You keep using that word: “healthy” does not mean what you think it means in older adult gait research

Abstract In older adult gait research, “healthy” often characterizes study samples yet is typically defined by absence of disease rather than by positive characterization. This matters beyond gait, because such samples anchor reference values, mobility thresholds, and estimates of age-related decline. This scoping review examined how "healthy" is defined and operationalized in the older adult gait literature. Following PRISMA-ScR guidance, a search of Web of Science, SPORTDiscus, MEDLINE, and PubMed (January-February 2026) identified peer-reviewed studies assessing gait in adults ≥60 years described as “healthy,” “community-dwelling,” or defined through exclusion criteria. Records were independently screened and charted for terminology, inclusion/exclusion criteria, gait methodology, reported gait speed, and reporting completeness, and categorized by discipline and region. Of 3,011 records, 161 studies were included. Overall, 77% provided no explicit definition of health, and only 7% used inclusion-based criteria. Among the 41 studies labeling samples “healthy,” 80% gave no definition and none used inclusion-based criteria; among the 90 “community-dwelling” studies, 92% did not define health status. Of studies reporting usual-pace speed, 73% had means ≥1.0 m/s, yet samples performed similarly to population-cohort reference values (mean difference −0.03 m/s), themselves drawn from volunteers. Ethnicity (72%), physical activity (44%), and BMI (43%) were frequently unreported. “Healthy,” functions largely as a label of exclusion rather than a defined construct. Transparent participant characterization, guided by the preliminary reporting recommendations proposed here, is needed to judge whom gait reference values represent and where the boundary between normal aging and disease is drawn.