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Journal of Physical Therapy Science logoLink to Journal of Physical Therapy Science
. 2015 Nov 30;27(11):3481–3485. doi: 10.1589/jpts.27.3481

Japanese elderly persons walk faster than non-Asian elderly persons: a meta-regression analysis

Masataka Ando 1, Naoto Kamide 2,3,*
PMCID: PMC4681929  PMID: 26696722

Abstract

[Purpose] The purpose of this study was to clarify ethnic differences in walking speed by comparing walking speed in both Japanese and non-Asian elderly individuals and to investigate the necessity of consideration of ethnic differences in walking speed. [Subjects and Methods] Articles that reported comfortable walking speeds for community-dwelling elderly individuals were identified from electronic databases. Articles that involved community-dwelling individuals who were 60 years old or older and well functioning were included in the study. Articles that involved Asians were excluded. Weighted means for 5-m walking times were calculated as walking speeds from the Japanese and non-Asian sample data. The effects of age, gender, and ethnicity on 5-m walking times were then investigated using meta-regression analysis. [Results] Twenty studies (34 groups) were included for Japanese, and 16 studies (28 groups) were included for non-Asians. The weighted mean 5-m walking time was estimated to be 4.15 sec (95% confidence interval [CI]: 3.87–4.44) for Japanese and 4.24 sec (95% CI: 4.09–4.40) for non-Asians. Furthermore, using meta-regression analysis adjusted for age and gender, the 5-m walking time was 0.40 sec faster (95% CI: 0.03–0.77) for Japanese than for non-Asian elderly individuals. [Conclusion] Walking speed appeared faster for Japanese community-dwelling elderly individuals than for non-Asian elderly individuals.

Key words: Meta-regression analysis, Walking speed, Ethnicity

INTRODUCTION

Measurement of walking speed has been widely used to evaluate the physical function of elderly individuals. In addition, walking speed is an index that can predict falls1), decreased activities of daily living (ADLs)2), and life expectancy3) in the elderly; it has also been recently used as one of the diagnostic criteria for sarcopenia4, 5). Therefore, walking speed is a useful and convenient index that accurately reflects the health status of elderly individuals.

To evaluate the walking speed of the elderly in the clinical setting, walking speed reference values are required; this has been investigated in previous studies6,7,8). Although ethnic differences have been suspected in physical function measures for the elderly such as walking speed9), no ethnic differences have been identified in previously reported reference values6,7,8), and studies that address this issue have been insufficient. Therefore, whether ethnic differences exist in the walking speed of the elderly currently remains unclear. If ethnic differences in walking speed do exist, walking speed reference values that take ethnicity into account are needed.

The purpose of this study was to clarify ethnic differences in walking speed by comparing walking speed in both Japanese and non-Asian elderly individuals such as black, white and Hispanic individuals and to investigate the necessity of consideration of ethnic differences in walking speed.

SUBJECTS AND METHODS

In this study, relevant research articles that reported data on walking speeds of community-dwelling elderly individuals were retrieved from electronic databases, and a systematic review that reported walking speed reference values. For relevant research articles, peer-reviewed articles published until December 2011 that reported data for 5-m or 10-m walking times were searched. Data for walking speed measured under comfortable conditions were collected for further statistical analysis. In order to obtain sufficient data for analysis, articles on walking speed were identified using different search strategies for Japanese and non-Asian elderly individuals.

For articles on the walking speed of Japanese elderly individuals, relevant research articles were identified from the MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Igaku Chuo Zasshi (ICHUSHI) electronic databases. The terms “gait speed/Hokou Sokudo (in Japanese),” “gait velocity,” “walking speed,” “walking velocity,” “walking time/Hokou Jikan (in Japanese),” and “elderly/Koureisha (in Japanese)” were used in combination in the search. Retrieved articles were examined based on the following inclusion criteria: 1) the articles involved Japanese people; 2) the articles involved community-dwelling individuals who were 60 years old or older; 3) the articles involved well-functioning individuals; 4) the articles did not involve frail elderly individuals or patients who had specific diseases such as neuromuscular disease and hip fracture; and 5) the articles described the sample size, mean, and standard deviation (SD) for walking time or speed measured under comfortable conditions. Well-functioning individuals were defined as those independent in ADLs and instrumental ADLs (IADLs); independence of subjects in ADLs and IADLs was judged from descriptions in the text.

