Self-reported physical activity and gait in older adults without dementia: A longitudinal study

Janina Krell-Roesch; Jeremy A Syrjanen; Tobias Moeller; Jelena Krafft; Bettina Barisch-Fritz; Walter K Kremers; Farwa Ali; David S Knopman; Ronald C Petersen; Thorsten Stein; Alexander Woll; Maria Vassilaki; Yonas E Geda

doi:10.1002/hsr2.70108

Self-reported physical activity and gait in older adults without dementia: A longitudinal study

Health Sci Rep. 2024 Nov 6;7(11):e70108. doi: 10.1002/hsr2.70108. eCollection 2024 Nov.

Authors

Affiliations

¹ Institute of Sports and Sports Science Karlsruhe Institute of Technology Karlsruhe Germany.
² Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA.
³ Department of Neurology Mayo Clinic Rochester Minnesota USA.
⁴ Department of Neurology and the Franke Barrow Global Neuroscience Education Center Barrow Neurological Institute Phoenix Arizona USA.

Abstract

Background and aims: Physical activity (PA) is associated with higher gait speed. We aimed to examine the associations between PA and change in spatial and temporal gait measures as well as fall risk in community-dwelling individuals free of dementia.

Methods: Longitudinal study among 4173 individuals aged ≥50 years (mean age 71 years; 2078 males; median follow-up 4 years) enrolled in the Mayo Clinic Study of Aging. Self-reported late-life PA was used to calculate overall PA and moderate-vigorous PA (MVPA) scores. Gait was assessed using GAITRite® and Zeno™ systems. Incident falls information was based on diagnostic codes retrieved from medical records. We ran linear mixed effects models to examine associations between z-scored PA variables and longitudinal gait parameters, adjusted for age, sex, education, body mass index (BMI), medical comorbidities, and including interactions between PA and time since baseline. In secondary analyses, we calculated Cox Proportional hazard models with age as time scale predicting incident falls by PA, adjusting for sex, education, BMI, medical comorbidities, and falls history.

Results: At baseline, higher PA was associated with higher velocity (overall PA: estimate 2.9935; MVPA: 2.2961; p < 0.001), higher cadence (overall PA: 1.0665; MVPA: 0.9073; p < 0.001), greater stride length (overall PA: 2.0805; MVPA: 1.4726; p < 0.001), shorter double support time (overall PA: -0.0257; MVPA: -0.0205; p < 0.001), and lower stance time variability (overall PA: -0.0204, p < 0.001; MVPA: -0.0152; p = 0.006). Overall PA was longitudinally associated with less decline in cadence, and MVPA with less increase in intraindividual stance time variability. Overall PA (Hazard ratio 0.892, 95% confidence interval 0.828-0.961, p = 0.003) and MVPA (HR 0.901; 95% CI 0.835-0.973, p = 0.008) were associated with a decreased risk of incident falls.

Conclusion: Late-life PA was associated with favorable gait outcomes and decreased risk of incident falls. Thus, late-life PA may help to maintain gait performance and decrease fall risk in old age.

Keywords: fall risk; gait; longitudinal; physical activity.