Longevity

Walking speed: the vital sign you can time with a watch

Walking speed is the one vital sign you can measure with a tape measure and a stopwatch. In a pooled analysis of 34,485 adults aged 65 and over, each 0.1 metres per second of usual pace went with a 12 percent lower risk of death; 0.8 m/s marked median life expectancy for age and sex, and 1.0 m/s or faster went with better survival than age and sex alone would predict. At 45, usual pace in a New Zealand birth cohort averaged 1.30 m/s, and the slowest walkers had aged 5.0 years faster than the fastest over two decades.

Why walking speed counts as a vital sign

Pulse, blood pressure, breathing rate and temperature are the four classic vital signs, with pain often counted as the fifth. In 2009, two physiotherapists in the United States published a white paper proposing walking speed as the sixth, because a single corridor walk predicted falls, hospital admission, the need for personal care, functional decline and death. Their 2015 review put the case simply: speed is the product of postural control, leg strength, aerobic capacity, proprioception and vision working together, so one measurement stands in for many systems.

The authors of the largest survival analysis write that walking requires energy, movement control and support, and places demands on the heart, lungs, circulation, nervous system and musculoskeletal system. When any falters, pace drops, often before a diagnosis is made. In their pooled data, a prediction from age, sex and gait speed was as accurate as one from age, sex, chronic conditions, smoking history, blood pressure, body mass index and hospitalisation: the C statistic for 5-year mortality rose from 0.690 with age and sex to 0.717 with gait speed added.

Unlike VO2 max, it needs no laboratory: the test costs nothing, takes under a minute and can be repeated at home.

What the numbers mean after 65

The reference study is a pooled analysis published in JAMA in 2011, combining individual data from 9 cohort studies collected between 1986 and 2000, with 34,485 community-dwelling adults aged 65 and over, mean age 73.5 years, 59.6 percent women. All used a standing start and usual pace, over distances from 8 feet to 6 metres. Mean speed was 0.92 m/s, from below 0.4 m/s (1,247 people) to above 1.4 m/s (1,491 people). Follow-up lasted 6 to 21 years, during which 17,528 participants died; 5-year survival was 84.8 percent and 10-year survival 59.7 percent.

Gait speed was associated with survival in all 9 cohorts. The pooled hazard ratio was 0.88 per 0.1 m/s, a 12 percent lower risk of death per tenth of a metre per second, with no plateau across the range. At age 75, predicted 10-year survival ranged from 19 to 87 percent in men and 35 to 91 percent in women across the range of gait speeds. For 70-year-old men, remaining life expectancy ranged from 7 to 23 years, for women from 10 to 30 years.

Three thresholds fall out of the curves. At about 0.8 m/s, predicted survival sits at the median for age and sex. From 1.0 m/s upwards it was consistently longer than age and sex alone would predict. Above 1.2 m/s, the authors suggest, life expectancy may be exceptional, though they call these cut points provisional. The European Working Group on Sarcopenia in Older People set the same 0.8 m/s or slower as its cut-off for low physical performance in 2019, alongside the grip strength cut-offs described in the grip strength guide.

The data are observational, so they cannot show that walking faster causes longer life; someone already ill walks slowly and dies sooner. The 9 cohorts were selected rather than one representative sample, 79.8 percent white, and speed was measured once at baseline.

Walking speed at 45

Most gait speed research concerns people over 65, so a 2019 study in JAMA Network Open asked what the measure says at 45. The Dunedin study has followed 1,037 people, 91 percent of eligible births in one New Zealand city in 1972 and 1973. At 45, 904 of the 997 survivors (90.7 percent) walked a 6 metre electronic walkway, with 2 metres of acceleration and 2 metres of deceleration, under three conditions. Usual pace averaged 1.30 m/s, walking while reciting alternate letters of the alphabet 1.16 m/s, and maximum pace 1.99 m/s.

The same people had 19 biomarkers measured at ages 26, 32, 38 and 45, giving a pace of biological ageing. The slowest walkers had aged 5.0 years faster between 26 and 45 than the fastest. They also had smaller brain volume, a thinner cortex and more white matter lesions on MRI, weaker grip and poorer balance, and their faces were rated as looking older. Poor brain health at age 3 already predicted who would walk slowly four decades later.