For articles about non-Asian elderly individuals, relevant research articles were identified from electronic databases (PubMed and CINAHL) and systematic reviews that reported walking speed reference values. For database searching, the terms “gait speed”, “walking speed”, “normal”, “comfortable”, “usual”, “preferred”, and “self-selected” were used in combination. The inclusion criteria for non-Asian individuals were the same as those described above. In addition, articles that involved Asians, such as Chinese and Koreans, were excluded because these individuals may share similar characteristics with Japanese individuals.

After articles were identified, their titles and abstracts were screened, and articles not related to the main purpose of this study were excluded. The full texts of articles that passed the screening evaluation were then reviewed, and those that fulfilled the inclusion criteria were included. The retrieved articles were examined by two reviewers (MA, NK). The relevant research articles were summarized to obtain the source of the article, information on participants (age, gender, ethnicity [Japanese or non-Asian]), sample size, and means and SDs for 5-m or 10-m walking times. All information was tabulated and entered into a computer database. When multiple 5-m or 10-m walking times were reported in an article (e.g., data were reported by gender or data were reported by age group), the data of each group were entered into the database.

All walking time data that fulfilled the inclusion criteria were converted into 5-m walking times. If articles reported data on 10-m walking times, the data were divided by two and converted into 5-m walking times; this method was adopted according to methodology reported previously6). The weighted means and 95% confidence intervals (CIs) of the 5-m walking time were calculated for both the Japanese sample data and the non-Asian sample data, using a random effects model. The weighted means were calculated by the DerSimonian-Laird method. The 95% CI values were calculated using the Knapp and Hartung adjustment. Furthermore, the effects of age, gender, and ethnicity (Japanese or non-Asian) on the reference values for the 5-m walking time were analyzed by meta-regression analysis. In the meta-regression analysis, 5-m walking time was the dependent variable, ethnicity (Japanese or non-Asian) was the independent variable, and age and gender were the adjusted variables. Statistical analysis was performed using the R programming language and environment (version 3.0.1)10) and the R package metafor (version 1.9-0)11). The significance level was set at 5%.

RESULTS

A total of 2,753 articles that contained data on Japanese elderly individuals were identified from electronic database searches. However, after checking the titles and abstracts, 2,563 articles that did not fulfill the inclusion criteria were excluded. After checking the full texts, 170 articles that were found to not fulfill the inclusion criteria were further excluded. Thus, 20 articles (34 groups)12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31) were included in the meta-analysis for estimating the 5-m walking time of Japanese elderly individuals (Fig. 1). Studies with Japanese data involved 6,704 subjects (1,644 males, 4,481 females, 579 gender unknown; mean age range 65.7–81.4 years). The weighted mean 5-m walking time in Japanese individuals was estimated to be 4.15 sec (95% CI: 3.87–4.44 sec) (Table 1).

Fig. 1.

Fig. 1.

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Flow chart regarding selection of relevant research articles for meta-regression analysis

Table 1. Characteristics of participants and weighted mean 5-m walking times (estimated by random effect model) in Japanese and non-Asians.

