Accelerated Aging: Early Signal Of Worsening Gait Characteristics And Its Association With Health In Post-9/11 Veterans

Worsening gait is commonly observed in older adults and serves as an early marker of health decline. Veterans may experience changes in gait much earlier due to their military-related exposures. PURPOSE: To characterize the relationship between age, gait, and cohort-specific risk factors for poor gait and their association with general health among Veterans. METHODS: Post-9/11 Veterans who completed the gait assessment were included in this study (n = 103, age range: 18-65). Gait characteristics including gait speed, step length, percent single-support, and variability were assessed under normal and fast-paced walking conditions. Self-rated general health, lifetime mild or severe traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and pain interference were measured. Locally estimated scatter plot smoothing and regression models were used to characterize the relationship between age and gait. Multivariable linear regressions were used to evaluate the relationship between gait and risk factors for poor gait. Logistic regressions were used to explore the association between gait and general health. RESULTS: Gait, but not variability, was associated with older age. Starting around 40-46 years, worsening gait was associated with advanced age. We found no significant associations between gait, lifetime TBI, PTSD, or pain under normal walking. However, under fast-paced walking, we observed statistically significant associations between pain with gait speed, step length, percent single-support but not lifetime TBI or PTSD after adjusting for age and gender (β:-3.29, p = 0.004; β:-0.91, p = 0.03; β:-0.16, p = 0.04, respectively). An increase in percent single-support was associated with reduced odds of reporting fair/poor general health under normal and fast-paced walking conditions after adjusting for age, gender, lifetime TBI and PTSD, and pain (Odds Ratio (OR):0.60, p = 0.005, OR:0.71, p = 0.03, respectively). CONCLUSION: Post-9/11 Veterans show signs of accelerated aging, with worsening gait observed as early as their fourth decade of life. Gait, particularly related to stability and balance, was associated with general health. These findings emphasize the clinical significance of addressing pain and mobility in this cohort and reinforce the importance of early intervention. Supported by: VA Rehabilitation Research and Development Service: IK1RX003636, IK2RX003564, I50RX003430, I50RX003001