Abstract
BackgroundThis study explores whether a sex difference in sensitivity to (strength of the association) and/or in exposure to (prevalence) determinants of gait speed contributes to the observed lower gait speed among older women compared to men.MethodsData from the Longitudinal Aging Study Amsterdam (LASA) were used. In total 2407 men and women aged 55–81 years were included, with baseline measurements in 1992/2002 and follow-up measurements every 3–4 years for 15/25 years. Multivariable mixed model analysis was used to investigate sex differences in sensitivity (interaction term with sex) and in exposure to (change of the sex difference when adjusted) socio-demographic, lifestyle, social and health determinants of gait speed.ResultsWomen had a 0.054 m/s (95 % CI: 0.076 − 0.033, adjusted for height and age) lower mean gait speed compared to men. In general, men and women had similar determinants of gait speed. However, higher BMI and lower physical activity were more strongly associated with lower gait speed in women compared to men (i.e. higher sensitivity). More often having a lower educational level, living alone and having more chronic diseases, pain and depressive symptoms among women compared to men also contributed to observed lower gait speed in women (i.e. higher exposure). In contrast, men more often being a smoker, having a lower physical activity and a smaller personal network size compared to women contributed to a lower gait speed among men (i.e. higher exposure).ConclusionsBoth a higher sensitivity and higher exposure to determinants of gait speed among women compared to men contributes to the observed lower gait speed among older women. The identified (modifiable) contributing factors should be taken into account when developing prevention and/or treatment strategies aimed to enhance healthy physical aging. This might require a sex-specific approach in both research and clinical practice, which is currently often lacking.
Highlights
This study explores whether a sex difference in sensitivity to and/or in exposure to determinants of gait speed contributes to the observed lower gait speed among older women compared to men
For women, more often being lower educated, more often living alone and having a higher prevalence of chronic disease, pain and depressive symptoms compared to men, contributed to the lower gait speed among women compared to men
The findings of this study show that both the sex differential sensitivity to lower physical activity and higher Body Mass Index (BMI), and sex differential exposure to lower educational level, living alone, chronic diseases, pain and depressive symptoms contribute to the observed lower gait speed among women aged 55 years and older compared to men
Summary
This study explores whether a sex difference in sensitivity to (strength of the association) and/or in exposure to (prevalence) determinants of gait speed contributes to the observed lower gait speed among older women compared to men. Sex-specific regression models show different lifestyle determinants of physical performance (including gait speed) for older men and women; namely doing exercise and engagement in social activities for men and sleep quality for women [9]. This suggests a sex difference (women versus men) in sensitivity towards these lifestyle factors, interaction with sex was not statistically tested. Most studies adjust their multivariate regression models on determinants of physical performance for sex [10,11,12], limiting our knowledge on sex differences in sensitivity
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