Live Longer, Walk Faster

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Predicted Median Life Expectancy by Age and Gait Speed

(Studenski, S. et al. JAMA 2011;305:50-58).

Staying active, along with a balanced health diet, is probably the best way to age gracefully. An elegantly simple study was just published in the Journal of the American Medical Association that clearly demonstrates the relationship between longevity and walking speed. Researchers studied close to 35,000 people aged 65 years or above (a mean of 74 years) with data taken from six to 21 years.

I love studies such as this – ask a simple question, propose a clear experimental design, and analyze the data carefully, including a statistical analysis. They did not prove that if you walk faster, you can live longer. Instead, they demonstrate that walking speed can be an accurate predictor of longevity, useful for informing physicians about how best to treat their patients. For example, if a patient is predicted to live well more than a decade, it makes sense to consider long term preventative strategies.

According to the paper:

How might gait speed be used clinically? First, gait speed might help identify older adults with a high probability of living for 5 or 10 more years, who may be appropriate targets for preventive interventions that require years for benefit. Second, gait speed might be used to identify older adults with increased risk of early mortality, perhaps those with gait speeds slower than 0.6 m/s. In these patients, further examination is targeted at potentially modifiable risks to health and survival. A recommended evaluation and management of slow walking includes cardiopulmonary, neurological and musculoskeletal systems.6​,18 Third, gait speed might promote communication. Primary clinicians might characterize an older adult as likely to be in poor health and function because the gait speed is 0.5 m/s. In research manuscripts, baseline gait speed might help to characterize the overall health of older research participants. Fourth, gait speed might be monitored over time, with a decline indicating a new health problem that requires evaluation. Fifth, gait speed might be used to stratify risks from surgery or chemotherapy. Finally, medical and behavioral interventions might be assessed for their effect on gait speed in clinical trials. Such true experiments could then evaluate causal pathways to determine whether interventions that improve gait speed lead to improvements in function, health, and longevity.

The data provided herein are intended to aid clinicians, investigators, and health system planners who seek simple indicators of health and survival in older adults. Gait speed has potential to be implemented in practice, using a stop watch and a 4-m course. From a standing start, individuals are instructed to walk at their usual pace, as if they were walking down the street, and given no further encouragement or instructions. The data in this article can be used to help interpret the results. Gait speed may be a simple and accessible indicator of the health of the older person.

This gives us something to think about the next time you decide to take a walk – are you a “shuffler” or do you have to slow yourself down sometimes?

Comments

  1. #1 The Phytophactor
    January 5, 2011

    As both a field researcher and a pedestrian commuter, my gait moves right along although it’s not as fast as it was a couple of decades ago, but there has to be a huge variance on such data, and that in and of itself would seem to rule out its clinical use any more than just asking if you’re active (gardening, sports, walking) or not.

  2. #2 Zeno
    January 5, 2011

    I’m definitely a strider. Walking with a friend is always an exercise in restraint, because most people amble.

  3. #3 Russell
    January 5, 2011

    Is “gait speed” one’s fastest walking speed? And if not, what?

  4. #4 Jeff
    January 5, 2011

    Your natural walking speed; the pace you would use without any outside inducement.

  5. #5 Russell
    January 5, 2011

    That seems an odd definition. I walk several miles a day. Some days I amble along, because is is spring and the wildflowers are all in bloom, or dusk, and the stars are out. Some days I go at a much faster pace, more in the mood to shake a leg. Most days, it’s in-between, or varied. So if someone asked me to walk along at my natural speed, I have no idea what that would mean.

    That may be because I’m an outlier with regard to how many miles I travel on foot. On the other hand, I suspect what is median in our time and place would the outlier relative to virtually every human culture prior to 1940. We have made ourselves into the people who don’t walk.

  6. #6 jeff
    January 5, 2011

    I would like to see a study or metastudy (no idea how to design it)that would quantify the correlation of a bunch of metrics that all seem to accompany long-lived health. I bet they are all extremely correlated, and therefore not very interesting–but it would be interesting, indeed, if something stands out.

    Obviously, smokers and obese people are less likely to walk well at an advanced age, for example; similarly, wealthy and educated people are less likely to be obese or smoke, and more likely to exercise. Basically, I’m suggesting that most of these associations with long-life/health are just indications of being happy and wealthy.

    It seems to me that perhaps the take away message from these sorts of studies is that one ought, if one cares about one’s health, to try to be well-educated, happy, and healthy. I suppose it would be cruel to add, Calvinistically, that the same group will be rewarded eternally, as well.

    I bet there’s an astonishing correlation between owning a Lexis and an appreciation for Bordeaux as well.

  7. #7 stripey_cat
    January 6, 2011

    I’m thinking it could also be a useful predictor for early interventions. If, for instance, you walk significantly slower than friends of a similar height and fitness, you might want to ride your doctor a little harder for things like frequent check-ups.

    I also suspect there might be some causal effects, too: several people I know (including myself) who are the short one in their family have very fast gaits as a result of keeping up with tall parents as kids. Translated into adulthood, we’re accustomed to a walking pace that raises your heart-rate faster than most people whose parents walked at slower speeds with them. And a lifetime spent walking fast is going to have some effects on your cardiovascular system.

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  9. #9 Andy King
    January 7, 2011

    When I walk for exercise, I always walk fast, real fast. It enhances the health.

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