Normative reference values for the six-minute walk test in older adults: A systematic review and meta-analysis

The six-minute walk test (6MWT) is widely used to assess functional capacity in older adults, but performance differs by various factors. This review compiled 6MWT reference values and identified key predictors of performance.

Studies on average 6MWT distances in older adults were found through PubMed, Scopus, Web of Science, Ovid, and PEDro, with no date limits. Participant data were summarized using descriptive statistics. A random-effects meta-analysis combined mean distances, with heterogeneity assessed using Cochran's Q test and I² statistics. Subgroup analyses examined variations by age, gender, BMI, height, and region, while regression analyses identified predictors of 6MWT performance.

Of 72 studies, 28 were included in the meta-analysis. Men walked farther (473.11 m) than women (428.35 m). Distance declined with age, from 587.43 m (age 60-64) to 325.53 m (age ≥80). Overweight participants walked more (461.24 m) than those with normal BMI (425.33 m). By region, Oceania showed the highest distance (485.42 m), followed by Europe, the Americas, and Asia. Meta-regression showed distance decreased by 10.25 m per year of age and increased by 4.44 m per kg of weight. Gender, BMI, and height were not significant predictors.

The 6MWT remains a valuable tool for assessing functional capacity in older adults. Age and weight were the most significant predictors of 6MWT performance, with distance decreasing markedly with age and increasing with body weight. Regional factors also influenced outcomes, while gender, BMI, and body height had less impact. Clinicians should use age-adjusted evaluations and promote weight management strategies to preserve mobility in older adults.