Japanese non-Asians
Subjects 6,704
(1,644 males, 4,481 females, 579 gender unknown) 		12,322
(2,580 males, 3,018 females, 6,724 gender unknown)
Mean age range 65.7–81.4 years 69.6–83.6 years
Weighted mean 5-m walking time [95% CI] 4.15 [3.87–4.44] sec 4.24 [4.09–4.40] sec
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*p < 0.05

A total of 1,657 articles from electronic databases and systematic reviews were identified as containing data on non-Asian elderly individuals. However, after checking the titles and abstracts, 1,478 articles that did not fulfill the inclusion criteria were excluded. After checking the full texts, 163 articles that were found to not fulfill the inclusion criteria were further excluded. Thus, 16 articles (28 groups)32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47) were included in the meta-analysis for estimating the 5-m walking time of elderly non-Asian individuals (Fig. 1). Studies with non-Asian data involved 12,322 subjects (2,580 males, 3,018 females; 6,724 gender unknown; mean age range 69.6–83.6 years). The weighted mean 5-m walking time of non-Asian individuals was estimated to be 4.24 sec (95% CI: 4.09–4.40 sec) (Table 1).

The distributions of age and gender differed in the Japanese elderly and non-Asian elderly samples. To adjust for the effects of age and gender, an estimate of the true difference in 5-m walking time between Japanese and non-Asian elderly individuals was necessary. Therefore, meta-regression analysis adjusted for age and gender was used to examine the difference in 5-m walking times between Japanese and non-Asian elderly individuals. As result of meta-regression analysis, ethnicity (Japanese or non-Asian) was found to be significantly associated with 5-m walking time, adjusted for age and gender (p < 0.05). From the partial regression coefficient, the 5-m walking time of Japanese elderly individuals was 0.40 sec (95% CI: 0.03–0.77 sec) faster than that of non-Asian individuals (Table 2).

Table 2. Comparison between Japanese and non-Asian elderly individuals using meta-regression analysis.

Variables Unstandardized partial
regression coefficient		 95% CI
Intercept −7.806 * −11.601 to −4.011
Ethnicity (non-Asian) 0.402 * 0.031 to 0.773
Age 0.155 * 0.104 to 0.206
Gender (females) 0.377 * 0.054 to 0.699
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*p < 0.05. Test for residual heterogeneity: QE (df = 28) = 1,205.8445 *Dependent variable: 5-m walking time. Independent variable: ethnicity (as a dummy variable, Japanese=0 and non-Asian=1). Adjusted variable: age and gender (as a dummy variable, males=0 and females=1)

DISCUSSION

The goal of this study was to clarify ethnic differences in walking speed by comparing walking speed of both Japanese and non-Asian community-dwelling elderly individuals using meta-regression analysis. First, the weighted means of comfortable 5-m walking times were calculated for both Japanese and non-Asian elderly individuals using a random effects model. The difference in 5-m walking times between Japanese and non-Asian elderly individuals was approximately 0.09 seconds (4.15 sec for Japanese versus 4.24 sec for non-Asians). The 5-m walking time in Japanese elderly individuals tended to be faster than in non-Asian elderly individuals. Furthermore, using meta-regression analysis adjusted for age and gender, a significant difference in walking speed between Japanese and non-Asians was found. This result suggests that ethnic differences do exist in walking speed when adjusted for age and gender. A difference between Japanese and non-Asian (African Americans and Caucasians) elderly individuals has also been observed in the Timed Up and Go (TUG) test48), a type of physical performance test. It was suggested in a previous study that physical function shows ethnic differences9). The present results are in agreement with that previous study, and we therefore concluded that there is an ethnic difference in the 5-m walking time.

The difference in 5-m walking times between Japanese and non-Asian elderly individuals was 0.4 seconds. Morita et al. reported that the difference in 5-m walking time between individuals who experienced a fall and those who did not experience a fall was approximately 0.5 seconds in community-dwelling Japanese elderly49). In addition, Shinkai et al. showed that the risk of ADL impairment was increased by a difference of approximately 0.4 seconds in 5-m walking time in a prospective cohort study of community-dwelling Japanese elderly individuals50). Therefore, a difference of 0.4 seconds in 5-m walking time cannot be ignored.

