Combining Gait Speed and Recall Memory to Predict Survival in Late Life: Population‐Based Study

• Published in: Journal of the American Geriatrics Society (JAGS) 2017-03, Vol.65 (3), p.614-618
• Main Authors: Marengoni, Alessandra, Bandinelli, Stefania, Maietti, Elisa, Guralnik, Jack, Zuliani, Giovanni, Ferrucci, Luigi, Volpato, Stefano
• Format: Article
• Language: English
• Subjects: Aged; Cohort Studies; Female; Follow-Up Studies; Gait; gait speed; Health risk assessment; Humans; Italy; Male; Mental Recall; Mortality; Motor ability; Multivariate analysis; Neuropsychological Tests; Older people; older persons; Population studies; Population-based studies; Recall; recall memory; Survival; Walking; Walking Speed
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.14705

Objectives To evaluate the relationship between gait speed, recall memory, and mortality. Design A cohort study (last follow‐up December 2009). Setting Tuscany, Italy. Participants Individual data from 1,014 community‐dwelling older adults aged 60 years or older with baseline gait speed and recall memory measurements and follow‐up for a median time of 9.10 (IQR 7.1;9.3) years. Participants were a mean (SD) age of 73.9 (7.3) years, and 55.8% women. Participants walking faster than 0.8 m/s were defined as fast walkers; good recall memory was defined as a score of 2 or 3 in the 3‐word delayed recall section of the Mini‐Mental State Examination. Measurements All‐cause mortality. Results There were 302 deaths and the overall 100 person‐year death rate was 3.77 (95% CI: 3.37–4.22). Both low gait speed and poor recall memory were associated with mortality when analysed separately (HR = 2.47; 95% CI: 1.87–3.27 and HR = 1.47; 95% CI: 1.16–1.87, respectively). When we grouped participants according to both recall and gait speed, death rates (100 person‐years) progressively increased from those with both good gait speed and memory (2.0; 95% CI: 1.6–2.5), to those with fast walk but poor memory (3.4; 95% CI: 2.8–4.2), to those with slow walk and good memory (8.8; 95% CI: 6.4–12.1), to those with both slow walk and poor memory (13.0; 95% CI: 10.6–16.1). In multivariate analysis, poor memory significantly increases mortality risk among persons with fast gait speed (HR = 1.40; 95% CI: 1.04–1.89). Conclusion In older persons, gait speed and recall memory are independent predictors of expected survival. Information on memory function might better stratify mortality risk among persons with fast gait speed.