The sex difference in gait speed among older adults: how do sociodemographic, lifestyle, social and health determinants contribute?

Abstract

Background This study explores whether a sex difference in sensitivity to (strength of the association) and/or in exposure to (prevalence) determinants of gait speed contributes to the observed lower gait speed among older women compared to men. Methods Data from the Longitudinal Aging Study Amsterdam (LASA) were used. In total 2407 men and women aged 55–81 years were included, with baseline measurements in 1992/2002 and follow-up measurements every 3–4 years for 15/25 years. Multivariable mixed model analysis was used to investigate sex differences in sensitivity (interaction term with sex) and in exposure to (change of the sex difference when adjusted) socio-demographic, lifestyle, social and health determinants of gait speed. Results Women had a 0.054 m/s (95 % CI: 0.076 − 0.033, adjusted for height and age) lower mean gait speed compared to men. In general, men and women had similar determinants of gait speed. However, higher BMI and lower physical activity were more strongly associated with lower gait speed in women compared to men (i.e. higher sensitivity). More often having a lower educational level, living alone and having more chronic diseases, pain and depressive symptoms among women compared to men also contributed to observed lower gait speed in women (i.e. higher exposure). In contrast, men more often being a smoker, having a lower physical activity and a smaller personal network size compared to women contributed to a lower gait speed among men (i.e. higher exposure). Conclusions Both a higher sensitivity and higher exposure to determinants of gait speed among women compared to men contributes to the observed lower gait speed among older women. The identified (modifiable) contributing factors should be taken into account when developing prevention and/or treatment strategies aimed to enhance healthy physical aging. This might require a sex-specific approach in both research and clinical practice, which is currently often lacking.

Determinants of Frailty and Gait Speed in People Over 65 Years of Age

“…In Bohannon's study, age, height, and waist circumference were found to be highly correlated with gait speed (7). In the cohort study that included 2407 participants by Sialino et al, female gender, lower education level, and having more chronic diseases were found to be associated with slower gait speed (28). In our study, we found that a high education level positively affected gait speed and shape.…”

Walking Speed Assessed by 4-Meter Walk Test in the Community-Dwelling Oldest Old Population in Vietnam

“…Declined lower limb muscle function and fewer muscle fibers in female compared with male along with aging process and the attribution of the larger step and stride length in male may be the cause of this condition [ 27 , 28 ]. Other potential determinants have been proposed to account for gender differences in walking speed such as a greater change toward smaller fibers in females during aging-related atrophy [ 29 ], a substantial decrease in estrogen, a potent hormone improving the intrinsic quality of skeletal muscle [ 30 ], body composition [ 31 ] or lower level of physical activity [ 32 ]. Our study showed that a slow walking speed was significantly associated with high fall risk, ADL/IADL dependence and frailty syndrome.…”

Walking on the bright side: Associations between affect, depression, and gait

“…Therefore, it is plausible to assume that gait differences are less relevant to earlier episodes of depression. Additionally, gait changes are likely confounded by comorbidity with physical health disorders [ 10 , 38 ], the latter of which are less likely to be present in younger samples. In support, the majority of our study participants were physically active.…”