The cause of ethnic differences in 5-m walking times could not be clarified based on the data and analyses of the present study. However, based on a previous study that suggested ethnic differences in the TUG test, some possible causes can be suggested48). First, differences in body composition between Japanese and non-Asian individuals may be the cause of the ethnic difference. Takasaki et al. reported that fat-free mass density was possibly lower in Caucasians than in Japanese51). Since fat-free mass is strongly associated with whole body muscle mass, the generation of strength and power while walking may also be affected. Second, lifestyle may cause ethnic differences in 5-m walking times. For example, many Japanese elderly individuals sleep on a futon on tatami mats; this requires independent standing from the floor in everyday life. Therefore, use of a futon or tatami mats in everyday life may contribute to the development of balance and lower limb function, and it may explain ethnic differences in 5-m walking times. In fact, Japanese elderly individuals who sleep on futons have a lower hip fracture risk than Japanese elderly people who sleep on a Western-type bed52).

It was not possible to identify the results among black, white, Hispanic, and other peoples with regard to the sample of non-Asian elderly individuals in the present study, as sufficient information on ethnic groups in the relevant research articles could not be obtained. Therefore, data from non-Asian elderly individuals were consolidated as one group in this study. Though a difference in 5-m walking times between Japanese and non-Asian individuals was found, differences among black, white, Hispanic, and other peoples could not be assessed. Further, we cannot clarify whether differences in 5-m walking time among Asian elderly individuals exist or not; thus, these are limitations of the present study. In addition, ethnic differences in 5-m walking time at a comfortable pace were investigated in the present study. However, 5-m walking time at maximum effort is also measured in the clinical setting. In fact, maximum walking speed has been suggested to be closely related to bone strength in postmenopausal females53). Therefore, in addition to comfortable walking speed, maximum walking speed is also a useful index. However, the presence of ethnic differences in 5-m walking times at maximum effort could be inferred from the data of the present study. Therefore, whether similar ethnic differences exist for walking speed at maximum effort is as yet unknown, and this is also a limitation of this study.

In conclusion, walking speed in Japanese community-dwelling elderly individuals appears to be faster than that for non-Asian community-dwelling elderly individuals. The present results thus demonstrate the existence of ethnic differences in walking speed between Japanese and non-Asian community-dwelling elderly individuals. Currently, with regard to diagnosis of sarcopenia, the same walking speed cutoff points are applied to both Asians and Europeans4, 5). The results of this study suggest that careful consideration of ethnic differences is necessary for assessment of walking speed. When walking speed is measured to assess physical function in the elderly, consideration of ethnic differences may be necessary to estimate reference values. Walking speed reference values therefore need to be determined for each ethnic group.

Acknowledgments

This study was partially funded by the Ministry of Education, Culture, Sports, Science and Technology of Japan (Grant-in-Aid for Young Scientists (B) No. 25870703). The funder had no role in the study design, data collection and analysis, or the decision to publish.

