Gait characteristics associated with walking speed decline in older adults: Results from the Baltimore Longitudinal Study of Aging

Abstract

BackgroundUnderstanding the mechanisms that contribute to walking speed decline can provide needed insight for developing targeted interventions to reduce the rate and likelihood of decline. ObjectiveExamine the association between gait characteristics and walking speed decline in older adults. MethodsParticipants in the Baltimore Longitudinal Study of Aging aged 60 to 89 were evaluated in the gait laboratory which used a three dimensional motion capture system and force platforms to assess cadence, stride length, stride width, percent of gait cycle in double stance, anterior–posterior mechanical work expenditure (MWE), and medial–lateral MWE. Usual walking speed was assessed over 6m at baseline and follow-up. Gait characteristics associated with meaningful decline (decline ≥0.05m/s/y) in walking speed were evaluated by logistic regression adjusted for age, sex, race, height, weight, initial walking speed and follow-up time. ResultsAmong 362 participants, the average age was 72.4 (SD=8.1) years, 51% were female, 27% were black and 23% were identified has having meaningful decline in usual walking speed with an average follow-up time of 3.2 (1.1) years. In the fully adjusted model, faster cadence [ORadj=0.65, 95% CI (0.43,0.97)] and longer strides [ORadj=0.87, 95% CI (0.83,0.91)] were associated with lower odds of decline. However age [ORadj=1.04, 95% CI (0.99,1.10)] was not associated with decline when controlling for gait characteristics and other demographics. ConclusionA sizable proportion of healthy older adults experienced walking speed decline over an average of 3 years. Longer stride and faster cadence were protective against meaningful decline in usual walking speed.