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Updated: May 22, 2025
Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults
Published on: November 7, 2014
Longitudinal, Bidirectional Association between Gait Speed and Cognitive Function in Community-Dwelling Older Adults
Ying-Hao Su1, Jeng-Min Chiou2, Chengshi Shiu3
1Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Orthopedic Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan.
Objectives:
The causal relationship between slow gait speed and poor cognition is uncertain due to potential reverse causality. This study aimed to examine the reciprocal relationship between gait speed and global as well as domain-specific cognitive functions in older adults.
Design:
Prospective cohort study (2013-2022) including 4 repeated measures.
Settings And Participants:
Community-dwelling and adults without dementia aged ≥65 recruited at baseline.
Methods:
Biennial evaluations included assessments of 4-m usual walking speed, global cognition using the Taiwanese version of the Montreal Cognitive Assessment (MoCA), and cognitive domains (memory, executive function, verbal fluency, and attention) using a battery of neuropsychological tests. Cross-lagged models and linear mixed models were used to examine the bidirectional association between gait speed and cognitive functions with adjustment for potential confounders.
Results:
At baseline, 511 participants were enrolled, and 459 individuals with a mean age of 74.5 years were ultimately analyzed. A 1-SD decrease in gait speed was associated with a 0.07-0.09 SD decrease in subsequent global cognition [βˆWave 1→2: 0.07, standard error (SE): 0.03; βˆWave 2→3: 0.09, SE: 0.04; βˆWave 3→4: 0.09, SE: 0.04; all P < .05]. Similarly, a 1-SD decrease in global cognition was associated with a 0.18 to 0.19 SD decrease in subsequent gait speed (βˆWave 1→2: 0.18, SE: 0.05; βˆWave 2→3: 0.18, SE: 0.06; βˆWave 3→4: 0.19, SE: 0.07; all P < .001). In addition, slower gait speed was associated with poor memory, verbal fluency, and executive function, and vice versa. The results of linear mixed models were consistent with the findings obtained from cross-lagged models.
Conclusions And Implications:
This study found a reciprocal association between gait speed and global or domain-specific cognition. Regularly screening gait speed and cognitive function enables the early detection of declines in physical function and cognition.
