Cognition Mediates the Relationship Between Sensory Function and Gait Speed in Older Adults: Evidence from the English Longitudinal Study of Ageing

Abstract

Background/Objective: Gait speed is an important indicator for assessing overall health status. Previous studies have reported the important role of sensory function in gait speed; however, the underlying mechanism is still unclear. This study aimed to examine whether cognition mediates the association of sensory function with gait speed among English older adults. Methods: Gait speed was assessed by "timed walking test". Hearing was measured by using a hearing screening device. Vision was self-reported. Cognition was assessed by questionnaire. Baron and Kenny's causal steps method and Sobel test were used to examine the mediating effect. Results: Among 4,197 participants aged 60 years and older, 13.5% had poor hearing and 12.6% had poor vision, 2.6% had both poor hearing and poor vision. Multiple linear regression models suggested that poor hearing (␤ = -1.905, p < 0.001), poor vision (␤ = -1.309, p = 0.004), and poor dual sensory function (␤ = -2.442, p = 0.013) was associated with worse cognition. Cognition was correlated with gait speed (␤ = 0.004, p < 0.001). Poor hearing (␤ = -0.072, p < 0.001), poor vision (␤ = -0.031, p = 0.029), and poor dual sensory function (␤ = -0.081, p = 0.011) was associated with slower gait speed. After introducing cognition into the models, regression coefficients between sensory function and gait speed decreased (␤ = -0.066, p < 0.001 for hearing; ␤ = -0.027, p = 0.054 for vision; ␤ = -0.073, p = 0.020 for combined hearing and vision). Sobel test identified the significant mediating effect of cognition on the association between sensory function and gait speed. Conclusion: Cognition partially mediates the association between sensory function and gait speed. Efforts to maintain mobility performance in older adults should consider protecting both sensory function and cognition.

Association between age‐related sensory impairment with sarcopenia and its related components in older adults: a systematic review

“…We found strong evidence of an independent association between sensory impairment parameters, particularly, HI [28][29][30]33 and VI, 28,31,34 and slow gait speed. For instance, Chen and coworkers 33 in an 11-year longitudinal study of US adults aged ≥70 years found that subjects with HI had slower slow gait speed than those with no HI.…”

“…Four studies drew from Asian populations, seven from Caucasian populations and two from a combination of multiple ethnicities from six low‐ and middle‐income countries (LMIC). Two studies 30 , 38 had a moderate (NOS 5–7) and the remaining 22 , 23 , 28 , 29 , 31 , 32 , 33 , 34 , 39 , 40 , 41 ( n = 11) had a low (NOS ≥ 8) risk of bias ( Table 2 for longitudinal studies; Table 3 for cross‐sectional studies).…”

“… 22 , 23 Establishing this relationship is important, as sensory impairments can be managed effectively with sensory interventions such as cataract surgery, provision of glasses and hearing aids, and olfactory management. 24 , 25 , 26 , 27 Specifically, cross‐sectional 22 , 28 , 29 , 30 , 31 and longitudinal 32 , 33 , 34 studies have documented the association between sensory impairments and the associated components of sarcopenia. As such, sensory impairments may represent an early indicator and modifiable risk factor of sarcopenia.…”

The Association of Vision, Hearing, and Dual-Sensory Loss with Walking Speed and Incident Slow Walking: Longitudinal and Time to Event Analyses in the Health and Retirement Study

“…[15][16][17] Furthermore, the association between DSL and walking speed was reported in an English cohort of older adults. 18 However, most prior studies have been cross-sectional. This longitudinal study assesses the association between DSL and walking speed using a population-based sample of older adults in the United States, the Health and Retirement Study (HRS).…”

Envelhecendo na cidade: análises longitudinais do declínio da mobilidade e sobrevida de idosos com múltiplas estratégias

“…Nesse sentido, é importante ressaltar a importância do sistema cognitivo 76 , que, entre as suas funções, permite que um indivíduo seja capaz de organizar os padrões de movimento direcionados a um certo objetivo, papel conhecido como planejamento motor 77 . Além disso, também permite que a atenção seja dividida entre diferentes demandas 66,67,76 , como ocorre, por exemplo, quando se conversa ao caminhar.…”