Does walking speed predict how long older adults live?

Yes. Older adults who walk slower are more likely to die sooner, and the link is consistent across many studies. It shows risk in groups and can't forecast one person's lifespan.

Who it's for

Adults 65 and older; the link is clearest in men.

What to expect

Each 0.1 m/s slower is linked to about 12% higher risk of death.

Watch out for

Walking speed predicts but isn't shown to extend life if raised.

What the studies show

• A pooled analysis of 9 studies followed 34,485 adults aged 65 or older for 6 to 21 years. Each 0.1 m/s faster speed was linked to a 12% lower relative riskrelative risk How much more or less likely something is in one group than another, as a ratio. A big relative change can still be a small change for any one person. of death, and survival rose across the whole range of speeds1Meta-analysis · 2011Gait speed and survival in older adults.In this pooled analysis of individual data from 9 selected cohorts, gait speed was associated with survival in older adults.JAMA. For 75-year-olds, predicted 10-year survival ranged from 19% to 87% in men and 35% to 91% in women, depending on speed1Meta-analysis · 2011Gait speed and survival in older adults.In this pooled analysis of individual data from 9 selected cohorts, gait speed was associated with survival in older adults.JAMA.
• A review of 44 articles covering 48 groups (101,945 people, average age 72, median 5.4 years of follow-up) found each 0.1 m/s slower was linked to a 12% higher relative risk of earlier death. It was also linked to an 8% higher risk of heart disease, and not linked to cancer4Meta-analysis · 2018 · 101,945 peopleAssociation Between Gait Speed With Mortality, Cardiovascular Disease and Cancer: A Systematic Review and Meta-analysis of Prospective Cohort Studies.Slow gait speed may be a predictor of mortality and CVD in older adults. Because gait speed is a quick and inexpensive measure to obtain, our study suggests that it should be routinely used and may help identify people at risk of premature mortality and CVD.J Am Med Dir Assoc. Results varied a lot between studies, though all pointed the same way4Meta-analysis · 2018 · 101,945 peopleAssociation Between Gait Speed With Mortality, Cardiovascular Disease and Cancer: A Systematic Review and Meta-analysis of Prospective Cohort Studies.Slow gait speed may be a predictor of mortality and CVD in older adults. Because gait speed is a quick and inexpensive measure to obtain, our study suggests that it should be routinely used and may help identify people at risk of premature mortality and CVD.J Am Med Dir Assoc.
• A review comparing the slowest with the fastest quarter of walkers (5 studies, 14,692 people) found the slowest had about 2.9 times the risk of death2Meta-analysis · 2010 · 692 peopleObjectively measured physical capability levels and mortality: systematic review and meta-analysis.Objective measures of physical capability are predictors of all cause mortality in older community dwelling populations. Such measures may therefore provide useful tools for identifying older people at higher risk of death.BMJ. Another review of 9 studies (12,901 people) found about 1.9 times the risk3Meta-analysis · 2016 · 12,901 peopleUsual walking speed and all-cause mortality risk in older people: A systematic review and meta-analysis.20). Slow usual walking speed is an independent predictor of all-cause mortality in men but not in women among older adulthood approaching age 65 years or more.Gait Posture. Those figures compare groups, so the gain or loss for one person depends on their starting risk.
• In that second review, the link held in men but was not statistically clear in women, so it could be down to chance3Meta-analysis · 2016 · 12,901 peopleUsual walking speed and all-cause mortality risk in older people: A systematic review and meta-analysis.20). Slow usual walking speed is an independent predictor of all-cause mortality in men but not in women among older adulthood approaching age 65 years or more.Gait Posture. The larger pooled analysis found a link in all studies1Meta-analysis · 2011Gait speed and survival in older adults.In this pooled analysis of individual data from 9 selected cohorts, gait speed was associated with survival in older adults.JAMA.
• Gait speed gained over one year was tied to survival. In 439 adults aged 65 and older, 8-year mortality was 31.6% with improved speed and 49.3% with never-improved speed8Observational study · 2007 · 439 peopleImprovement in usual gait speed predicts better survival in older adults.Improvement in usual gait speed predicts a substantial reduction in mortality. Because gait speed is easily measured, clinically interpretable, and potentially modifiable, it may be a useful "vital sign" for older adults. Further research is needed to determine whether interventions to improve gait speed affect…J Am Geriatr Soc. This is observationalobservational Studies that watch what happens to people rather than assigning a treatment. They can show links, not cause and effect., so it doesn't show that raising speed extends life8Observational study · 2007 · 439 peopleImprovement in usual gait speed predicts better survival in older adults.Improvement in usual gait speed predicts a substantial reduction in mortality. Because gait speed is easily measured, clinically interpretable, and potentially modifiable, it may be a useful "vital sign" for older adults. Further research is needed to determine whether interventions to improve gait speed affect…J Am Geriatr Soc.
• Speed alone predicted survival about as well as age and sex combined with chronic conditions, smoking history, blood pressure, body mass index and hospital stays1Meta-analysis · 2011Gait speed and survival in older adults.In this pooled analysis of individual data from 9 selected cohorts, gait speed was associated with survival in older adults.JAMA.
• Slower speed also predicted later trouble with bathing, dressing and walking within 3 years5Meta-analysis · 2016Gait Speed Predicts Incident Disability: A Pooled Analysis.In older adults, gait speed predicts 3 year incidence of bathing or dressing dependence, mobility difficulty, and a composite outcome of disability and mortality.J Gerontol A Biol Sci Med Sci.

Key studies

What we don't know

• Whether helping people walk faster extends life. No trial in these sources tested that8Observational study · 2007 · 439 peopleImprovement in usual gait speed predicts better survival in older adults.Improvement in usual gait speed predicts a substantial reduction in mortality. Because gait speed is easily measured, clinically interpretable, and potentially modifiable, it may be a useful "vital sign" for older adults. Further research is needed to determine whether interventions to improve gait speed affect…J Am Geriatr Soc.
• Whether the link holds at younger ages or beyond 10 years of follow-up2Meta-analysis · 2010 · 692 peopleObjectively measured physical capability levels and mortality: systematic review and meta-analysis.Objective measures of physical capability are predictors of all cause mortality in older community dwelling populations. Such measures may therefore provide useful tools for identifying older people at higher risk of death.BMJ, and whether it differs in women3Meta-analysis · 2016 · 12,901 peopleUsual walking speed and all-cause mortality risk in older people: A systematic review and meta-analysis.20). Slow usual walking speed is an independent predictor of all-cause mortality in men but not in women among older adulthood approaching age 65 years or more.Gait Posture.