title: Combined Effect of Slow Gait Speed and Depressive Symptoms on Incident Disability in Older Adults.
abstract: OBJECTIVE
  To elucidate whether a combination of slow gait speed and depressive symptoms result in higher risk of incident disability in older adults than either symptom individually.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Obu City, Aichi Prefecture, Japan.
  
  
  METHODS
  Participants were 4038 older adults (48.7% male, mean age = 71 years) who met the study inclusion criteria.
  
  
  METHODS
  Longitudinal data on incident disability were collected up to 33 months [median 31 months (interquartile range 29-32 months)] after baseline. We monitored monthly incident disability, defined as Japanese long-term care insurance certification for personal support or care. Baseline measurements included covariates for incident disability, gait speed, and the Geriatric Depression Scale for assessing depressive symptoms. The associations between slow gait, depressive symptoms, or their co-occurrence, and incident disability were examined.
  
  
  RESULTS
  Control participants were the reference in an adjusted Cox proportional hazard regression model. Participants with co-occurring slow gait and depressive symptoms showed a greater risk of incident disability [hazard ratio (HR) 3.08, confidence interval (CI) 95% 2.00-4.75]. Greater risk was also found for participants with slow gait speed alone (HR 2.44, CI 95% 1.71-3.47) and depressive symptoms alone (HR 1.60, CI 95% 1.01-2.53).
  
  
  CONCLUSIONS
  Older adults with both risk factors may require early detection and physical and psychological intervention.
authors.affiliation: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan. Electronic address: k-tsutsu@ncgg.go.jp.
authors.forename: Kota
authors.initials: K
authors.lastname: Tsutsumimoto
authors.affiliation: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Doi
authors.affiliation: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimada
authors.affiliation: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Hyuma
authors.initials: H
authors.lastname: Makizako
authors.affiliation: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Hotta
authors.affiliation: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Nakakubo
authors.affiliation: Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D051346:Mobility Limitation; D011446:Prospective Studies
keywords: Incident disability; depression; gait speed; older adults