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(Stroke. 2008;39:1233.)
© 2008 American Heart Association, Inc.

Original Contributions

Walking Speed and Risk of Incident Ischemic Stroke Among Postmenopausal Women

Aileen P. McGinn, PhD; Robert C. Kaplan, PhD; Joe Verghese, MD, MS; Daniel M. Rosenbaum, MD; Bruce M. Psaty, MD, PHD; Alison E. Baird, MD, PhD; John K. Lynch, DO, MPH; Philip A. Wolf, MD; Charles Kooperberg, PhD; Joseph C. Larson, MS Sylvia Wassertheil-Smoller, PhD

From the Departments of Epidemiology and Population Health (R.C.K., A.P.M., S.W.S.) and Neurology (J.V., D.M.R.), Albert Einstein College of Medicine, Bronx NY; Fred Hutchinson Cancer Research Center (C.K., J.C.L.), Seattle, Wash; Departments of Epidemiology, Medicine and Health Services (B.M.P.), Cardiovascular Health Research Unit, University of Washington, Seattle; National Institute of Neurological Disorders and Stroke, Stroke Neuroscience Unit (A.E.B.) and Neuroepidemiology Branch (J.K.L.), Department of Neurology, Boston University School of Medicine, Boston, Mass (P.A.W.).

Correspondence to Aileen P. McGinn, PhD, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue Belfer 1006A, Bronx, NY 10461. E-mail amcginn{at}aecom.yu.edu

Background and Purpose— Walking speed is a simple, reliable, and valid measure of functional status that has been shown to be strongly correlated with age-related outcomes and may be an indicator of subclinical cerebrovascular disease. However, few studies have investigated the association of walking speed with risk of incident ischemic stroke.

Methods— The present analyses included 13 048 postmenopausal women (mean age 65 years) from the Women’s Health Initiative free of stroke at baseline, 264 of whom had incident ischemic strokes on follow-up. Cox proportional hazards regression was used to obtain hazard ratios (HRs) and 95% confidence intervals (CIs) to assess the relationship between performance on a timed walk and risk of incident ischemic stroke. Multivariate adjustment included age, race/ethnicity, body mass index, waist-hip ratio, depression, arthritis, hypertension, smoking, systolic blood pressure, treated diabetes, hormone use, NSAID use, aspirin use, self-reported general health, and history of coronary heart disease.

Results— Slower walking speed was a significant predictor of incident ischemic stroke. After multivariate adjustment, the hazard for incident ischemic stroke was increased for the slowest walking speed tertile compared to the fastest walking speed tertile (HR=1.69, 95% CI: 1.21, 2.36). Additional adjustment for other physical function variables (grip strength and chair stands) did not change the association significantly.

Conclusions— Slow walking speed was found to be a strong predictor of increased risk of incident ischemic stroke among postmenopausal women independent of other established risk factors for stroke.

Key Words: physical function • stroke • walking speed • women

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