The authors call the test cheap, safe and repeatable in people in their 40s, and propose it for anti-ageing trials. The findings come from one cohort, 93 percent white, and neither gait nor brain imaging was measured before 45, so they show association, not sequence.

Self-rated pace and life expectancy

You do not even need a stopwatch. A 2018 analysis in the British Journal of Sports Medicine pooled 11 population surveys from England and Scotland taken between 1994 and 2008, in which 50,225 walkers rated their usual pace as slow, average or brisk. Excluding anyone who died in the first 2 years left 49,731 people. Against slow walkers, average-pace walkers had a 20 percent lower risk of death from any cause (95 percent confidence interval 12 to 28 percent) and brisk walkers 24 percent lower (13 to 33 percent); for cardiovascular death the reductions were 24 and 21 percent. There was no association with cancer mortality. The associations were evident in people over 50, in those who did not meet activity recommendations and in those doing no vigorous exercise, and did not differ by sex or body mass index. The authors themselves write "assuming causality", because a survey answer cannot separate fitness from early illness.

A 2019 study in Mayo Clinic Proceedings turned the same question into years. Among 474,919 UK Biobank participants, median age 58.2, followed for a median of 6.97 years with 12,823 deaths, brisk walkers had an estimated life expectancy from age 45 of 86.7 to 87.8 years in women and 85.2 to 86.8 years in men, at every level of body mass index. Slow walkers with a body mass index below 20 fared worst: 72.4 years for women and 64.8 years for men, a gap of more than 20 years against brisk-walking men. Grip strength produced smaller and less consistent differences. Very thin slow walkers may already have been ill, and UK Biobank volunteers are healthier than the general population.

How to test your own speed, and what to do with the number

The 2015 review recommends timing 5 to 10 metres with about 2.5 metres of run-in, so you are at pace when the clock starts; clinics often use 4 or 10 metres. Walk at your usual, comfortable pace, not your fastest, time 2 or 3 passes and divide the distance by the average time. Over 10 metres, 12.5 seconds is 0.8 m/s, 10 seconds is 1.0 m/s and 8.3 seconds is 1.2 m/s. Keep shoes, course and instructions identical. In community-dwelling older adults the minimal detectable change is 0.11 to 0.14 m/s depending on baseline speed, so a smaller difference between two tests may be measurement noise. The Walking Calculator turns your time into speed and pace.

Brisk, in UK health service guidance, means about 3 miles an hour (4.8 km/h, or 1.34 m/s), the pace at which you can talk but not sing. That is close to the 1.32 m/s that a review of community walking in the United States puts at the minimum for crossing a street safely.

No trial has yet shown that raising gait speed lengthens life. What is established is that its components respond to training at any age: leg strength (see strength training after 40), aerobic fitness and balance, while a higher daily step count keeps the habit in place.

See a doctor rather than a table if your pace has slowed noticeably over weeks or months, if walking brings chest pain, breathlessness or dizziness, if one leg has become weak, or if you have fallen. If you have heart disease, take medication that affects balance or blood pressure, or feel unsteady, do the test with someone present. A single slow reading in later life, below 0.8 m/s, is a prompt for assessment of muscle, heart, lung, joint and nerve causes, not a verdict.

Timing your own walking speed

Frequently asked

What is a good walking speed for my age?

At 65 and over, the pooled cohorts averaged 0.92 m/s, and 1.0 m/s or faster went with better survival than age and sex alone would predict. The European sarcopenia working group treats 0.8 m/s or slower as low physical performance. At 45, usual pace averaged 1.30 m/s in the Dunedin cohort.

Is walking speed really a vital sign like blood pressure?

It is not recorded on every ward like the four classic vital signs, but a 2009 white paper proposed it as the sixth because of what it predicts. In 34,485 older adults, age, sex and gait speed predicted survival as accurately as age, sex, chronic conditions, smoking, blood pressure, body mass index and hospitalisation combined.

Does walking faster make you live longer?

That has not been shown. The 12 percent per 0.1 m/s and the 20 to 24 percent for self-rated pace are associations from observational cohorts, and illness slows people down before it kills them. What is known is that leg strength, aerobic fitness and balance, the components of speed, improve with training at any age.

