The Lancet Healthy Longevity

Walking limitations developed earlier in low-income countries

Walking limitations developed an estimated 12 years earlier in low-income than high-income countries, in a cohort followed for a mean 14.5 years.

Cohort study of 150,221 community-dwelling adults without walking limitations at baseline, 14·5 yearsPopulations

172,889 participants, multicenter

Limit: Walking difficulty was self-reported

Edited by Boris Djordjevic · AgingResearch.News

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Community-dwelling adults aged 35–70 at enrollment in 25 countries took part in this prospective observational cohort study. Researchers included 150,221 people without walking limitations at baseline; 122,538 had follow-up walking data. Those with follow-up data averaged 49.7 years old at baseline, and 58.3% were women. Follow-up averaged 14.5 years.

Models estimated that one-third would develop walking limitations by age 64 in low-income countries, compared with age 76 in high-income countries. Women had a higher likelihood of developing walking limitations across ages than men. Low education, low recreational physical activity, poor diet and hypertension, or high blood pressure, were among the leading factors associated with both walking limitations and death. The authors estimated that potentially modifiable individual risk factors accounted for approximately 32.9% of population-level walking-limitation risk.

Why it matters

Healthy aging involves fewer limitations in daily activities, not just longer lives. The authors highlighted opportunities for midlife prevention strategies targeting disability and premature death together.

Caveats

This observational study relied on self-reported walking difficulty and could not establish that changing associated factors would prevent disability or death. The walking-limitation analysis excluded people who already had difficulty walking at baseline.