Slow walking speed and cardiovascular death in well functioning older adults: prospective cohort study

Julien Dumurgier, Alexis Elbaz, Pierre Ducimetière, Béatrice Tavernier, Annick Alpérovitch, Christophe Tzourio, Julien Dumurgier, Alexis Elbaz, Pierre Ducimetière, Béatrice Tavernier, Annick Alpérovitch, Christophe Tzourio

Abstract

Objective: To study the relation between low walking speed and the risk of death in older people, both overall and with regard to the main causes of death.

Design: Prospective cohort study.

Setting: Dijon centre (France) of the Three-City study.

Participants: 3208 men and women aged >or=65 living in the community, recruited from 1999 to 2001, and followed for an average of 5.1 years.

Main outcome measures: Mortality, overall and according to the main causes of death, by thirds of baseline walking speed (measured at maximum speed over six metres), adjusted for several potential confounders; Kaplan-Meier survival curves by thirds of baseline walking speed. Vital status during follow-up. Causes of death. Results During 16 414 person years of follow-up, 209 participants died (99 from cancer, 59 from cardiovascular disease, 51 from other causes). Participants in the lowest third of baseline walking speed had an increased risk of death (hazard ratio 1.44, 95% confidence interval 1.03 to 1.99) compared with the upper thirds. Analyses for specific causes of death showed that participants with low walking speed had about a threefold increased risk of cardiovascular death (2.92, 1.46 to 5.84) compared with participants who walked faster. There was no relation with cancer mortality (1.03, 0.65 to 1.70). In stratified analyses, cardiovascular mortality was increased across various strata defined by sex, median age, median body mass index (BMI), and level of physical activity. Conclusion Slow walking speed in older people is strongly associated with an increased risk of cardiovascular mortality.

Conflict of interest statement

Competing interests: None declared.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4787543/bin/dumj674077.f1_default.jpg
Fig 1 Kaplan-Meier estimates of cumulative incidence of death according to thirds of walking speed, overall and by cause of death. Cut offs (tertiles) for definition of thirds of walking speed were ≤1.50 m/s, 1.51-1.84 m/s, and ≥1.85 m/s for men and ≤1.35 m/s, 1.36-1.50 m/s, and >1.50 m/s for women
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4787543/bin/dumj674077.f2_default.jpg
Fig 2 Walking speed in lowest third and risk of cardiovascular death: stratified analyses. Hazard ratios estimate relative risk of cardiovascular death in those in lowest third of walking speed (≤1.50 m/s for men; ≤1.35 m/s for women) compared with those in two highest thirds (reference group)

