ORIGINAL RESEARCH article

Front. Aging Neurosci.

Sec. Neurocognitive Aging and Behavior

Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1537413

This article is part of the Research TopicThe Role of Physical Activity in Healthy Aging: Mechanisms and InterventionsView all 13 articles

Combined Association of Gait Speed and Processing Speed on Cardiometabolic Disease Mortality Risk in the US Older Adults: A Prospective Cohort Study from NHANES

Provisionally accepted
  • 1Department of Rehabilitation, First Affiliated Hospital, Zhejiang Chinese Medical University, Zhenjiang, Zhejiang Province, China
  • 2Department of Cardiology, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China

The final, formatted version of the article will be published soon.

Background: Gait speed and processing speed, as measured by the Digit Symbol Substitution Test (DSST), are important indicators of health in older adults, with their potential impact on mortality risk. However, their combined effects on cardiometabolic disease (CMD) mortality remain unclear. Objective:This study investigates how gait speed and cognitive function, individually and combined, influence CMD-specific and all-cause mortality in older adults.Methods: Data were obtained from the National Health and Nutrition Examination Survey 1999-2002, with mortality follow-up linked to the National Death Index. Gait speed was measured by the timed 20-foot walk and processing speed was assessed using the DSST. Then the combined Gait-DSST groups were created and the Cox proportional hazards regression (HR) models were applied to examine their associations on CMD-specific and all-cause mortality, as well as the subgroup analyses stratified by age, sex and education. Results: A total of 2,482 participants aged ≥60 years were included in the study with a median follow-up of 175 months, during which 587 CMD-specific deaths and 1,627 all-cause deaths were recorded. The slow gait was significantly associated with increased risk of CMD mortality, while low processing speed was only significantly associated with increased all-cause mortality risk. When analyzing the combined groups, individuals with slow gait and high processing speed exhibited a 86% increased risk of CMD mortality (HR = 1.86, 95% CI: 1.29, 2.68). However, the group with poor gait and processing speed had a twofold increased risk for all-cause mortality (HR = 2.01, 95% CI: 1.69, 2.39). The significant associations between slow gait with low processing speed and CMD mortality was more likely to be in age<75 years, male, and less-educated populations. Conclusion: Slow gait is a significant predictor of CMD-specific mortality in older adults, largely independent of processing speed. Routine screening of gait speed and DSST performance should be prioritized in clinical and public health settings. Future intervention studies should aim at elucidating the biological and behavioral mechanisms linking physical and cognitive function to CMD outcomes.

Keywords: gait speed, processing speed, Combined association, Cardiometabolic diseases, Mortality

Received: 30 Nov 2024; Accepted: 29 May 2025.

Copyright: © 2025 Yang, Zhou, Wang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Xiaoming Xu, Department of Cardiology, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, 310006, Zhejiang Province, China

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