According to a study of 2,733 older adults published in the Journal of the American Geriatrics Society, hypertension, or high blood pressure, accelerates gait slowing (walking speed) in older adults over a long period of time. Researchers found that gait speed was significantly slower in people with high blood pressure, and that the slowing happened faster in people with this condition than in people with normal blood pressure.
Though no one knows why having high blood pressure might slow walking speed, the researchers theorized that a condition called white matter hyperintensities (WMH) might be the link. WMHs, which show up as bright white spots in brain scans, are areas of inflammation. The researchers found that people with high blood pressure tend to have more WMHs than other people and that having greater numbers of WMHs is linked to slower gait and impaired mobility.
The Need for Speed
As the physical act of walking requires maintaining sufficient speed, gait speed is an important factor in older adults’ health and ability to live independently. It is a marker and a predictor of how well they function, take care of themselves, and participate in vital social activities. According to the study, limitations such as slow gait speed increase the risk for hospitalization, and even death. A slower walking speed also seems to predict the development of dementia and disability.
Adults in their early 70s who live independently usually have a gait speed of about one meter or about 3 feet per second. The gait speed of older adults who need help with their daily activities is only about half that rate.
What You Can Do
First, know your loved one’s blood pressure numbers and be sure they are checked regularly. It is important for elderly people diagnosed with high blood pressure to get it under control through doctor-recommended lifestyle changes, like a low-sodium diet, and medication, if needed. If they’re on medication, they need to take it as directed. Remember that high blood pressure does not have any symptoms. People may feel fine but still have high blood pressure. Older adults need to keep to their doctor-recommended regimen or risk a variety of other heart conditions.
Next, be sure your loved one’s doctor periodically evaluates their gait speed. "I think physicians should add gait speed to their routine exams for older adults," said the study’s lead author, Caterina Rosano, MD, MPH, associate professor of epidemiology in the department of epidemiology at the University of Pittsburgh's Center for Aging and Population Research. "Our research team has repeatedly shown that slowing gait is associated with underlying brain abnormalities." By keeping blood pressure under control as early as possible, older adults can help prevent gait slowing, stay functional, and live independently.
About the study. The full report, titled "High Blood Pressure Accelerates Gait Slowing in Well-Functioning Older Adults Over 18 Years of Follow-Up," was authored by Dr. Rosano; William T. Longstreth, Jr., MD; Robert Boudreau, PhD; Christopher A. Taylor, PhD; Yan Du, MS; Lewis H. Kuller, MD, DrPH; and Anne B. Newman, MD. It was funded with grants from the National Heart, Lung and Blood Institute with additional contributions from the National Institute of Neurological Disorders and Stroke.