Gait speed under varied challenges and cognitive decline in older persons: a prospective study.
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.


METHODS
prospective study.


METHODS
population-based sample of community-dwelling older persons.


METHODS
660 older participants (age > or = 65 years).


METHODS
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 > or = 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.


CONCLUSIONS
measuring fast gait speed in older persons may assist in identifying those at high risk of cognitive decline.
Deshpande
Nandini
N
Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, KS 66160, USA. nandinijd@yahoo.com
Metter
E Jeffrey
EJ
Bandinelli
Stefania
S
Guralnik
Jack
J
Ferrucci
Luigi
L
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016138:Walking