Zaninotto, P; Di Gessa, G; (2020) Cause-Specific Trajectories Of Terminal Decline In Walking Speed: Evidence From The English Longitudinal Study Of Ageing. Journal of Gerontology & Geriatric Medicine 10.24966/GGM-8662/100051. (In press).

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Abstract

Objective: To explore trajectories of terminal decline and terminal drop in a large nationally representative sample of older adults aged 60 and over living in England. We further explore whether trajectories in terminal decline differed according to the cause of death. Methods: Data are from participants aged 60 and over of the English Longitudinal Study of Ageing (ELSA) from 2002 to 2018. Repeated measures of walking speed were used, which was assessed objectively over a distance of 8ft (2.4m). Mortality by cause was ascertained up to 2018. Mixed effects models were used to estimate growth curve models of walking speed by cause of death, adjusted for confounders. Results: Compared to survivors, respondents who died of cancer (b=-0.034m/s; 95% CI: -0.05; -0.01), cardiovascular diseases (b=-0.082m/s; 95% CI: -0.13; -0.06), and respiratory diseases (b=- 0.137m/s; 95% CI: -0.24; -0.10) reported significant lower walking speed. Also, declines in walking speed accelerate closer to death particularly for those who died of cardiovascular (b=-0.003m/s) and respiratory diseases (b=-0.005m/s). Conclusion: We observed both terminal decline and terminal drop in walking speed in the years preceding death. Participants aged 70 who died of cardiovascular and respiratory conditions had steeper decline of walking speed than those who stayed alive.

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