What Makes Us Walk: Predictors and the Interplay of Physical and Cognitive Factors on Gait Speed in Community Dwelling Older Adults

Abstract

This study investigated the predictors of gait speed in community dwelling older adults while examining interplay between physical performance and cognition on comfortable and fast gait speed. Sixty-six community-dwelling older adults (mean age 80.8 71% female) completed the following: 30-Second Chair Stand (30-SCS), Functional Reach (FR), Flanker Task, Digit Symbol Substitution Test (DSST), and gait speed (comfortable and fast). Hierarchical linear regression examined the relationship of comfortable and fast gait speeds with physical performance (30-SCS, FR) and cognitive domains (DSST, CDT, Flanker effect). Unique predictors of comfortable gait speed included 30-SCS (B=1.86, p<0.001), FR (B=3.37, p=0.005), and Flanker effect (B=-0.02, p=0.05). Unique predictors of fast gait speed included 30-SCS (B=2.61, p<0.001), FR (B=3.58, p=0.04), and DSST (B=0.95, p=0.01). Both comfortable and fast gait speed were primarily predicted by strength and balance while cognitive factors, including executive function and processing speed, also contribute to predicting gait speed. Lower extremity strength and balance are independently predictive of both comfortable and fast gait speed. Executive function and cognitive inhibition, as assessed by the Flanker effect, predicted comfortable gait speed, while processing speed, as assessed by the DSST,

Motoric Cognitive Risk Syndrome and Cognitive Frailty

“…Poorer performance in cognitive tasks was also associated with slower gait, independent of demographic and health characteristics 51. More recently, while strength and balance are independently predictive of both comfortable and fast walking speed, executive function and processing speed were identified as key cognitive factors of comfortable and fast walking speed 52…”

“…51 More recently, while strength and balance are independently predictive of both comfortable and fast walking speed, executive function and processing speed were identified as key cognitive factors of comfortable and fast walking speed. 52 Gait speed as measured over a 6-m walk distance (with an additional 2-m acceleration and deceleration on either side) has been shown to have good relative reliability in people with cognitive impairment. 53 As referenced earlier, a hallmark of MCR syndrome is slow gait speed 1 standard deviation below age/sex match norms.…”