The Association Between Four Gait Speed Assessments and Incident Stroke in Older Adults: The Health, Aging and Body Composition Study

Objective To examine the association between gait speed and incident stroke and compare the predictive value between four gait speed assessments (6-meter, 20-meter, 2-min, and 400-meter). Design Prospective cohort study. Setting 1,779 older adults from the Health, Aging and Body Composition study. All participants had no history of cardiovascular or cerebrovascular disease at baseline. Methods We used Cox proportional hazards regression model to identify the relationship between each of four gait speed assessment and incident stroke. We used the c-statistic, Akaike information criterion (AIC), and Bayesian information criterion (BIC) to compare the predictive validity between four measures. Results 176 (9.9%) had incident stroke during an average 10.3-year follow-up. After multivariable adjustment, hazard ratio of incident stroke was 0.89 (95% CI: 0.82-0.97), 0.90 (95%CI: 0.82-0.98), 0.88 (95% CI: 0.80-0.97), and 0.86 (95% CI: 0.78-0.95) for 6-meter, 20-meter, 2-min, and 400-meter test, respectively. We found only negligible difference in the c-statistic between four gait speed assessments (range: 0.66-0.67). Similarly, we did not observe huge difference in AIC or BIC between four assessments. Conclusions Gait speed was independently associated with stroke among older adults. Different gait speed assessments had similar prognostic value for predicting stroke.