{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T16:39:06Z","timestamp":1792773546199,"version":"4.5.0"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Walking speed has been shown to be associated with mortality and is conventionally obtained from short walking tests in clinical settings. Free-living walking parameters such as walking cadence can be derived from accelerometers.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine whether walking parameters measured in clinical and free-living settings are associated with comparable discriminative ability for all-cause mortality risk.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This population-based cohort study, the Whitehall II accelerometer substudy in the UK, included a baseline from January 2012 to December 2013 and follow-up through August 19, 2024. The study included participants with valid accelerometer data, clinical walking speed, covariates, and electronic health records information. Analyses were performed between September 2025 and February 2026.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Clinical walking speed in meters per second was obtained from a 2.44-m walking test, and 2 free-living metrics of walking cadence in steps per minute (the median walking cadence and the 95th percentile walking cadence) were derived from 9 days of wrist-worn accelerometer data.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n All-cause mortality was ascertained from a British national mortality register. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) for all-cause mortality. Discriminative ability was assessed using the Harrel concordance index (C index).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 4067 participants (mean [SD] age, 69.3 [5.7] years; 3024 males [74.4%]) were included in the analysis. The median (IQR) follow-up was 11.8 (11.5-12.1) years. In models containing mortality risk factors (sociodemographic, behavioral, and health-related factors), higher clinical walking speed (HR, 0.77 [95% CI, 0.71-0.84]), median walking cadence (HR, 0.83 [95% CI, 0.77-0.90]), and 95th percentile walking cadence (HR, 0.82 [95% CI, 0.75-0.89]) were associated with lower all-cause mortality risk (per 1 higher SD) and with a similar discriminative ability (clinical walking speed: C index, 0.747 [95% CI, 0.730-0.764]; median walking cadence: C index, 0.744 [95% CI, 0.726-0.761]; and 95th percentile walking cadence: C index, 0.745 [95% CI, 0.727-0.762]). Only clinical walking speed was associated with an improved discriminative ability of a model including mortality risk factors.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study, clinical walking speed and free-living walking cadence were both associated with all-cause mortality risk and had a similar discriminative ability for all-cause mortality. These results suggest that both measures can be used in population-based studies, and the choice between the 2 methods may depend on research objectives, implementation constraints, and the strengths of each method.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.40122","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T15:30:22Z","timestamp":1792769422000},"page":"e2640122","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Walking Speed, Free-Living Walking Cadence, and All-Cause Mortality"],"prefix":"10.1001","volume":"9","author":[{"given":"Rayane","family":"Haddadj","sequence":"first","affiliation":[{"name":"Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian Meneghel","family":"Danilevicz","sequence":"additional","affiliation":[{"name":"Centre for Research in Epidemiology and Statistics, 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