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We investigated the associations between PA relative to walking performance and the prevalence and incidence of early and advanced walking difficulties compared to generally used measures of PA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Perceived walking difficulty was evaluated in 994 community-dwelling participants at baseline (age 75, 80, or 85 years) and 2 years later over 2 km (early difficulty) and 500 m (advanced difficulty). We used a thigh-mounted accelerometer to assess moderate-to-vigorous PA, daily mean acceleration, and relative PA as movement beyond the intensity of preferred walking speed in a 6-minute walking test (PArel). Self-reported PA was assessed using questionnaires.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence and incidence were 36.2% and 18.9% for early and 22.4% and 14.9% for advanced walking difficulty, respectively. PArel was lower in participants with prevalent (mean 42 [SD 45] vs 69 [91] min\/week, p &amp;lt; .001) but not incident early walking difficulty (53 [75] vs 72 [96] min\/week, p = .15) compared to those without difficulty. The associations between absolute measures of PA and incident walking difficulty were attenuated when adjusted for preferred walking speed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The variation in habitual PA may not explain the differences in the development of new walking difficulty. Differences in physical performance explain a meaningful part of the association of PA with incident walking difficulty. Scaling of accelerometry to preferred walking speed demonstrated independence on physical performance and warrants future study as a promising indicator of PA in observational studies among older adults.<\/jats:p><\/jats:sec>","DOI":"10.1093\/gerona\/glab277","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T06:22:36Z","timestamp":1632982956000},"page":"597-604","source":"Crossref","is-referenced-by-count":3,"title":["Physical Activity Scaled to Preferred Walking Speed as a Predictor of Walking Difficulty in Older Adults: A 2-Year Follow-up"],"prefix":"10.1093","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1372-2304","authenticated-orcid":false,"given":"Laura","family":"Karavirta","sequence":"first","affiliation":[{"name":"Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyv\u00e4skyl\u00e4, 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