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Email:
mmontero@uwo.ca
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Project ID:
180609
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Project Summary
Most of the disabilities of aging will arise from gait and cognitive impairments, that when combined affect one-third of the elderly yielding five billion/year in health costs. Until recently, gait and cognitive impairments were evaluated and managed separately, obscuring common connections. However, new evidence shows that the concurrent gait and cognitive impairment seen in aging increases the risk of falls, fractures, dementia, and also mortality. To date, systematic investigations of modifiable risk factors for concurrent gait and cognitive impairments in large population-based samples have not been pursued. Importantly, these modifiable factors may emerge between mid and later life, and differ between women and men. Our goal is to identify common modifiable risk factors that will open the opportunity to treat this syndrome as a single entity, thus doubling the intervention repertoire.
Project Findings
Walking speed is an important marker of health in older adults, as individuals with slow walking speed are at higher risk of falls, multimorbidity, cognitive decline, mortality, and loss of independence in daily activities. This study identified several non-modifiable and potentially modifiable factors associated with slower walking speed that could be targeted to prevent or delay walking speed decline and its associated negative outcomes.
Non-modifiable factors accounted for 15.6% of walking speed variability, and modifiable factors explained 4.1%, contributing nearly 20% combined. Non-modifiable factors linked to slower walking included older age, being female, non-white ethnicity, shorter height, and lower educational attainment. A range of potentially modifiable cognitive, clinical, chronic disease, and lifestyle factors were also associated with slower walking speed. These included cardiovascular disease, stroke, osteoarthritis, obesity, lower vitamin D levels, higher C-reactive protein, depressive symptoms, physical inactivity, muscle weakness, chronic pain, and difficulty reaching the bathroom on time. Poorer cognitive performance, including memory, verbal fluency, and executive function, was also associated with slower walking speed. In conclusion, the correlates of walking speed in adulthood are multifactorial, with many being potentially modifiable through clinical intervention, education, and lifestyle changes.