TY - JOUR
T1 - Gait speed as predictor of transition into cognitive impairment
T2 - Findings from three longitudinal studies on aging
AU - Hoogendijk, Emiel O.
AU - Rijnhart, Judith J.M.
AU - Skoog, Johan
AU - Robitaille, Annie
AU - van den Hout, Ardo
AU - Ferrucci, Luigi
AU - Huisman, Martijn
AU - Skoog, Ingmar
AU - Piccinin, Andrea M.
AU - Hofer, Scott M.
AU - Muniz Terrera, Graciela
N1 - Funding Information:
This research was supported by the U.S. National Institute on Aging of the National Institutes of Health under Award Number P01AG043362 , Integrative Analysis of Longitudinal Studies of Aging and Dementia (IALSA). This study was in part funded by the Intramural Research Program at the National Institute on Aging . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. H70 was funded by the Swedish Research Council 2015-02830, Swedish Research Council for Health, Working Life and Welfare (2010-0870, 2013-1202, 2013-2300, 2013-2496, 2013-0475, 2018-00471), Hjärnfonden, Alzheimerfonden, The Alzheimer's Association Stephanie B. Overstreet Scholars (IIRG-00-2159), the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (ALF 716681). The InCHIANTI study baseline (1998–2000) was funded by the Italian Ministry of Health (ICS110.1/RF97.71) and in part by the U.S. National Institute on Aging, Bethesda, Maryland (contracts 236 MD 916413 and 236 MD 821336). The InCHIANTI follow-up 1 (2001−2003) was funded by the U.S. National Institute on Aging (Contracts: N.1-AG-1-1 and N.1-AG-1-2111); the InCHIANTI follow-up 2 and 3 studies (2004–2010) were financed by the U.S. National Institute on Aging (Contract: N01-AG-5-0002). The Longitudinal Aging Study Amsterdam (LASA) is largely supported by a grant from the Netherlands Ministry of Health, Welfare and Sports, Directorate of Long-Term Care. Emiel O. Hoogendijk was supported by an NWO/ZonMw Veni fellowship [grant number 91618067].
Publisher Copyright:
© 2019 The Authors
PY - 2020/1
Y1 - 2020/1
N2 - Objectives: Very few studies looking at slow gait speed as early marker of cognitive decline investigated the competing risk of death. The current study examines associations between slow gait speed and transitions between cognitive states and death in later life. Methods: We performed a coordinated analysis of three longitudinal studies with 9 to 25 years of follow-up. Data were used from older adults participating in H70 (Sweden; n = 441; aged ≥70 years), InCHIANTI (Italy; n = 955; aged ≥65 years), and LASA (the Netherlands; n = 2824; aged ≥55 years). Cognitive states were distinguished using the Mini-Mental State Examination. Slow gait speed was defined as the lowest sex-specific quintile at baseline. Multistate models were performed, adjusted for age, sex and education. Results: Most effect estimates pointed in the same direction, with slow gait speed predicting forward transitions. In two cohort studies, slow gait speed predicted transitioning from mild to severe cognitive impairment (InCHIANTI: HR = 2.08, 95%CI = 1.40–3.07; LASA: HR = 1.33, 95%CI = 1.01–1.75) and transitioning from a cognitively healthy state to death (H70: HR = 3.30, 95%CI = 1.74–6.28; LASA: HR = 1.70, 95%CI = 1.30–2.21). Conclusions: Screening for slow gait speed may be useful for identifying older adults at risk of adverse outcomes such as cognitive decline and death. However, once in the stage of more advanced cognitive impairment, slow gait speed does not seem to predict transitioning to death anymore.
AB - Objectives: Very few studies looking at slow gait speed as early marker of cognitive decline investigated the competing risk of death. The current study examines associations between slow gait speed and transitions between cognitive states and death in later life. Methods: We performed a coordinated analysis of three longitudinal studies with 9 to 25 years of follow-up. Data were used from older adults participating in H70 (Sweden; n = 441; aged ≥70 years), InCHIANTI (Italy; n = 955; aged ≥65 years), and LASA (the Netherlands; n = 2824; aged ≥55 years). Cognitive states were distinguished using the Mini-Mental State Examination. Slow gait speed was defined as the lowest sex-specific quintile at baseline. Multistate models were performed, adjusted for age, sex and education. Results: Most effect estimates pointed in the same direction, with slow gait speed predicting forward transitions. In two cohort studies, slow gait speed predicted transitioning from mild to severe cognitive impairment (InCHIANTI: HR = 2.08, 95%CI = 1.40–3.07; LASA: HR = 1.33, 95%CI = 1.01–1.75) and transitioning from a cognitively healthy state to death (H70: HR = 3.30, 95%CI = 1.74–6.28; LASA: HR = 1.70, 95%CI = 1.30–2.21). Conclusions: Screening for slow gait speed may be useful for identifying older adults at risk of adverse outcomes such as cognitive decline and death. However, once in the stage of more advanced cognitive impairment, slow gait speed does not seem to predict transitioning to death anymore.
KW - Cognition
KW - Dementia
KW - Multistate modeling
KW - Walking speed
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U2 - 10.1016/j.exger.2019.110783
DO - 10.1016/j.exger.2019.110783
M3 - Article
C2 - 31751664
AN - SCOPUS:85075264858
SN - 0531-5565
VL - 129
JO - Experimental Gerontology
JF - Experimental Gerontology
M1 - 110783
ER -