Gait speed as predictor of transition into cognitive impairment: Findings from three longitudinal studies on aging
Date
2020
Authors
Hoogendijk, Emiel O.
Rijnhart, Judith J.M.
Skoog, Johan
Robitaille, Annie
van den Hout, Ardo
Ferrucci, Luigi
Huisman, Martijn
Skoog, Ingmar
Piccinin, Andrea M.
Hofer, Scott M.
Journal Title
Journal ISSN
Volume Title
Publisher
Experimental Gerontology
Abstract
Objectives
Very few studies looking at slow gait speed as early marker of cognitive decline investigated the competing risk of death. The current study examines associations between slow gait speed and transitions between cognitive states and death in later life.
Methods
We performed a coordinated analysis of three longitudinal studies with 9 to 25 years of follow-up. Data were used from older adults participating in H70 (Sweden; n = 441; aged ≥70 years), InCHIANTI (Italy; n = 955; aged ≥65 years), and LASA (the Netherlands; n = 2824; aged ≥55 years). Cognitive states were distinguished using the Mini-Mental State Examination. Slow gait speed was defined as the lowest sex-specific quintile at baseline. Multistate models were performed, adjusted for age, sex and education.
Results
Most effect estimates pointed in the same direction, with slow gait speed predicting forward transitions. In two cohort studies, slow gait speed predicted transitioning from mild to severe cognitive impairment (InCHIANTI: HR = 2.08, 95%CI = 1.40–3.07; LASA: HR = 1.33, 95%CI = 1.01–1.75) and transitioning from a cognitively healthy state to death (H70: HR = 3.30, 95%CI = 1.74–6.28; LASA: HR = 1.70, 95%CI = 1.30–2.21).
Conclusions
Screening for slow gait speed may be useful for identifying older adults at risk of adverse outcomes such as cognitive decline and death. However, once in the stage of more advanced cognitive impairment, slow gait speed does not seem to predict transitioning to death anymore.
Description
Keywords
Cognition, Dementia, Walking speed, Multistate modeling
Citation
Hoogendijk, E.O., Rijnhar, J.J.M., Skoog, J., Robitaille, A., v.d.H, Ardo, Ferrucci, L., ... Terrera, G.M. (2020). Gait speed as predictor of transition into cognitive impairment: Findings from three longitudinal studies on aging. Experimental Gerotology, 129, 110783. https://doi.org/10.1016/j.exger.2019.110783