Published 10 November 2009, doi:10.1136/bmj.b4460
Cite this as: BMJ 2009;339:b4460

Research

Slow walking speed and cardiovascular death in well functioning older adults: prospective cohort study

¹ INSERM, U708, F-75013, Paris, France, ² UPMC Univ Paris 06, F-75005, Paris, France, ³ CMRR Paris Nord-IDF, GH Lariboisière – Fernand Widal, F-75010, Paris, France, ⁴ INSERM, U780, Villejuif, France, ⁵ Université Paris-Sud, France, ⁶ CHU de Dijon, Department of Geriatrics, F-21000, Dijon, France

Objective To study the relation between low walking speed and the risk of death in older people, both overall and with regard to the main causes of death.

Design Prospective cohort study.

Setting Dijon centre (France) of the Three-City study.

Participants 3208 men and women aged 65 living in the community, recruited from 1999 to 2001, and followed for an average of 5.1 years.

Main outcome measures Mortality, overall and according to the main causes of death, by thirds of baseline walking speed (measured at maximum speed over six metres), adjusted for several potential confounders; Kaplan-Meier survival curves by thirds of baseline walking speed. Vital status during follow-up. Causes of death.

Results During 16 414 person years of follow-up, 209 participants died (99 from cancer, 59 from cardiovascular disease, 51 from other causes). Participants in the lowest third of baseline walking speed had an increased risk of death (hazard ratio 1.44, 95% confidence interval 1.03 to 1.99) compared with the upper thirds. Analyses for specific causes of death showed that participants with low walking speed had about a threefold increased risk of cardiovascular death (2.92, 1.46 to 5.84) compared with participants who walked faster. There was no relation with cancer mortality (1.03, 0.65 to 1.70). In stratified analyses, cardiovascular mortality was increased across various strata defined by sex, median age, median body mass index (BMI), and level of physical activity.

Conclusion Slow walking speed in older people is strongly associated with an increased risk of cardiovascular mortality.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

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