Age and Ageing Advance Access originally published online on June 23, 2009
Age and Ageing 2009 38(5):509-514; doi:10.1093/ageing/afp093
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Gait speed under varied challenges and cognitive decline in older persons: a prospective study
1 Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, MS 2002, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
2 Longitudinal Study Section, Clinical Research Branch, National Institute on Aging, National Institute of Health, Harbor Hospital, 3001 S. Hanover Street, Baltimore, MD 21225, USA
3 Geriatric Rehabilitation Unit, ASF, Tuscany Regional Health Agency, Azienda Sanitaria di Firenze, Florence, Italy
4 Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, 9000, Rockville Pike, Bethesda, MD 20892, USA
5 Longitudinal Study Section, Clinical Research Branch, National Institute on Aging, National Institute of Health, Harbor Hospital, 3001 S. Hanover Street, Baltimore, MD 21225, USA
Address correspondence to: N. Deshpande. Tel: (+1) 913 588 4343; Fax: (+1) 913 588 4568. Email: nandinijd{at}yahoo.com
Objective: to examine whether usual gait speed, fast gait speed or speed while walking with a cognitive or neuromuscular challenge predicts evolving cognitive decline over 3 years.
Design: prospective study.
Setting: population-based sample of community-dwelling older persons.
Participants: 660 older participants (age 
65 years).
Measurements: usual gait speed, fastest gait speed, gait speed during ‘walking-while-talking’, depression, comorbidities, education, smoking and demographics were assessed at baseline. Cognition was evaluated at baseline and follow-up. A decline in MMSE score by 3 points was considered as significant cognitive decline (SCD).
Results: adjusting for confounders, only fast speed was associated with cognitive performance at 3-year follow-up. One hundred thirty-five participants had SCD over 3 years. Participants in the lowest quartile of usual speed or walking-while-talking speed were more likely to develop SCD. Conversely, participants in the third and fourth quartiles of fast speed were more likely to develop SCD. J-test showed that the model including fast speed quartiles as a regressor was significantly more predictive of SCD than the models with usual speed or walking-while-talking speed quartiles.
Conclusion: measuring fast gait speed in older persons may assist in identifying those at high risk of cognitive decline.
Keywords: Elderly, cognition, gait speed, ageing, significant cognitive decline
Received 14 October 2008; accepted in revised form 11 March 2009.