The Bidirectional Association Between Cognitive Function and Gait Speed in Chinese Older Adults: Longitudinal Observational Study
BackgroundCognitive and gait speed decline are common conditions in older adults and are often associated with future adverse consequences. Although an association between cognitive function and gait speed has been demonstrated, its temporal sequence remains unclear, especial...
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| Format: | Article |
| Language: | English |
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JMIR Publications
2023-03-01
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| Series: | JMIR Public Health and Surveillance |
| Online Access: | https://publichealth.jmir.org/2023/1/e44274 |
| _version_ | 1797734334143135744 |
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| author | Haibin Li Jiajia Zhang Xinye Zou Xiuqin Jia Deqiang Zheng Xiuhua Guo Wuxiang Xie Qi Yang |
| author_facet | Haibin Li Jiajia Zhang Xinye Zou Xiuqin Jia Deqiang Zheng Xiuhua Guo Wuxiang Xie Qi Yang |
| author_sort | Haibin Li |
| collection | DOAJ |
| description |
BackgroundCognitive and gait speed decline are common conditions in older adults and are often associated with future adverse consequences. Although an association between cognitive function and gait speed has been demonstrated, its temporal sequence remains unclear, especially in older Chinese adults. Clarifying this could help identify interventions to improve public health in older adults.
ObjectiveThis study aims to examine the longitudinal reciprocal association between gait speed and cognitive function and the possible temporal sequence of changes in both factors in a national longitudinal cohort.
MethodsData were derived from 2 waves (2011 baseline and 2015 follow-up) of the China Health and Retirement Longitudinal Study (CHARLS). Participants 60 years or older, without dementia or Parkinson disease at baseline, and with completed data on gait speed and cognition at both baseline and follow-up were included. Usual gait speed was measured over two 2.5-m walks. Mental intactness and episodic memory were used to assess global cognitive function. Cross-lagged panel models and linear mixed-effects models were used to examine the association between cognition and gait speed over time. Standardized coefficients were reported.
ResultsA total of 3009 participants (mean age 66.4 years, SD 5.4 years; 1422/3009, 47.26%, female participants) were eligible for inclusion in our analyses. Cross-lagged panel analyses revealed that after accounting for baseline gait speed, cognition, and potential confounders, baseline global cognition (β=.117, 95% CI 0.082-0.152; P<.001), mental intactness (β=.082, 95% CI 0.047-0.118; P<.001), and episodic memory (β=.102, 95% CI 0.067-0.137; P<.001) were associated with subsequent gait speed. Simultaneously, baseline gait speed was also associated with subsequent global cognition (β=.056, 95% CI 0.024-0.087; P=.001), mental intactness (β=.039, 95% CI 0.008-0.069; P=.01), and episodic memory (β=.057, 95% CI 0.023-0.092; P=.001). The comparison of standardized cross-lagged coefficients suggested that the effect size of baseline global cognition on subsequent gait speed was significantly larger than the reverse effect (χ12=6.50, P for difference=.01). However, the effects of both mental intactness and episodic memory on subsequent gait speed were not significantly stronger than those of the reverse pathway (χ12=3.33, P for difference=.07 and χ12=3.21, P for difference=.07). Linear mixed-effects analyses further supported these bidirectional relationships, revealing that lower baseline cognitive scores predicted steeper declines in gait speed trajectory, and slower baseline gait speed predicted more declines in cognitive trajectory over time.
