Improvement in usual gait speed predicts better survival in older adults

J Am Geriatr Soc. 2007 Nov;55(11):1727-34. doi: 10.1111/j.1532-5415.2007.01413.x. Epub 2007 Oct 3.


Objectives: To estimate the relationship between 1-year improvement in measures of health and physical function and 8-year survival.

Design: Prospective cohort study.

Setting: Medicare health maintenance organization and Veterans Affairs primary care programs.

Participants: Persons aged 65 and older (N=439).

Measurements: Six measures of health and function assessed at baseline and quarterly over 1 year. Participants were classified as improved at 1 year, transiently improved, or never improved for each measure using a priori definitions of meaningful change: gait speed (usual walking pace over 4 m), 0.1 m/s; Short Physical Performance Battery, 1 point; Medical Outcomes Study 36-item Short Form Health Survey physical function, 10 points; EuroQol, 0.1 point; National Health Interview activity of daily living scale, 2 points; and global health change, two levels or reaching the ceiling. Mortality was ascertained from the National Death Index. Covariates included demographics, comorbidity, cognitive function, and hospitalization.

Results: Of the six measures, only improved gait speed was associated with survival. Mortality after 8 years was 31.6%, 41.2%, and 49.3% for those with improved, transiently improved, and never improved gait speed, respectively. The survival benefit for improvement at 1 year persisted after adjustment for covariates (hazard ratio=0.42, 95% confidence interval=0.29-0.61, P<.001) and was consistent across subgroups based on age, sex, ethnicity, initial gait speed, healthcare system, and hospitalization.

Conclusion: Improvement in usual gait speed predicts a substantial reduction in mortality. Because gait speed is easily measured, clinically interpretable, and potentially modifiable, it may be a useful "vital sign" for older adults. Further research is needed to determine whether interventions to improve gait speed affect survival.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / classification
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Gait*
  • Geriatric Assessment / statistics & numerical data*
  • Health Status Indicators
  • Humans
  • Male
  • Mobility Limitation*
  • Mortality*
  • Physical Fitness*
  • Predictive Value of Tests
  • Prospective Studies
  • Statistics as Topic
  • Survival Analysis
  • United States
  • Walking