Walking Cadence and Mortality Among Community-Dwelling Older Adults

Brown, Justin C.; Harhay, Michael O.; Harhay, Meera N.

doi:10.1007/s11606-014-2926-6

Cited by 46 publications

(34 citation statements)

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“…Specifically, for each 10 steps per minute increase in cadence there was a 40% lower likelihood of meaningful decline in usual gait speed.Among NHANES participants a cadence that was ten steps per minute faster was associated with a 4% decrease in all-cause mortality and the ability to walk 100 steps per minute was associated with a reduction in cardiovascular related deaths (Brown, Harhay, & Harhay, 2014). In the latter case it is not clear if cadence is simply a gait characteristic or actually a marker for cardiovascular fitness.…”

Section: Discussionmentioning

confidence: 99%

Gait characteristics associated with walking speed decline in older adults: Results from the Baltimore Longitudinal Study of Aging

Jerome

Kauffman

et al. 2015

Archives of Gerontology and Geriatrics

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Background Understanding the mechanisms that contribute to walking speed decline can provide needed insight for developing targeted interventions to reduce the rate and likelihood of decline. Objective Examine the association between gait characteristics and walking speed decline in older adults. Methods Participants in the Baltimore Longitudinal Study of Aging aged 60 to 89 were evaluated in the gait laboratory which used a three dimensional motion capture system and force platforms to assess cadence, stride length, stride width, percent of gait cycle in double stance, anterior-posterior mechanical work expenditure (MWE), and medial-lateral MWE. Usual walking speed was assessed over 6 meters at baseline and follow-up. Gait characteristics associated with meaningful decline (decline ≥ 0.05 m/s/y) in walking speed were evaluated by logistic regression adjusted for age, sex, race, height, weight, initial walking speed and follow-up time. Results Among 362 participants, the average age was 72.4 (SD=8.1) years, 51% were female, 27% were black and 23% were identified has having meaningful decline in usual walking speed with an average follow-up time of 3.2 (1.1) years. In the fully adjusted model, faster cadence [ORadj=0.65 95% CI (0.43,0.97)] and longer strides [ORadj=0.87 95% CI (0.83,0.91)] were associated with lower odds of decline. However age [ORadj=1.04 95% CI (0.99,1.10)] was not associated with decline when controlling for gait characteristics and other demographics. Conclusion A sizable proportion of healthy older adults experienced walking speed decline over an average of 3 years. Longer stride and faster cadence were protective against meaningful decline in usual walking speed.

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Section: Discussionmentioning

confidence: 99%

Gait characteristics associated with walking speed decline in older adults: Results from the Baltimore Longitudinal Study of Aging

Jerome

Kauffman

et al. 2015

Archives of Gerontology and Geriatrics

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“…The existing evidence of a benefit of LTPA with regard to CVD mortality is to some extent controversial. Men with the ability to walk more than 100 steps per minute had lower CVD mortality than those who could not, and physical activity was associated with lower CVD mortality in a 4‐year follow‐up of British men . Another study found a 34% lower risk of CVD mortality in a follow‐up study of 9,518 community‐dwelling white women aged 65 and older.…”

Section: Discussionmentioning

confidence: 99%

“…Moderate and high levels of LTPA have been shown to reduce all‐cause mortality in older men and women . In addition, walking, a specific form of LTPA, has been found to be associated with lower risk of all‐cause mortality Apparently, even occasional physical activity reduces the risk of all‐cause mortality in older adults …”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8][9] Less evidence of the effects of LTPA on all-cause and CVD mortality is available in older adult populations, [10][11][12][13][14][15][16][17][18][19][20][21] and the available studies in older adults have provided insight into the effect of LTPA on total mortality alone [11][12][13][14][15]17,[20][21][22][23] , whereas evidence of the associations between LTPA and CVD mortality or morbidity is scant. 10,11,16,20,21 Moreover, some of the studies assessed only certain domains of LTPA such as walking 10,12,16 or non-LTPA 18 or were conducted in a special population group such as older nonsmoking adults. 12 In addition, the vast majority of studies were conducted in men, and evidence of the effects of LTPA on all-cause or CVD mortality in older women is sparse.…”

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confidence: 99%

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Leisure‐Time Physical Activity Reduces Total and Cardiovascular Mortality and Cardiovascular Disease Incidence in Older Adults

