Gait Speed and Survival in Those With Exceptional Longevity: The
LifeAfter90
Study
Rifat Alam, Hilary L. Colbeth, Alexander Ivan B. Posis, Kristen M. George, Katherine Colcord, Claire C. Meunier, Paola Gilsanz, Maria M. Corrada, Rachel A. Whitmer ABSTRACT
Background
Although gait speed is a well‐established predictor of mortality, it is understudied among ethnoracially diverse oldest‐old cohorts. We examined the association between gait speed and all‐cause mortality in an ethnoracially diverse 90+ population.
Methods
We examined the association between gait speed and survival over an average follow up of 3.6 ± 2.0 years. Follow‐up time was defined as years from baseline to death, loss to follow‐up, refusal, or study end, June 19, 2025, whichever occurred first. Baseline gait speed (m/s) was measured using the 4‐meter walk test. Cox proportional hazards model evaluated associations between gait speed and mortality, adjusting for age, sex/gender, race/ethnicity, and education. Interactions by sex/gender, age, race/ethnicity, and device were tested.
Results
Among 502 participants ( M age 92.9 ± 2.4 years; 62.6% women; 20.9% Asian, 22.3% Black, 12.4% Latinx, 8.6% Multiracial/Other, 35.9% White), mean gait speed was 0.55 ± 0.21 m/s and 259 deaths occurred. Each 1 SD (0.21 m/s) increase in gait speed was associated with a 20% lower risk of mortality (HR = 0.80; 95% CI = 0.69–0.91) after adjustments for demographics. In this cohort, this increase corresponds to completing the 4‐meter walk test about 2 s faster. The association was modified by age ( p ‐interaction = 0.01). There were no significant differences by sex/gender, race/ethnicity or device ( p ‐interaction > 0.1). In age‐stratified analyses, faster gait speed predicted lower risk of mortality among participants aged 90–94 years (HR = 0.70; 95% CI = 0.60–0.82), whereas the results were attenuated for the 95+ group (HR = 1.02; 95% CI = 0.77–1.30).
Conclusion
Faster gait speed was associated with a lower risk of mortality in adults aged 90 and older. These results were consistent across gender, race/ethnicity, and assistive device use, but differed by age group. Routine gait speed assessment may serve as a simple clinical tool to identify oldest‐old adults at higher risk of mortality.