Association Between Gait Speed With Mortality, Cardiovascular Disease and Cancer: A Systematic Review and Meta-analysis of Prospective Cohort Studies.

Nicola Veronese, Brendon Stubbs, Stefano Volpato, Giovanni Zuliani, Stefania Maggi, Matteo Cesari, Darren M Lipnicki, Lee Smith, Patricia Schofield, Joseph Firth, Davy Vancampfort, Ai Koyanagi, Alberto Pilotto, Emanuele Cereda

Journal: Journal of the American Medical Directors Association 2019;19(11):981-988.e7

PMID: 30056008

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Abstract

OBJECTIVES

Slow gait speed may be associated with premature mortality, cardiovascular disease (CVD), and cancer, although a comprehensive meta-analysis is lacking. In this systematic review and meta-analysis, we explored potential associations between gait speed and mortality, incident CVD, and cancer.

DESIGN

A systematic search in major databases was undertaken from inception until March 15, 2018 for prospective cohort studies reporting data on gait speed and mortality, incident CVD, and cancer.

SETTING AND PARTICIPANTS

All available.

MEASURES

The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs), based on the model with the maximum number of covariates for each study between gait speed (categorized as decrease in 0.1 m/s) and mortality, incident CVD, and cancer, were meta-analyzed with a random effects model.

RESULTS

Among 7026 articles, 44 articles corresponding to 48 independent cohorts were eligible. The studies followed up on a total of 101,945 participants (mean age 72.2 years; 55% women) for a median of 5.4 years. After adjusting for a median of 9 potential confounders and the presence of publication bias, each reduction of 0.1 m/s in gait speed was associated with a 12% increased risk of earlier mortality (45 studies; HR = 1.12, 95% CI: 1.09-1.14; I = 90%) and 8% increased risk of CVD (13 studies; HR = 1.08, 95% CI: 1.03-1.13; I = 81%), but no relationship with cancer was observed (HR = 1.00, 95% CI: 0.97-1.04; I = 15%).

CONCLUSION/IMPLICATIONS

Slow gait speed may be a predictor of mortality and CVD in older adults. Because gait speed is a quick and inexpensive measure to obtain, our study suggests that it should be routinely used and may help identify people at risk of premature mortality and CVD.

Address: National Research Council, Neuroscience Institute-Aging Branch, Padova, Italy; Geriatrics Unit, Department of Geriatric Care, OrthoGeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, National Relevance and High Specialization Hospital, Genova, Italy. Electronic address: [email protected].; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, King's College London, De Crespigny Park, London, United Kingdom; Anglia Ruskin University, Bishop Hall Lane, Chelmsford, United Kingdom.; Department of Medical Science, University of Ferrara, Ferrara, Italy.; National Research Council, Neuroscience Institute-Aging Branch, Padova, Italy.; Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Università di Milano, Milano, Italy.; UNSW Medicine, School of Psychiatry, Sydney, New South Wales, Australia.; Anglia Ruskin University, Bishop Hall Lane, Chelmsford, United Kingdom.; NICM, School of Science and Health, University of Western Sydney, Sydney, New South Wales, Australia; Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom.; KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium.; Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.; Geriatrics Unit, Department of Geriatric Care, OrthoGeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, National Relevance and High Specialization Hospital, Genova, Italy.; Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

DOI: 10.1016/j.jamda.2018.06.007

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MeSH Terms: Cardiovascular Diseases, Humans, Mortality, Neoplasms, Risk Assessment, Walking Speed