REFERENCES

  • 1.Verghese J, Holtzer R, Lipton RB, et al. : Quantitative gait markers and incident fall risk in older adults. J Gerontol A Biol Sci Med Sci, 2009, 64: 896–901. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Vermeulen J, Neyens JC, van Rossum E, et al. : Predicting ADL disability in community-dwelling elderly people using physical frailty indicators: a systematic review. BMC Geriatr, 2011, 11: 33. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Stanaway FF, Gnjidic D, Blyth FM, et al. : How fast does the Grim Reaper walk? Receiver operating characteristics curve analysis in healthy men aged 70 and over. BMJ, 2011, 343: d7679. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. European Working Group on Sarcopenia in Older People: Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing, 2010, 39: 412–423. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5.Chen LK, Liu LK, Woo J, et al. : Sarcopenia in Asia: consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc, 2014, 15: 95–101. [DOI] [PubMed] [Google Scholar]
  • 6.Ando M, Kamide N: The reference values for the 5m walking time in community-dwelling Japanese elderly people: determination using the methodology meta-analysis. Sogo Rihabiriteshon, 2013, 41: 961–967(in Japanese). [Google Scholar]
  • 7.Bohannon RW, Williams Andrews A: Normal walking speed: a descriptive meta-analysis. Physiotherapy, 2011, 97: 182–189. [DOI] [PubMed] [Google Scholar]
  • 8.Seino S, Shinkai S, Fujiwara Y, et al. TMIG-LISA Research Group: Reference values and age and sex differences in physical performance measures for community-dwelling older Japanese: a pooled analysis of six cohort studies. PLoS ONE, 2014, 9: e99487. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Aoyagi K, Ross PD, Nevitt MC, et al. : Comparison of performance-based measures among native Japanese, Japanese-Americans in Hawaii and Caucasian women in the United States, ages 65 years and over: a cross-sectional study. BMC Geriatr, 2001, 1: 3. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.R Development Core Team: R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria 2011. http://www.R-project.org/ (Accessed May 16, 2013)
  • 11.Viechtbauer W: Conducting meta-analyses in R with the metaphor package. J Stat Softw, 2010, 36: 1–48. [Google Scholar]
  • 12.Watanabe M, Tanimoto Y, Kono R, et al. : [Objective assessment of walking in housebound elderly who are able to go out alone]. Nippon Ronen Igakkai Zasshi, 2011, 48: 170–175(in Japanese). [DOI] [PubMed] [Google Scholar]
  • 13.Makizako H, Furuna T, Shimada H, et al. : Relationship between 5-m walking time and the need for longterm care among community-dwelling adults aged above 75 years: a 39-month longitudinal study. J Jpn Phys Ther Assoc, 2011, 38: 27–33(in Japanese). [Google Scholar]
  • 14.Minematsu A, Gotoh N, Yoshizaki K: Maintenance of physical functions in elderly people by self-exercise. Rigakuryoho Kagaku, 2010, 25: 625–629(in Japanese). [Google Scholar]
  • 15.Kono R: [Relationship between occlusal force and preventive factors for disability among community-dwelling elderly persons]. Nippon Ronen Igakkai Zasshi, 2009, 46: 55–62(in Japanese). [DOI] [PubMed] [Google Scholar]
  • 16.Hirai T, Chidori K, Watanabe N, et al. : Evaluation of the grading ability of walking speed by the elderly. Rigakuryoho Kagaku, 2008, 23: 711–715(in Japanese). [Google Scholar]
  • 17.Hirota C, Watanabe M, Tanimoto Y, et al. : [A cross-sectional study on the relationship between the Trail Making Test and mobility-related functions in community-dwelling elderly]. Nippon Ronen Igakkai Zasshi, 2008, 45: 647–654(in Japanese). [DOI] [PubMed] [Google Scholar]
  • 18.Yamada M, Murata S, Otao H, et al. : Attention function is involved in walking ability under the dual-task condition among the elderly people living in the community. Rigakuryoho Kagaku, 2008, 23: 435–439(in Japanese). [Google Scholar]
