Walking Cadence and Mortality Among Community-Dwelling Older Adults

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?p??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.