This test is increasingly used in the UK and beyond as a simple yet effective screening test for frailty. The test is validated for use in primary or secondary care (outpatient) settings, and is highly sensitive for indicating frailty if a person takes longer than the specified time to complete it.

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However, the test is not specific for frailty, nor does it give a reliable indication of the severity of the frailty.  Therefore, it is essential that anyone screened as potentially having frailty by this test undergoes further more detailed assessment to decide if they have frailty and and what level of severity.  This further assessment would be ideally carried out by any process based on the Comprehensive Geriatric Assessment (CGA).

The gait speed test measures the length of time a person takes to walk a set distance and can take several forms in terms of what distance is set.  NICE guidance on multimorbidity recommends that it can be used as an informal assessment in primary and community settings (for example, time taken to answer the door, time taken to walk from the waiting room), as well as a formal assessment.  The instructions below illustrate the most commonly used distance in the UK for the formal assessment and represent the basic instructions regardless of the distance set.

  1. Ensure that the person to be assessed is rested and not acutely ill, and is wearing clothing and footwear which is comfortable and not restrictive.
  2. Measure out a straight line distance of 4m (approximately 13 feet) along a flat, even, unobstructed and non-slippery floor.
  3. Ask the person to walk, from a standing start, the pre-measured 4m distance and time them. The person is allowed to use any walking aid that they would normally use. Some variations ask that the person is also allowed to have a 1.5m ‘start’ before the 4m timed distance, and a 1.5m ‘slow down’ distance at the end.
  4. Allow the person to rest, and then ideally repeat the timed test 3 times in total.
  5. Take an average time for the 3 tests. If that time is longer than 5 seconds to walk the 4m distance, the test is positive for potential frailty and that person should be assessed further, as described earlier.

In effect, any person taking 5 secs or more to walk 4m is walking slower than 0.8m per second (or taking more than 1.25 seconds to walk each metre), and this walking speed is recognised as the ‘cut-off’ for any timed distance used (e.g., some variations of the test use 5m or 7m).  Any walking speed slower than 0.8m per second indicates a positive gait speed test for frailty and merits further assessment for the person concerned.

Example distances and times:

  • 4m – positive result if time taken is greater than 5 seconds
  • 5m – positive result if time taken is greater than 6.25 seconds
  • 6m – positive result if time taken is greater than 7.5 seconds
  • 7m – positive result if time taken is greater than 8.75 seconds

The gait speed test is also recommended for self-diagnosis as part of supported self-care promoted through A Practical Guide to Healthy Ageing.

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