  • 19.Huo M, Chang D, Maruyama H: An approach to the assessment of risk of falls in the elderly: prove reaction time during stepping. Rigakuryoho Kagaku, 2007, 22: 359–364(in Japanese). [Google Scholar]
  • 20.Tainaka K, Aoki J: Fitness-related factors associated with falling in older women. Jpn J Phys Fit Sports Med, 2007, 56: 279–286(in Japanese). [Google Scholar]
  • 21.Tainaka K, Funakura M, Aoki J: Age-related changes in walking ability and leg strength of stay-at-home elderly women. J Jpn Phys Ther Assoc, 2004, 31: 385–390(in Japanese). [Google Scholar]
  • 22.Shimada H, Kim H, Yoshida H, et al. : Factors associated with the timed up and go test score in elderly woman. J Phys Ther Sci, 2010, 22: 273–278. [Google Scholar]
  • 23.Kamide N, Shiba Y, Koide K, et al. : The timed up and go test is related to quantitative ultrasound parameters of bone strength in Japanese community-dwelling elderly women. J Phys Ther Sci, 2009, 21: 373–378. [Google Scholar]
  • 24.Huo M, Maruyama H, Akiyama S: An approach to assessment of the fall risk for the elderly by probe reaction time during walking. J Phys Ther Sci, 2009, 21: 311–316. [Google Scholar]
  • 25.Yamada M, Ichihashi N: Predicting the probability of falls in community-dwelling elderly individuals using the trail-walking test. Environ Health Prev Med, 2010, 15: 386–391. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Aoyagi Y, Park H, Watanabe E, et al. : Habitual physical activity and physical fitness in older Japanese adults: the Nakanojo Study. Gerontology, 2009, 55: 523–531. [DOI] [PubMed] [Google Scholar]
  • 27.Suzuki T, Kwon J, Kim H, et al. : Low serum 25-hydroxyvitamin D levels associated with falls among Japanese community-dwelling elderly. J Bone Miner Res, 2008, 23: 1309–1317. [DOI] [PubMed] [Google Scholar]
  • 28.Hirota C, Watanabe M, Sun W, et al. : Association between the Trail Making Test and physical performance in elderly Japanese. Geriatr Gerontol Int, 2010, 10: 40–47. [DOI] [PubMed] [Google Scholar]
  • 29.Kamide N, Shiba Y, Shibata H: Effects on balance, falls, and bone mineral density of a home-based exercise program without home visits in community-dwelling elderly women: a randomized controlled trial. J Physiol Anthropol, 2009, 28: 115–122. [DOI] [PubMed] [Google Scholar]
  • 30.Tainaka K, Takizawa T, Katamoto S, et al. : Six-year prospective study of physical fitness and incidence of disability among community-dwelling Japanese elderly women. Geriatr Gerontol Int, 2009, 9: 21–28. [DOI] [PubMed] [Google Scholar]
  • 31.Suzuki T, Kim H, Yoshida H, et al. : Randomized controlled trial of exercise intervention for the prevention of falls in community-dwelling elderly Japanese women. J Bone Miner Metab, 2004, 22: 602–611. [DOI] [PubMed] [Google Scholar]
  • 32.Atkinson HH, Rosano C, Simonsick EM, et al. Health ABC study: Cognitive function, gait speed decline, and comorbidities: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci, 2007, 62: 844–850. [DOI] [PubMed] [Google Scholar]
  • 33.DePasquale L, Toscano L: The Spring Scale Test: a reliable and valid tool for explaining fall history. J Geriatr Phys Ther, 2009, 32: 159–167. [PubMed] [Google Scholar]
  • 34.Lindsey C, Brownbill RA, Bohannon RA, et al. : Association of physical performance measures with bone mineral density in postmenopausal women. Arch Phys Med Rehabil, 2005, 86: 1102–1107. [DOI] [PubMed] [Google Scholar]
  • 35.Wolfson L, Whipple R, Derby C, et al. : Balance and strength training in older adults: intervention gains and Tai Chi maintenance. J Am Geriatr Soc, 1996, 44: 498–506. [DOI] [PubMed] [Google Scholar]
  • 36.Thorpe RJ, Jr, Koster A, Kritchevsky SB, et al. Health, Aging, and Body Composition Study: Race, socioeconomic resources, and late-life mobility and decline: findings from the Health, Aging, and Body Composition study. J Gerontol A Biol Sci Med Sci, 2011, 66: 1114–1123. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 37.Nagano H, Begg RK, Sparrow WA, et al. : Ageing and limb dominance effects on foot-ground clearance during treadmill and overground walking. Clin Biomech (Bristol, Avon), 2011, 26: 962–968. [DOI] [PubMed] [Google Scholar]
