Potential Marker of Accelerated Aging: Worsening of Gait Speed in Post-9/11 Veterans in the TRACTS Longitudinal Cohort

Abstract Introduction Veterans may experience negative changes in gait at younger ages because of military-related exposures and prevalent health conditions, such as traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), depression, and metabolic syndrome (MetS). This study aimed to evaluate gait speed by age and examine factors associated with gait speed among veterans. Materials and Methods Post-9/11 U.S. veterans were included in this study (n = 100, mean 42 ± 11 years). Gait speed was assessed under usual and fast-paced walking conditions. Military-related risk factors (combat experience, PTSD, TBI) and established clinical and functional factors associated with gait (depression severity, MetS, perceived balance disturbance, attention, and working memory) were evaluated. Results Non-linear associations were observed between age and gait speeds. Starting at age 41 years for usual pace (β = −.01, P = .01) and 40 years for past-paced walking (β = −.01, P = .03), gait speed decreased with advancing age. Better attention and working memory was associated with faster gait speed under usual pace (β = .007, 95% CI: 0.001 to 0.013, P = .02). Under fast-paced walking, better attention and working memory (β = .009, 95% CI: −0.003 to −0.001, P = .04) was positively associated with gait speed and MetS (β = −.121, 95% CI: −0.243 to −0.001, P = .04) and PTSD symptom severity (β = −.006, 95% CI: −0.011 to −0.002, P = .01) were negatively associated with gait speed. Conclusions Veterans exhibit age-related slower gait observed beginning in midlife, suggesting that gait may serve as a low-cost, clinically feasible potential early marker of accelerated aging. Worse cognitive function, presence of MetS, and higher PTSD severity were associated with slower gait speed. Interventions targeting physical health (gait, cardiometabolic health) and mind (cognition, mental health) may be critical to preserving mobility.