References

    1. Hall WJ. Update in geriatrics. Ann Intern Med 2006;145:538-43.
    1. Barak Y, Wagenaar RC, Holt KG. Gait characteristics of elderly people with a history of falls: a dynamic approach. Phys Ther 2006;86:1501-10.
    1. Morita M, Takamura N, Kusano Y, Abe Y, Moji K, Takemoto T, et al. Relationship between falls and physical performance measures among community-dwelling elderly women in Japan. Aging Clin Exp Res 2005;17:211-6.
    1. Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000;55:M221-31.
    1. Montero-Odasso M, Schapira M, Soriano ER, Varela M, Kaplan R, Camera LA, et al. Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. J Gerontol A Biol Sci Med Sci 2005;60:1304-9.
    1. Penninx BW, Ferrucci L, Leveille SG, Rantanen T, Pahor M, Guralnik JM. Lower extremity performance in nondisabled older persons as a predictor of subsequent hospitalization. J Gerontol A Biol Sci Med Sci 2000;55:M691-7.
    1. Cesari M, Kritchevsky SB, Penninx BW, Nicklas BJ, Simonsick EM, Newman AB, et al. Prognostic value of usual gait speed in well-functioning older people—results from the health, aging and body composition study. J Am Geriatr Soc 2005;53:1675-80.
    1. Ostir GV, Kuo YF, Berges IM, Markides KS, Ottenbacher KJ. Measures of lower body function and risk of mortality over 7 years of follow-up. Am J Epidemiol 2007;166:599-605.
    1. Liston R, Mickelborough J, Bene J, Tallis R. A new classification of higher level gait disorders in patients with cerebral multi-infarct states. Age Ageing 2003;32:252-8.
    1. Elbaz A, Ripert M, Tavernier B, Fevrier B, Zureik M, Gariepy J, et al. Common carotid artery intima-media thickness, carotid plaques, and walking speed. Stroke 2005;36:2198-202.
    1. The 3C Study Group. Vascular factors and risk of dementia: design of the three-city study and baseline characteristics of the study population. Neuroepidemiology 2003;22:316-25.
    1. Radloff LS. The CES-D scale: a self report depression scale for research in the general population. Appl Psychol Meas 1977;1:385-401.
    1. Graham JE, Ostir GV, Kuo YF, Fisher SR, Ottenbacher KJ. Relationship between test methodology and mean velocity in timed walk tests: a review. Arch Phys Med Rehabil 2008;89:865-72.
    1. Newman AB, Simonsick EM, Naydeck BL, Boudreau RM, Kritchevsky SB, Nevitt MC, et al. Association of long-distance corridor walk performance with mortality, cardiovascular disease, mobility limitation, and disability. JAMA 2006;295:2018-26.
    1. Dobkin BH. Short-distance walking speed and timed walking distance: redundant measures for clinical trials? Neurology 2006;66:584-6.
    1. Wei M, Kampert JB, Barlow CE, Nichaman MZ, Gibbons LW, Paffenbarger RS Jr, et al. Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA 1999;282:1547-53.
    1. Nocon M, Hiemann T, Muller-Riemenschneider F, Thalau F, Roll S, Willich SN. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil 2008;15:239-46.
    1. Soumare A, Elbaz A, Ducros V, Tavernier B, Alperovitch A, Tzourio C. Cross-sectional association between homocysteine and motor function in the elderly. Neurology 2006;67:985-90.
    1. Volpato S, Ble A, Metter EJ, Lauretani F, Bandinelli S, Zuliani G, et al. High-density lipoprotein cholesterol and objective measures of lower extremity performance in older nondisabled persons: the InChianti study. J Am Geriatr Soc 2008;56:621-9.
    1. Cesari M, Penninx BW, Pahor M, Lauretani F, Corsi AM, Rhys Williams G, et al. Inflammatory markers and physical performance in older persons: the InCHIANTI study. J Gerontol A Biol Sci Med Sci 2004;59:242-8.
    1. Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000;342:836-43.
    1. Arvanitakis Z, Wilson RS, Bienias JL, Bennett DA. Diabetes and parkinsonian signs in older persons. Alzheimer Dis Assoc Disord 2007;21:144-9.
    1. Soumare A, Elbaz A, Zhu Y, Maillard P, Crivello F, Tavernier B, et al. White matter lesions volume and motor performances in the elderly. Ann Neurol 2009;65:706-15.
    1. Wolfson L, Wei X, Hall CB, Panzer V, Wakefield D, Benson RR, et al. Accrual of MRI white matter abnormalities in elderly with normal and impaired mobility. J Neurol Sci 2005;232:23-7.
    1. Rosano C, Brach J, Longstreth Jr WT, Newman AB. Quantitative measures of gait characteristics indicate prevalence of underlying subclinical structural brain abnormalities in high-functioning older adults. Neuroepidemiology 2006;26:52-60.
    1. Rosano C, Sigurdsson S, Siggeirsdottir K, Phillips CL, Garcia M, Jonsson PV, et al. Magnetization transfer imaging, white matter hyperintensities, brain atrophy and slower gait in older men and women. Neurobiol Aging 2008. Sep 5 [Epub ahead of print].
    1. Baezner H, Blahak C, Poggesi A, Pantoni L, Inzitari D, Chabriat H, et al. Association of gait and balance disorders with age-related white matter changes: the LADIS study. Neurology 2008;70:935-42.
    1. McDermott MM, Liu K, Ferrucci L, Criqui MH, Greenland P, Guralnik JM, et al. Physical performance in peripheral arterial disease: a slower rate of decline in patients who walk more. Ann Intern Med 2006;144:10-20.
    1. Beunza JJ, Martinez-Gonzalez MA, Ebrahim S, Bes-Rastrollo M, Nunez J, Martinez JA, et al. Sedentary behaviors and the risk of incident hypertension: the SUN Cohort. Am J Hypertens 2007;20:1156-62.
    1. Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 2003;289:1785-91.
    1. Criqui MH. Response bias and risk ratios in epidemiologic studies. Am J Epidemiol 1979;109:394-9.

Source: PubMed

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