ConclusionsThere is a longitudinal bidirectional association between usual gait speed and both global cognitive function and specific domains of mental intactness and episodic memory among Chinese older adults. Baseline global cognition is likely to have a stronger association with subsequent gait speed than the reverse pathway. This interlinkage is noteworthy and may have implications for public health. Maintaining normal cognitive function may be an important interventional strategy for mitigating age-related gait speed reduction. |
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| institution | Directory Open Access Journal |
| issn | 2369-2960 |
| language | English |
| last_indexed | 2024-03-12T12:42:45Z |
| publishDate | 2023-03-01 |
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| spelling | doaj.art-ce75502f7fc04d23b433a581ae4d98bc2023-08-28T23:45:44ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602023-03-019e4427410.2196/44274The Bidirectional Association Between Cognitive Function and Gait Speed in Chinese Older Adults: Longitudinal Observational StudyHaibin Lihttps://orcid.org/0000-0002-6932-982XJiajia Zhanghttps://orcid.org/0000-0002-4506-9015Xinye Zouhttps://orcid.org/0000-0002-6360-1271Xiuqin Jiahttps://orcid.org/0000-0003-3920-2884Deqiang Zhenghttps://orcid.org/0000-0002-5659-5045Xiuhua Guohttps://orcid.org/0000-0001-6657-6940Wuxiang Xiehttps://orcid.org/0000-0001-7527-1022Qi Yanghttps://orcid.org/0000-0002-5773-0456 BackgroundCognitive and gait speed decline are common conditions in older adults and are often associated with future adverse consequences. Although an association between cognitive function and gait speed has been demonstrated, its temporal sequence remains unclear, especially in older Chinese adults. Clarifying this could help identify interventions to improve public health in older adults. ObjectiveThis study aims to examine the longitudinal reciprocal association between gait speed and cognitive function and the possible temporal sequence of changes in both factors in a national longitudinal cohort. MethodsData were derived from 2 waves (2011 baseline and 2015 follow-up) of the China Health and Retirement Longitudinal Study (CHARLS). Participants 60 years or older, without dementia or Parkinson disease at baseline, and with completed data on gait speed and cognition at both baseline and follow-up were included. Usual gait speed was measured over two 2.5-m walks. Mental intactness and episodic memory were used to assess global cognitive function. Cross-lagged panel models and linear mixed-effects models were used to examine the association between cognition and gait speed over time. Standardized coefficients were reported. ResultsA total of 3009 participants (mean age 66.4 years, SD 5.4 years; 1422/3009, 47.26%, female participants) were eligible for inclusion in our analyses. Cross-lagged panel analyses revealed that after accounting for baseline gait speed, cognition, and potential confounders, baseline global cognition (β=.117, 95% CI 0.082-0.152; P<.001), mental intactness (β=.082, 95% CI 0.047-0.118; P<.001), and episodic memory (β=.102, 95% CI 0.067-0.137; P<.001) were associated with subsequent gait speed. Simultaneously, baseline gait speed was also associated with subsequent global cognition (β=.056, 95% CI 0.024-0.087; P=.001), mental intactness (β=.039, 95% CI 0.008-0.069; P=.01), and episodic memory (β=.057, 95% CI 0.023-0.092; P=.001). The comparison of standardized cross-lagged coefficients suggested that the effect size of baseline global cognition on subsequent gait speed was significantly larger than the reverse effect (χ12=6.50, P for difference=.01). However, the effects of both mental intactness and episodic memory on subsequent gait speed were not significantly stronger than those of the reverse pathway (χ12=3.33, P for difference=.07 and χ12=3.21, P for difference=.07). Linear mixed-effects analyses further supported these bidirectional relationships, revealing that lower baseline cognitive scores predicted steeper declines in gait speed trajectory, and slower baseline gait speed predicted more declines in cognitive trajectory over time. ConclusionsThere is a longitudinal bidirectional association between usual gait speed and both global cognitive function and specific domains of mental intactness and episodic memory among Chinese older adults. Baseline global cognition is likely to have a stronger association with subsequent gait speed than the reverse pathway. This interlinkage is noteworthy and may have implications for public health. Maintaining normal cognitive function may be an important interventional strategy for mitigating age-related gait speed reduction.https://publichealth.jmir.org/2023/1/e44274 |
| spellingShingle | Haibin Li Jiajia Zhang Xinye Zou Xiuqin Jia Deqiang Zheng Xiuhua Guo Wuxiang Xie Qi Yang The Bidirectional Association Between Cognitive Function and Gait Speed in Chinese Older Adults: Longitudinal Observational Study JMIR Public Health and Surveillance |
| title | The Bidirectional Association Between Cognitive Function and Gait Speed in Chinese Older Adults: Longitudinal Observational Study |
| title_full | The Bidirectional Association Between Cognitive Function and Gait Speed in Chinese Older Adults: Longitudinal Observational Study |
| title_fullStr | The Bidirectional Association Between Cognitive Function and Gait Speed in Chinese Older Adults: Longitudinal Observational Study |
| title_full_unstemmed | The Bidirectional Association Between Cognitive Function and Gait Speed in Chinese Older Adults: Longitudinal Observational Study |
| title_short | The Bidirectional Association Between Cognitive Function and Gait Speed in Chinese Older Adults: Longitudinal Observational Study |
| title_sort | bidirectional association between cognitive function and gait speed in chinese older adults longitudinal observational study |
| url | https://publichealth.jmir.org/2023/1/e44274 |
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