Barengo

Antikaínen

Borodulin

et al. 2016

J American Geriatrics Society

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OBJECTIVES:To determine whether leisure-time physical activity (LTPA) is independently associated with all-cause and cardiovascular mortality and with incidence of cardiovascular disease (CVD) and stroke in older adults. DESIGN: Population-based cohort study (median followup 11.8 years). SETTING: Community, five Finnish provinces. PARTICIPANTS: Men and women aged 65 to 74 who participated in a baseline risk factor survey between 1997 and 2007 in Finland (N = 2,456). MEASUREMENTS: The study protocol included a selfadministered questionnaire, health examination at the study site, and blood sample for laboratory analysis. LTPA was classified into three levels: low, moderate, high. Mortality data were obtained from the National Causes of Death Register and data on incident CVD (coronary heart disease, stroke) events from the National Hospital Discharge Register. RESULTS: Multifactorial-adjusted (age, area, study year, sex, smoking, body mass index, systolic blood pressure, serum cholesterol, education, marital status) risks of total mortality (moderate: hazard ratio (HR) = 0.61, 95% confidence interval (CI) = 0.50-0.74; high: HR = 0.47, 95% CI = 0.34-0.63, P for trend <.001), CVD mortality (moderate: HR = 0.46, 95% CI = 0.33-0.64; high: HR = 0.34, 95% CI = 0.20-0.59, P for trend <.001), and an incident CVD event (moderate HR = 0.69, 95% CI = 0.54-0.88; high: HR = 0.55, 95% CI = 0.38-0.79, P for trend <.001)were lower for those with moderate or high LTPA levels than for those with low LTPA levels. Further adjustment for self-reported inability to perform LTPA did not change the associations remarkably. CONCLUSIONS: Baseline LTPA reduces the risk of total and CVD mortality and incident CVD events in older adults independently of the major known CVD risk factors. The protective effect of LTPA is dose dependent. J Am Geriatr Soc 65:504-510, 2017.Key words: exercise; cardiovascular diseases; cerebrovascular disorders; mortality; heart disease A ccording to the World Health Organization, non-communicable diseases were responsible for more than two-thirds (38 million) of the world's 56 million deaths in 2012.1 Cardiovascular disease (CVD) alone caused more than 17 million deaths. Worldwide, physical inactivity is estimated to cause approximately 3.2 million deaths annually.1,2 Previous studies have revealed that regular leisuretime physical activity (LTPA) decreases all-cause and CVD mortality in middle-aged men and women.3-9 Less evidence of the effects of LTPA on all-cause and CVD mortality is available in older adult populations, 10-21 and the available studies in older adults have provided insight into the effect of LTPA on total mortality alone [11][12][13][14][15]17,[20][21][22][23] , whereas evidence of the associations between LTPA and CVD mortality or morbidity is scant. 10,11,16,20,21 Moreover, some of the studies assessed only certain domains of LTPA such as walking 10,12,16 or non-LTPA 18 or were conducted in a special population group such as older nonsmoking adults.12 In addition, the vast majority of studies...

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“…Performance was characterized by the cadence of the longest locomotion period, and the number of locomotion bouts longer than 30 steps with cadence equal or superior to 100 steps/min, that may correspond to outdoor purposeful activity [21][22][23] (expressed as % of the total number of locomotion bouts).…”

Section: Methodsmentioning

confidence: 99%

Concern about Falling and Complexity of Free-Living Physical Activity Patterns in Well-Functioning Older Adults

et al. 2018

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Background: Fall-related psychological concerns are common among older adults, potentially contributing to functional decline as well as to restriction of activities and social participation. To effectively prevent such negative consequences, it is important to understand how even very low concern about falling could affect physical activity behavior in everyday life. We hypothesized that concern about falling is associated with a reduction in diversity, dynamics, and performance of daily activities, and that these features can be comprehensively quantified in terms of complexity of physical activity patterns. Methods: A sample of 40 community-dwelling older adults were assessed for concern about falling using the Falls Efficacy Scale-International (FES-I). Free-living physical activity was assessed using a set of metrics derived from data recorded with a chest-worn tri-axial accelerometer. The devised metrics characterized physical activity behavior in terms of endurance (total locomotion time, longest locomotion period, usual walking cadence), performance (cadence of longest locomotion period, locomotion periods with at least 30 steps and 100 steps/min), and complexity of physical activity patterns. Complexity was quantified according to variations in type, intensity, and duration of activities, and was considered as an adaptive response to environmental exigencies over the course of the day. Results: Based on FES-I score, participants were classified into two groups: not concerned at all/fully confident (n = 25) and concerned/less confident (n = 15). Demographic and health-related variables did not differ significantly between groups. Comparison of physical activity behavior indicated no significant differences for endurance-related metrics. In contrast, performance and complexity metrics were significantly lower in the less confident group compared to the fully confident group. Among all metrics, complexity of physical activity patterns appeared as the most discriminative feature between fully confident and less confident participants (p = 0.001, non-parametric Cliff’s delta effect size = 0.63). Conclusions: These results extend our understanding of the interplay between low concern about falling and physical activity behavior of community-dwelling older persons in their everyday life context. This information could serve to better design and evaluate personalized intervention programs in future prospective studies.

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Walking Cadence and Mortality Among Community-Dwelling Older Adults

Abstract: The ability to walk ≥100 steps∙minute(-1) predicts a reduction in mortality among a sample of community-dwelling older adults.

Cited by 46 publications

References 28 publications

Gait characteristics associated with walking speed decline in older adults: Results from the Baltimore Longitudinal Study of Aging

Gait characteristics associated with walking speed decline in older adults: Results from the Baltimore Longitudinal Study of Aging

Leisure‐Time Physical Activity Reduces Total and Cardiovascular Mortality and Cardiovascular Disease Incidence in Older Adults

Concern about Falling and Complexity of Free-Living Physical Activity Patterns in Well-Functioning Older Adults

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