Exceptionally fast gait speed is associated with a lower risk for cognitive impairment, slower cognitive decline, and greater hippocampal volume in older adults, a new study showed.

While gait speed usually declines with age, the researchers identified a group of older adults with a walking pace similar to that of people 30 years younger. In a retrospective analysis of more than 3900 adults aged 80 years or older, these ‘super movers’ had gait speeds that were at least 1.5 SDs above the age- and sex-adjusted average for their cohort.

Compared with their slower-moving peers, super movers had a lower risk for cognitive impairment over 5 years of follow-up and showed slower decline in memory, processing speed, executive function, and global cognition. However, super movers did not have lower levels of Alzheimer’s disease and related dementia (ADRD) pathology.

“Our results support an exceptional aging phenotype in which superior gait performance in late life may serve as a marker of broader neurocognitive resilience,” lead investigator Oshadi Jayakody, PhD, postdoctoral research fellow, Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, and colleagues, wrote.

The study was published online on June 16 in Neurology.

A New Aging Phenotype

Gait speed is commonly used to measure mobility and overall health in older adults. Prior studies have shown that slower gait is associated with faster cognitive decline and a higher risk for dementia, which suggests that mobility and cognition may be closely tied in aging. However, most research has focused on impaired gait rather than exceptional gait performance in later life.

Previous work from the current investigators found that individuals with unusually high gait performance had fewer chronic medical conditions, healthier lifestyle profiles, and younger biological age than age-matched peers. They coined the term “super movers” to describe them.

For the current study, the investigators analyzed data from cohorts from the Health and Retirement Study International Network of Studies (HRS-INS), the LonGenity Study, and Rush Memory and Aging Project (RUSH-MAP) to determine if the super mover phenotype was also associated with cognitive trajectories, brain structure, and ADRD pathology.

The HRS-INS cohort included 3989 adults (mean baseline age range, 83.6-84.4 years; 47-65% women), 358 of whom met criteria for super mover status.

The LonGenity cohort included 197 adults (mean age, 84.6 years; 57.8% women; 14 super movers) of Ashkenazi Jewish ancestry with longitudinal cognitive testing and brain MRI data.

The RUSH MAP cohort included 692 adults (mean age at baseline, 85.6 years; 68.9% women; 84 super movers) who had consented to brain autopsy. The investigators evaluated AD pathology, beta-amyloid plaques, tau tangles, Lewy body pathology, and cerebrovascular pathology.

Faster Gait, Slower Decline

In the pooled HRS-INS analysis, super movers were 51% less likely to have cognitive impairment over follow-up periods that ranged from 3 years to 5 years compared with non-super movers (hazard ratio [HR], 0.49; P <.001). Super movers also had a lower risk for self-reported AD or dementia (HR, 0.40).

In the LonGenity cohort, super movers had slower declines across several cognitive domains than those with a slower gait, with an annual decline in memory performance over a mean follow-up of 4.4 years (P =.016). They also had significantly slower decline in processing speed, executive function, and global cognition.

Brain imaging findings showed that compared with non-super movers, super movers had greater right hippocampal volume; however, no significant differences were found in overall cortical thickness or ADRD-related pathology between groups.

In the RUSH MAP cohort, super movers had a later mean age at death than non-super movers (95 vs 93 years; P <.001). They also had better global cognition scores and lower prevalence of clinically diagnosed AD and other dementias, although the differences were not statistically significant.

Beyond the Findings

Study limitations included the small neuroimaging sample, limited evaluation of functional brain networks and genetic markers such as APOE epsilon 4, and potential residual confounding.

The investigators interpreted these findings as evidence that super movers may represent a group with enhanced cognitive resilience rather than reduced AD pathology.

“Future research is needed to determine whether being a super mover is itself neuroprotective,” they wrote.

“Identifying the behavioral, biological, and environmental factors that characterize super movers may assist developing targeted interventions to promote cognitive resilience,” they added.

The study was funded by National Institutes of Health grants. Disclosure information for study authors is available in the original study publication.