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Walking Cadence and Mortality Among Community-Dwelling Older Adults

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ABSTRACT

BACKGROUND

Older adults are encouraged to walk ≥100 steps∙minute−1 for moderate-intensity physical activity (i.e., brisk walking). It is unknown if the ability to walk ≥100 steps∙minute−1 predicts mortality.

OBJECTIVE

To determine if the ability to walk ≥100 steps∙minute−1 predicts mortality among older adults.

DESIGN, SETTING, AND PATIENTS

A population-based cohort study among 5,000 older adults from the Third National Health and Nutrition Survey (NHANES III; 1988–1994). Vital status and cause of death were collected through December 31, 2006. Median follow-up was 13.4 years. Average participant age was 70.6 years.

MEASUREMENTS

Walking cadence (steps∙minute−1) was calculated using a timed 2.4-m walk. Walking cadence was dichotomized at 100 steps∙minute−1 (≥100 steps∙minute−1 versus <100 steps∙minute−1) to demarcate the lower threshold of absolutely defined moderate-intensity physical activity. Walking cadence was also analyzed as a continuous variable. Predicted survival was compared between walking cadence and gait speed. The primary outcome was all-cause mortality. Secondary outcomes included cardiovascular-specific and cancer-specific mortality and mortality from other causes.

RESULTS

Among 5,000 participants, 3,039 (61 %) walked ≥100 steps∙minute−1. During follow-up, 3,171 subjects died. In multivariable-adjusted analysis, ability to walk ≥100 steps∙minute−1 predicted a 21 % reduction in all-cause mortality (hazard ratio [HR], 0.79; 95 % confidence interval [95 % CI], 0.71–0.89, p < 0.001). Each ten-step increase in walking cadence predicted a 4 % reduction in all-cause mortality (HR, 0.96, [0.94–0.98], p < 0.001). In secondary analyses, ability to walk ≥100 steps∙minute−1 predicted reductions in cardiovascular-specific mortality (HR, 0.79 [0.67–0.92], p = 0.002), cancer-specific mortality (HR, 0.76 [0.58–0.99], p = 0.050), and mortality from other causes (HR, 0.82 [0.68–0.97], p = 0.025). Predicted survival, adjusted for age and sex, was not different using walking cadence versus gait speed.

LIMITATIONS

Walking cadence was a cross-sectional measurement.

CONCLUSIONS

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

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ACKNOWLEDGEMENTS

Justin C. Brown had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Meera N. Harhay has received training grants (5T32DK007006-38 and F32DK096758-01) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Michael O. Harhay is supported as a pre-doctoral fellow by National Cancer Institute (NCI) grant R01 CA159932. Justin C. Brown is supported as a pre-doctoral fellow by NCI grant U54 CA155850. This study was completed without funding.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Authors and Affiliations

  1. Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, Philadelphia, PA, USA

    Justin C. Brown MA, Michael O. Harhay MPH & Meera N. Harhay MD, MSCE

  2. Renal-Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, PA, USA

    Meera N. Harhay MD, MSCE

  3. University of Pennsylvania School of Medicine, 8th Floor, Blockley Hall 423 Guardian Drive, Philadelphia, PA, 19104, USA

    Justin C. Brown MA, Michael O. Harhay MPH & Meera N. Harhay MD, MSCE

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  1. Justin C. Brown MA
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  2. Michael O. Harhay MPH
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  3. Meera N. Harhay MD, MSCE
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Correspondence to Justin C. Brown MA.

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Brown, J.C., Harhay, M.O. & Harhay, M.N. Walking Cadence and Mortality Among Community-Dwelling Older Adults. J GEN INTERN MED 29, 1263–1269 (2014). https://doi.org/10.1007/s11606-014-2926-6

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  • DOI: https://doi.org/10.1007/s11606-014-2926-6

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