High blood pressure accelerates gait slowing in well-functioning older adults over 18-years of follow-up

Topic: Risk, prevention and care in population studies

Objectives To examine whether the association between hypertension and decline in gait speed is significant in well-functioning older adults and whether other health-related factors, such as brain, kidney, and heart function, can explain it. Design Longitudinal cohort study. Setting Cardiovascular Health Study. Participants Of 2,733 potential participants with a brain magnetic resonance imaging (MRI) scan, measures of mobility and systolic blood pressure (BP), no self-reported disability in 1992 to 1994 (baseline), and with at least 1 follow-up gait speed measurement through 1997 to 1999, 643 (aged 73.6, 57% female, 15% black) who had received a second MRI in 1997 to 1999 and an additional gait speed measure in 2005 to 2006 were included. Measurements Mixed models with random slopes and intercepts were adjusted for age, race, and sex. Main explanatory factors included white matter hyperintensity progression, baseline cystatin-C, and left cardiac ventricular mass. Incidence of stroke and dementia, BP trajectories, and intake of antihypertensive medications during follow-up were tested as other potential explanatory factors. Results Higher systolic BP was associated with faster rate of gait speed decline in this selected group of 643 participants, and results were similar in the parent cohort (N = 2,733). Participants with high BP (n = 293) had a significantly faster rate of gait speed decline than those with baseline BP less than 140/90 mmHg and no history of hypertension (n = 350). Rates were similar for those with history of hypertension who were uncontrolled (n = 110) or controlled (n = 87) at baseline and for those who were newly diagnosed (n = 96) at baseline. Adjustment for explanatory factors or for other covariates (education, prevalent cardiovascular disease, physical activity, vision, mood, cognition, muscle strength, body mass index, osteoporosis) did not change the results. Conclusion High BP accelerates gait slowing in well-functioning older adults over a long period of time, even for those who control their BP or develop hypertension later in life. Health-related measurements did not explain these associations. Future studies to investigate the mechanisms linking hypertension to slowing gait in older adults are warranted.

Key findings

• Objectives To examine whether the association between hypertension and decline in gait speed is significant in well-functioning older adults and whether other health-related factors, such as brain, kidney, and heart function, can explain it.
• Results Higher systolic BP was associated with faster rate of gait speed decline in this selected group of 643 participants, and results were similar in the parent cohort (N = 2,733).
• Participants with high BP (n = 293) had a significantly faster rate of gait speed decline than those with baseline BP less than 140/90 mmHg and no history of hypertension (n = 350).
• Adjustment for explanatory factors or for other covariates (education, prevalent cardiovascular disease, physical activity, vision, mood, cognition, muscle strength, body mass index, osteoporosis) did not change the results.

Why it matters

In well-functioning older adults followed for 18 years, higher systolic blood pressure was linked to faster decline in walking speed. This connects blood pressure to a mobility change over time, not directly to treating, curing, or preventing Alzheimer's disease.

New to this subject? Start with our plain-English guide: Disparities →

Study details

• Study designcohort study
• Participants2,733
• Evidence strengthModerate

Read the original

• DOI: 10.1111/j.1532-5415.2010.03282.x
• PubMed: 21391929
• Original source →
• Free full text: PubMed Central →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{rosano2011-21391929,
  author  = {Rosano, C. and Longstreth, W. T. and Boudreau, R. and Taylor, C. A. and Du, Y. and Kuller, L. H. and Newman, A. B.},
  title   = {{High blood pressure accelerates gait slowing in well-functioning older adults over 18-years of follow-up}},
  journal = {Journal of the American Geriatrics Society},
  year    = {2011},
  doi     = {10.1111/j.1532-5415.2010.03282.x},
  pmid    = {21391929},
  url     = {https://doi.org/10.1111/j.1532-5415.2010.03282.x}
}

Later studies that cite this one

1 study in the alzhub library lists this one in its references.

• Hypertension and aging Ageing research reviews · 2016-02-01 · usefulness score 43/100 · How common it is

Related studies in Disparities

• Blood Pressure and Cognitive Decline Over 8 Years in Middle-Aged and Older Black and White Americans Hypertension (Dallas, Tex. : 1979) · 2019-02-01 · usefulness score 62/100
• Preclinical Dementia and Economic Well-Being Trajectories of Racially Diverse Older Adults Journal of aging and health · 2024-03-05 · usefulness score 43/100
• Association of Dual Decline in Cognition and Gait Speed With Risk of Dementia in Older Adults JAMA network open · 2022-05-02 · usefulness score 78/100
• Incidence of idiopathic normal pressure hydrocephalus (iNPH): a 10-year follow-up study of a rural community in Japan Journal of the neurological sciences · 2014-02-03 · usefulness score 42/100
• Association of Midlife to Late-Life Blood Pressure Patterns With Incident Dementia JAMA · 2019-08-01 · usefulness score 71/100
• Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals JAMA neurology · 2020-07-01 · usefulness score 67/100

Similar studies

• Slower gait, slower information processing and smaller prefrontal area in older adults 2012 · Vascular contributions
• 15-year longitudinal study of blood pressure and dementia 1996 · Risk factors
• Association of visit-to-visit variability in blood pressure with cognitive function in old age: prospective cohort study 2013 · Hippocampus size on brain scans
• The relationship of hypertension in the elderly to AD, vascular dementia, and cognitive function 2002 · Vascular contributions
• Longitudinal, Bidirectional Association between Gait Speed and Cognitive Function in Community-Dwelling Older Adults without Dementia 2025 · Getting a diagnosis
• The age-dependent relation of blood pressure to cognitive function and dementia 2005 · How common it is

More on Disparities

• A review that covers this ground Global Burden of Alzheimer's disease and other dementias in adults aged 65 years and older, 1991–2021: population-based study Frontiers in Public Health · 2025-07-01 · usefulness score 68/100
• Newest in this subject Racial Differences and Temporal Trends in Parkinson’s and Alzheimer’s Disease-Related medRxiv · 2026-10-24 · Preprint — not yet peer-reviewed · usefulness score 16/100
• Newest in this subject Prevalence of dementia and mild cognitive impairment in Morocco: A population-based study Research Square · 2026-10-22 · Preprint — not yet peer-reviewed · usefulness score 16/100

See all studies in Disparities →