The association between gait speed and cognitive status in community-dwelling older people: a systematic review and meta-analysis

BACKGROUND: Gait speed and cognitive performance tend to decline with age. A better understanding of the dynamics of the association between gait speed and cognitive status may identify preclinical markers and improve diagnostic assessments. The objective was to quantify the association between gait speed and cognitive status in later life. METHODS: A systematic search was undertaken of relevant databases for original articles published prior to June 2017, measuring the association between gait speed and cognition cross-sectionally or longitudinally among the community-dwelling population. A meta-analysis pooled results of the mean difference between concurrent measures of gait speed in the normal cognition group compared to non-normal cognition groups. RESULTS: Thirty-six studies were selected, providing data from 29520 participants. The majority of studies reported a significant association between slower gait speed and worse cognitive function in older people. Results of the meta-analysis of 27 studies showed that, compared to normal controls, clinically meaningful reductions in gait speed ranged from 0.11 m/sec in those with cognitive impairment, to 0.20 m/sec in those with mild dementia, to 0.41 m/sec in those with moderate dementia. CONCLUSION: The strength of evidence for an association between gait speed and cognition was demonstrated by the number and consistency of results, as well as quality of the studies. Identification of diagnostic markers of motor cognitive risk has led to increasing interest in the effects of interventions for prevention of gait speed loss and cognitive decline in aging