title: Perceived Walking Speed, Measured Tandem Walk, Incident Stroke, and Mortality in Older Latino Adults: A Prospective Cohort Study.
abstract: BACKGROUND
  Walking speed is associated with functional status and all-cause mortality. Yet the relationship between walking speed and stroke, also a leading cause of disability, remains poorly understood, especially in older Latino adults who suffer from a significant burden of stroke.
  
  
  METHODS
  A total of 1,486 stroke-free participants from the Sacramento Area Latino Study on Aging, aged 60 and older at baseline in 1998-1999, were followed annually through 2010. Participants reported their usual walking speed outdoors which was classified into slow, medium, or fast. We also assessed timed tandem walk ability (unable or eight or more errors vs less than eight errors). We ascertained three incident stroke endpoints: total stroke, nonfatal stroke, and fatal stroke. Using Cox proportional hazards models, we estimated hazard ratios (HRs) for stroke at different walking speed and timed tandem walk categories.
  
  
  RESULTS
  Over an average of 6 years of follow-up (SD = 2.8), the incidence rate of total strokes was 23.2/1,000 person-years for slow walkers compared to 15.6/1,000 person-years for medium walkers, and 7.6/1,000 person-years for fast walkers. In Cox models adjusted for sociodemographics, cardiovascular risk, cognition and functional status, and self-rated health, the hazard of total stroke was 31% lower for medium walkers (HR: 0.69, 95% confidence interval [CI]: 0.47, 1.02) and 56% lower for fast walkers (HR: 0.44, 95% CI: 0.24, 0.82) compared with slow walkers. We found similar associations with timed tandem walk ability (fully adjusted HR: 0.66, 95% CI: 0.45, 0.98).
  
  
  CONCLUSIONS
  Our findings suggest perceived walking speed captures more than self-rated health alone and is a strong risk factor for stroke risk in Latino older adults.
authors.affiliation: Division of Epidemiology, Department of Public Health Sciences, University of Miami, Florida.
authors.forename: Adina
authors.initials: A
authors.lastname: Zeki Al Hazzouri
authors.affiliation: Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco.
authors.forename: Elizabeth Rose
authors.initials: ER
authors.lastname: Mayeda
authors.affiliation: Division of Epidemiology, Department of Public Health Sciences, University of Miami, Florida.
authors.forename: Tali
authors.initials: T
authors.lastname: Elfassy
authors.affiliation: Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco.
authors.forename: Anne
authors.initials: A
authors.lastname: Lee
authors.affiliation: College of Public Health and Human Sciences, Oregon State University, Corvallis.
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Odden
authors.affiliation: College of Public Health and Human Sciences, Oregon State University, Corvallis.
authors.forename: Divya
authors.initials: D
authors.lastname: Thekkethala
authors.affiliation: Department of Neurology, Miller School of Medicine and.|Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Florida.
authors.forename: Clinton B
authors.initials: CB
authors.lastname: Wright
authors.affiliation: Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Glymour
authors.affiliation: Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco.
authors.forename: Mary N
authors.initials: MN
authors.lastname: Haan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000401:mortality* / Q000503:physiopathology*; D000072797:Walking Speed
keywords: Epidemiology; Minority aging; Physical function; Stroke; Walking speed