How do I measure my walking speed at home?

Mark a 10 metre stretch with about 2.5 metres of run-in, walk it at your usual pace 2 or 3 times and time each pass with a stopwatch. Ten metres in 10 seconds is 1.0 m/s; in 12.5 seconds it is 0.8 m/s.

What counts as brisk?

UK health service guidance puts a brisk walk at about 3 miles an hour (4.8 km/h, 1.34 m/s), the pace at which you can talk but not sing. In the UK Biobank study, pace was self-defined as slow, steady or brisk, and brisk-walking men had an estimated life expectancy more than 20 years above that of slow walkers with a body mass index below 20.

When should a slow walking speed be checked by a doctor?

When it has slowed noticeably over weeks or months, when walking brings chest pain, breathlessness or dizziness, when one leg has become weak, or after a fall. A reading below 0.8 m/s in later life warrants an assessment for muscle loss and for heart, lung, joint or nerve causes.

Sources

• Studenski et al. 2011, JAMA: Gait speed and survival in older adults · Pooled analysis of 9 cohorts collected 1986 to 2000, 34,485 community-dwelling adults aged 65 and over, mean age 73.5, 59.6 percent women, mean gait speed 0.92 m/s, follow-up 6 to 21 years, 17,528 deaths; hazard ratio 0.88 per 0.1 m/s; 5-year survival 84.8 percent, 10-year 59.7 percent; at 75, 10-year survival 19 to 87 percent in men and 35 to 91 percent in women; 0.8 m/s at the median, 1.0 m/s better than expected, 1.2 m/s proposed by the authors as exceptional; pooled 5-year C statistic 0.717 for age, sex and gait speed versus 0.690 for age and sex. Open access copy on PubMed Central
• Middleton, Fritz and Lusardi 2015, Journal of Aging and Physical Activity: Walking speed, the functional vital sign · Review following the 2009 white paper that proposed walking speed as the sixth vital sign; protocol with 5 to 10 metres timed and about 2.5 metres of acceleration, stopwatch acceptable; minimal detectable change 0.11 to 0.14 m/s in community-dwelling older adults; 0.43 m/s in acute care, 0.7 versus 1.2 m/s for personal care needs, 1.32 m/s for safe street crossing in the United States. Open access copy on PubMed Central
• Rasmussen et al. 2019, JAMA Network Open: Association of neurocognitive and physical function with gait speed in midlife · Dunedin birth cohort of 1,037 people born 1972 to 1973; 904 of 997 survivors measured at 45 on a 6 metre electronic walkway; usual 1.30 m/s, dual task 1.16 m/s, maximum 1.99 m/s; pace of ageing from 19 biomarkers at 26, 32, 38 and 45, slowest walkers aged 5.0 years faster than fastest; smaller brain volume, older facial appearance, neurocognitive function at age 3. Open access copy on PubMed Central
• Stamatakis et al. 2018, British Journal of Sports Medicine: Self-rated walking pace and all-cause, cardiovascular disease and cancer mortality, pooled analysis of 50,225 walkers from 11 British cohorts · 11 surveys in England and Scotland 1994 to 2008, 50,225 walkers, 49,731 after excluding events in the first 2 years; average pace 20 percent (95 percent CI 12 to 28) and brisk 24 percent (13 to 33) lower all-cause mortality than slow pace, cardiovascular mortality 24 and 21 percent lower, no association with cancer; associations evident over age 50. The journal site answers 403 to automated requests; abstract verified through the journal record
• Zaccardi et al. 2019, Mayo Clinic Proceedings: Comparative relevance of physical fitness and adiposity on life expectancy, a UK Biobank observational study · 474,919 UK Biobank participants recruited 2006 to 2016, median age 58.2, median BMI 26.7, median follow-up 6.97 years, 12,823 deaths; self-defined pace slow, steady or brisk; life expectancy from 45 for brisk walkers 86.7 to 87.8 years in women and 85.2 to 86.8 in men across all BMI levels; slow walkers with BMI below 20: 72.4 years women, 64.8 years men. DOI resolves to the publisher page

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This guide is for general information. It does not replace medical advice or an examination.