Modifiable Risk Factors for New-Onset Slow Gait in Older Adults

Objective: Despite the growing importance of slow gait as a universal screen of health, systematic investigation of risk factors for incident slow gait is lacking. Our objective was to identify potentially modifiable risk factors for incident slow gait. Design: Prospective cohort study. Setting: The Health and Retirement Study, a nationally representative US sample. Participants: A total of 2306 individuals age 65 and older (56.5% women) from the 2008 wave with timed walks at baseline and 4 years later. Measurements: Incident slow gait (walking speed 1 SD below age and sex means) was the outcome. Fifteen potentially modifiable medical and lifestyle risk factors were examined as predictors. Results: Incident slow gait developed in 243 participants (11%) at 4 years. Physical inactivity (adjusted relative risk [aRR] 1.94), cognitive impairment (aRR 1.77), muscle weakness (aRR 1.48), pain (aRR 1.45), obesity (aRR 1.35), vision (aRR 1.36), and falls (aRR 1.32) predicted increased risk of developing incident slow gait. Together, these risk factors accounted for 77% (95% confidence interval 14-95) of the Population Attributable Risk for incident slow gait. Conclusion: A limited set of potentially modifiable risk factors is associated with new-onset slow gait in older adults. These findings provide a foundation for developing clinical guidelines and preventive interventions for slow gait.