Older people with a slow walking pace are at increased risk of cognitive decline and dementia, according to a new meta-analysis.
“In light of its characteristics of safety, cost-effectiveness, and ease to test and interpret, walking pace may be an effective indicator of the development of cognitive decline and dementia in older people,” Dr. Minghui Quan of Shanghai University of Sport in China and colleagues write in their report, published online December 6 in the Journal of Gerontology: Medical Sciences.
Past research has linked walking pace to cognitive dysfunction, but the size of the association and whether there is a dose-response relationship has not been studied systematically, the researchers state. To investigate, they reviewed 17 prospective studies of walking pace. Seven looked at cognitive decline, seven at dementia, and three studies included both outcomes.
The 10 studies of cognitive decline included nearly 10,000 participants, while the 10 studies with dementia as an outcome included more than 14,000. The slowest walkers had an 89% higher risk of cognitive decline (95% confidence interval, 1.54 – 2.31), but there was no linear relationship between walking pace and cognitive decline risk.
Dementia risk was 66% higher in individuals with the slowest walking pace versus those with the fastest pace (95% CI, 1.43 – 1.92). Three studies included data on dose-response relationship, and found a relative risk of cognitive decline of 1.13 for each decimeter/second drop in walking pace (95% CI, 1.08 – 1.18).
Walking pace may be an indicator of cognitive function for many reasons, Dr. Quan and colleagues note. For example, walking pace is associated with muscle strength, and muscle loss has been tied to inflammation, oxidative stress and other factors related to cognitive function.
Walking is not an automatic activity, they add, but “requires a seamless coordination of several neurologic systems including motor, sensory, and cerebellar activities.” Slow walking pace could also contribute to physical inactivity, they add, which in turn is associated with cognitive decline and dementia.
“Since a randomized clinical trial on walking pace and cognitive function may not be feasible due to practical considerations, future well-designed, large-scale, prospective cohort studies are needed to determine the age-, sex-, and population-specified cutoff values for walking pace, in order to enhance the effectiveness and efficiency of this early indicator of cognitive decline and dementia,” Dr. Quan and colleagues conclude.