Original Study
Association Between Gait Speed With Mortality, Cardiovascular Disease and Cancer: A Systematic Review and Meta-analysis of Prospective Cohort Studies

https://doi.org/10.1016/j.jamda.2018.06.007Get rights and content

Abstract

Objectives

Slow gait speed may be associated with premature mortality, cardiovascular disease (CVD), and cancer, although a comprehensive meta-analysis is lacking. In this systematic review and meta-analysis, we explored potential associations between gait speed and mortality, incident CVD, and cancer.

Design

A systematic search in major databases was undertaken from inception until March 15, 2018 for prospective cohort studies reporting data on gait speed and mortality, incident CVD, and cancer.

Setting and Participants

All available.

Measures

The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs), based on the model with the maximum number of covariates for each study between gait speed (categorized as decrease in 0.1 m/s) and mortality, incident CVD, and cancer, were meta-analyzed with a random effects model.

Results

Among 7026 articles, 44 articles corresponding to 48 independent cohorts were eligible. The studies followed up on a total of 101,945 participants (mean age 72.2 years; 55% women) for a median of 5.4 years. After adjusting for a median of 9 potential confounders and the presence of publication bias, each reduction of 0.1 m/s in gait speed was associated with a 12% increased risk of earlier mortality (45 studies; HR = 1.12, 95% CI: 1.09-1.14; I2 = 90%) and 8% increased risk of CVD (13 studies; HR = 1.08, 95% CI: 1.03-1.13; I2 = 81%), but no relationship with cancer was observed (HR = 1.00, 95% CI: 0.97-1.04; I2 = 15%).

Conclusion/implications

Slow gait speed may be a predictor of mortality and CVD in older adults. Because gait speed is a quick and inexpensive measure to obtain, our study suggests that it should be routinely used and may help identify people at risk of premature mortality and CVD.

Section snippets

Methods

This systematic review was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria17 and the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.18 The protocol of this systematic review and meta-analysis is pre-conceived, but not published, and is available upon request from the corresponding author.

Results

The search identified 7026 nonduplicated, potentially eligible studies. After excluding 6927 papers on the grounds of a review of their titles and abstracts, 99 full-text articles were examined, and 44 articles11, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69 were finally included in our meta-analysis (Supplementary Figure 1), with one paper11 giving information for 5

Discussion

In this meta-analysis, including 48 cohorts and more than 100,000 participants, we found that slow gait speed was associated with an increased risk of earlier mortality and incident CVD, whereas we did not observe a relationship between gait speed and incident cancer. After adjusting for multiple confounders, the risk-effect associated with a reduction of 0.1 m/s in gait speed was consistent with death and the onset of CVD, which was present after adjusting for publication bias, and our

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    E.C. been a consultant and/or advisor to or has received honoraria from Nutricia, Wunder, and Akern.

    The authors declare no conflicts of interest.

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