  • 38.Rosano C, Longstreth WT, Jr, Boudreau R, et al. : High blood pressure accelerates gait slowing in well-functioning older adults over 18-years of follow-up. J Am Geriatr Soc, 2011, 59: 390–397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 39.St-Arnaud-McKenzie D, Payette H, Gray-Donald K: Low physical function predicts either 2-year weight loss or weight gain in healthy community-dwelling older adults. the NuAge Longitudinal Study. J Gerontol A Biol Sci Med Sci, 2010, 65: 1362–1368. [DOI] [PubMed] [Google Scholar]
  • 40.Youdas JW, Childs KB, McNeil ML, et al. : Responsiveness of 2 procedures for measurement of temporal and spatial gait parameters in older adults. PM R, 2010, 2: 537–543. [DOI] [PubMed] [Google Scholar]
  • 41.Tia B, Mourey F, Ballay Y, et al. : Improvement of motor performance by observational training in elderly people. Neurosci Lett, 2010, 480: 138–142. [DOI] [PubMed] [Google Scholar]
  • 42.Liu-Ambrose T, Davis JC, Nagamatsu LS, et al. : Changes in executive functions and self-efficacy are independently associated with improved usual gait speed in older women. BMC Geriatr, 2010, 10: 25. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 43.Hollman JH, Youdas JW, Lanzino DJ: Gender differences in dual task gait performance in older adults. Am J Men Health, 2011, 5: 11–17. [DOI] [PubMed] [Google Scholar]
  • 44.Hilmer SN, Mager DE, Simonsick EM, et al. Health ABC Study: Drug burden index score and functional decline in older people. Am J Med, 2009, 122: 1142–1149.e1, 2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 45.Hartmann A, Murer K, de Bie RA, et al. : Reproducibility of spatio-temporal gait parameters under different conditions in older adults using a trunk tri-axial accelerometer system. Gait Posture, 2009, 30: 351–355. [DOI] [PubMed] [Google Scholar]
  • 46.Cesari M, Kritchevsky SB, Newman AB, et al. Health, Aging and Body Composition Study: Added value of physical performance measures in predicting adverse health-related events: results from the Health, Aging And Body Composition Study. J Am Geriatr Soc, 2009, 57: 251–259. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47.Hartmann A, Luzi S, Murer K, et al. : Concurrent validity of a trunk tri-axial accelerometer system for gait analysis in older adults. Gait Posture, 2009, 29: 444–448. [DOI] [PubMed] [Google Scholar]
  • 48.Kamide N, Takahashi K, Shiba Y: Reference values for the Timed Up and Go test in healthy Japanese elderly people: determination using the methodology of meta-analysis. Geriatr Gerontol Int, 2011, 11: 445–451. [DOI] [PubMed] [Google Scholar]
  • 49.Morita M, Takamura N, Kusano Y, et al. : Relationship between falls and physical performance measures among community-dwelling elderly women in Japan. Aging Clin Exp Res, 2005, 17: 211–216. [DOI] [PubMed] [Google Scholar]
  • 50.Shinkai S, Watanabe S, Kumagai S, et al. : Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Age Ageing, 2000, 29: 441–446. [DOI] [PubMed] [Google Scholar]
  • 51.Takasaki Y, Loy SF, Juergens HW: Ethnic differences in the relationship between bioelectrical impedance and body size. J Physiol Anthropol Appl Human Sci, 2003, 22: 233–235. [DOI] [PubMed] [Google Scholar]
  • 52.Suzuki T, Yoshida H, Hashimoto T, et al. : Case-control study of risk factors for hip fractures in the Japanese elderly by a Mediterranean Osteoporosis Study (MEDOS) questionnaire. Bone, 1997, 21: 461–467. [DOI] [PubMed] [Google Scholar]
  • 53.Sakazaki T, Koike T, Yanagimoto Y, et al. : Association between gait speed and bone strength in community-dwelling postmenopausal Japanese women. Environ Health Prev Med, 2012, 17: 394–400. [DOI] [PMC free article] [PubMed] [Google Scholar]

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