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Longitudinal, Bidirectional Association between Gait Speed and Cognitive Function in Community-Dwelling Older Adults without Dementia
Ying‐Hao Su, Jeng‐Min Chiou, Chengshi Amory Shiu, Jen‐Hau Chen, Yen‐Ching Chen. Journal of the American Medical Directors Association, 2025-03-25
Topic: Risk, prevention and care in population studies
Objectives The causal relationship between slow gait speed and poor cognition is uncertain due to potential reverse causality. This study aimed to examine the reciprocal relationship between gait speed and global as well as domain-specific cognitive functions in older adults. Design Prospective cohort study (2013–2022) including 4 repeated measures. Settings and Participants Community-dwelling and adults without dementia aged ≥65 recruited at baseline. Methods Biennial evaluations included assessments of 4-m usual walking speed, global cognition using the Taiwanese version of the Montreal Cognitive Assessment (MoCA), and cognitive domains (memory, executive function, verbal fluency, and attention) using a battery of neuropsychological tests. Cross-lagged models and linear mixed models were used to examine the bidirectional association between gait speed and cognitive functions with adjustment for potential confounders. Results At baseline, 511 participants were enrolled, and 459 individuals with a mean age of 74.5 years were ultimately analyzed. A 1-SD decrease in gait speed was associated with a 0.07–0.09 SD decrease in subsequent global cognition [ β ˆ Wave 1→2 : 0.07, standard error (SE): 0.03; β ˆ Wave 2→3 : 0.09, SE: 0.04; β ˆ Wave 3→4 : 0.09, SE: 0.04; all P < .05]. Similarly, a 1-SD decrease in global cognition was associated with a 0.18 to 0.19 SD decrease in subsequent gait speed ( β ˆ Wave 1→2 : 0.18, SE: 0.05; β ˆ Wave 2→3 : 0.18, SE: 0.06; β ˆ Wave 3→4 : 0.19, SE: 0.07; all P < .001). In addition, slower gait speed was associated with poor memory, verbal fluency, and executive function, and vice versa. The results of linear mixed models were consistent with the findings obtained from cross-lagged models. Conclusions and Implications This study found a reciprocal association between gait speed and global or domain-specific cognition. Regularly screening gait speed and cognitive function enables the early detection of declines in physical function and cognition.
Key findings
- Results At baseline, 511 participants were enrolled, and 459 individuals with a mean age of 74.5 years were ultimately analyzed.
- A 1-SD decrease in gait speed was associated with a 0.07–0.09 SD decrease in subsequent global cognition [ β ˆ Wave 1→2 : 0.07, standard error (SE): 0.03; β ˆ Wave 2→3 : 0.09, SE: 0.04; β ˆ Wave 3→4 : 0.09, SE: 0.04; all P < .05].
- Similarly, a 1-SD decrease in global cognition was associated with a 0.18 to 0.19 SD decrease in subsequent gait speed ( β ˆ Wave 1→2 : 0.18, SE: 0.05; β ˆ Wave 2→3 : 0.18, SE: 0.06; β ˆ Wave 3→4 : 0.19, SE: 0.07; all P < .001).
- In addition, slower gait speed was associated with poor memory, verbal fluency, and executive function, and vice versa.
- The results of linear mixed models were consistent with the findings obtained from cross-lagged models.
Why it matters
In community-dwelling older adults without dementia, slower gait speed predicted later lower global cognition, and lower global cognition predicted later slower gait speed. This shows a bidirectional association over time but does not test any treatment, cure or prevention for Alzheimer's disease.
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Study details
- Study designcohort study
- Participants511
- Evidence strengthModerate
How this study scored 54/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Medical Directors Association) |
| Journal's citation record | 2 / 4 | Journal of the American Medical Directors Association: journal h-index 172 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 511 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 8 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 5.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Yen‐Ching Chen: h-index 33 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | National Taiwan University: institution h-index 752 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40086793) |
| Free to read | 2 / 2 | Free to read |
| Total | 54 / 100 | — |
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Read the original
- DOI: 10.1016/j.jamda.2025.105544
- PubMed: 40086793
- Original source →
- Free full text: Journal of the American Medical Directors Association →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Su, Y., Chiou, J., Shiu, C. A., Chen, J., & Chen, Y. (2025). Longitudinal, Bidirectional Association between Gait Speed and Cognitive Function in Community-Dwelling Older Adults without Dementia. Journal of the American Medical Directors Association. https://doi.org/10.1016/j.jamda.2025.105544
Vancouver
Su Y, Chiou J, Shiu CA, Chen J, Chen Y. Longitudinal, Bidirectional Association between Gait Speed and Cognitive Function in Community-Dwelling Older Adults without Dementia. Journal of the American Medical Directors Association. 2025. doi:10.1016/j.jamda.2025.105544. PMID: 40086793.
BibTeX
@article{su2025-40086793,
author = {Su, Ying‐Hao and Chiou, Jeng‐Min and Shiu, Chengshi Amory and Chen, Jen‐Hau and Chen, Yen‐Ching},
title = {{Longitudinal, Bidirectional Association between Gait Speed and Cognitive Function in Community-Dwelling Older Adults without Dementia}},
journal = {Journal of the American Medical Directors Association},
year = {2025},
doi = {10.1016/j.jamda.2025.105544},
pmid = {40086793},
url = {https://doi.org/10.1016/j.jamda.2025.105544}
}
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