gait speed appears to be an indicator of future disability; mobility limitation, hospitalisations, mortality and falls, and grip strength appears to be an indicator of future disability. Additionally, gait speed seems to be a stronger indicator of future disability than grip strength.