Fast walkers linked to lower cognitive decline

Neurology published a study on July 14 finding that adults 80 and older who walk much faster than their peers were less likely to develop cognitive impairment. The paper examined “super movers,” defined as people at least 80 years old whose gait speed was at least 1.5 standard deviations above age- and sex-adjusted averages. Across five cohorts, the researchers found those fast walkers had about half the risk of incident cognitive impairment compared with other older adults. The findings were highlighted this week by The Washington Post and earlier in July by NPR. The study was led by researchers including Oshadi Jayakody, Sofiya Milman, Nir Barzilai and Joe Verghese, according to the paper’s PubMed record. The authors used data from the Health and Retirement Study International Network of Studies, the LonGenity Study and the Rush Memory and Aging Project. Participants with Alzheimer’s disease, dementia or baseline cognitive impairment were excluded from the main incident-risk analysis. (pubmed.ncbi.nlm.nih.gov) ### Who counted as a “super mover”? The paper defined super movers as adults age 80 and older with gait speeds at least 1.5 standard deviations above age- and sex-adjusted means in their cohort. Joe Verghese told MedPage Today that those cutoffs corresponded to gait speeds seen in adults about 30 years younger. NPR, citing study author Sofiya Milman of Albert Einstein College of Medicine, described them as older adults who can walk as fast as people a few decades younger. (pubmed.ncbi.nlm.nih.gov) The timed walking test sorted participants by usual gait speed, and NPR reported that the fastest 9% qualified as super movers. In the pooled cohort used for incident cognitive impairment, 358 of 3,989 participants met that threshold. Baseline ages in those cohorts ranged from 83.6 to 84.4 years, and women accounted for 47% to 65% of participants, the paper said. (pubmed.ncbi.nlm.nih.gov) ### How large was the effect? Across the Health and Retirement Study network cohorts, the hazard ratio for incident cognitive impairment was 0.49 for super movers versus non-super movers. The paper reported a 95% confidence interval of 0.28 to 0.71 over follow-up periods ranging from 3.4 to 5.4 years. That is the figure behind headlines saying fast walkers in their 80s had about half the risk of cognitive decline. (pubmed.ncbi.nlm.nih.gov) The LonGenity cohort added another result. In that group of 197 participants with a mean baseline age of 84.6, super movers showed slower decline in memory and non-memory cognitive domains and preserved hippocampal volume in specific subfields, according to the paper. A George Washington University media note summarizing the study said the findings suggest gait speed may be a marker of healthy brain aging. (pubmed.ncbi.nlm.nih.gov) ### Did the study say brisk walking prevents dementia? The paper reported an association, not proof that walking faster by itself prevents dementia. PubMed describes the work as a retrospective study using existing aging cohorts, and the main result compares outcomes in people who already had different gait speeds. MedPage Today said Rush Memory and Aging Project autopsy data found no differences in the dementia-related pathologies examined, even though super movers had better cognition before death and lower prevalence of clinically diagnosed Alzheimer’s disease and other dementias. (pubmed.ncbi.nlm.nih.gov) Joe Verghese told MedPage Today that walking reflects the integrated function of the brain, cardiovascular system, muscles and sensory pathways. Bonnie Tsui, speaking to NPR, said the finding fits prior evidence linking muscle health and cognitive health, and noted that exercise can support the hippocampus, a brain region involved in learning and memory. (pubmed.ncbi.nlm.nih.gov) ### Why are headlines stressing pace instead of step counts? The Washington Post’s coverage framed the finding around walking speed rather than daily step totals, and that matches the study design. Researchers measured gait speed and compared the fastest older adults with peers of the same age and sex, rather than tracking whether participants hit a fixed number of steps. The paper’s central comparison is about functional pace in late life, not a universal step target. (medpagetoday.com) NPR quoted geriatrician Amit Saini of Kaiser Permanente in Northern California saying the ability to keep walking as people age is a marker of good health. That report also said walking increases blood flow to muscles and the brain. The study itself did not test a training program or prescribe a specific speed goal. (washingtonpost.com) ### What should readers watch for next? The July 14 Neurology paper is likely to be followed by more research on whether gait speed can be used as a practical screening marker for brain health in very old adults. The named cohorts in this study were the Health and Retirement Study International Network of Studies, LonGenity and the Rush Memory and Aging Project, and those datasets are where related follow-up analyses would most likely appear. (news.wfsu.org) (pubmed.ncbi.nlm.nih.gov)