Abstract
<jats:p>Background: Slowing of gait and daily activities, reported by older adults or by people close to them, may identify a clinically relevant motor phenotype in population-based movement-disorder epidemiology. We examined whether this simple baseline history item predicted long-term all-cause mortality in the Neurological Disorders in Central Spain (NEDICES) cohort. Methods: NEDICES was a prospective, population-based cohort of 5,278 census-based participants aged 65 years or older. Information on the slowing item was available for 3,994 participants. Reported slowing was defined as an affirmative answer to: &#039;Have you noticed, or has anyone told you, that lately you walk or do things more slowly?&#039; Vital status and date of death were obtained through linkage to the Spanish National Population Register (Instituto Nacional de Estadística; INE). Follow-up accrued from baseline assessment to death or to administrative censoring on 31 December 2017 for participants who were alive. Survival was assessed with Kaplan-Meier curves and Cox proportional-hazards models. The multivariable model adjusted for age, sex, education, hypertension, prevalent tremor, prevalent Parkinson&#039;s disease, osteoarthritis, osteoporosis, smoking, alcohol consumption, depressive symptoms and/or antidepressant use, and comorbidity using a Carey-based index. Results: At baseline, 1,516 participants (38.0%) reported slowing. Through 31 December 2017, 3,426 deaths occurred, and 568 participants were censored alive. The mean observed time to death or censoring was 12.9 years (median 12.6 years). Crude mortality was higher among participants with reported slowing than among those without it (89.4% vs. 83.6%). Kaplan-Meier survival was shorter in the reported-slowing group (median: 140 vs. 158 months; log-rank p&lt; 0.001). In the fully adjusted Cox model (n=3,841), reported slowing was independently associated with mortality (hazard ratio 1.09; 95% confidence interval 1.02-1.18; p=0.017). Conclusions: A single self- or informant-reported item on slowing of gait and daily activities identified older adults with a modest but independent excess long-term mortality risk.</jats:p>