Walking Speed May Be the Sixth Vital Sign: First Percentile Reference Values for Colombian Older Adults

How fast an older person walks may sound like a trivial detail, but in geriatric medicine it has earned a striking nickname: the sixth vital sign. Usual gait speed, the pace at which someone walks at their normal, comfortable tempo, is a simple, inexpensive, and remarkably informative indicator of physical function, wellbeing, frailty, and even survival in aging populations. Now, a large new study has delivered the first population-specific reference values and percentile model for usual gait speed among community-dwelling Colombian older adults, offering clinicians in the country a practical yardstick for interpreting one of the most powerful measures in routine geriatric assessment.

The research, published in Frontiers in Aging, drew on data from the Survey on Health, Wellbeing, and Aging in Latin America and the Caribbean, known as SABE, a nationally representative 2015 survey of health and aging in Colombia. From an initial pool of 23,510 participants aged 60 and older, the researchers performed a complete-case analysis that ultimately retained 11,945 community-dwelling older adults, roughly 49 percent of the original sample. Participants came from both urban and rural areas across the country, and trained staff measured usual gait speed using standardized procedures: each person was asked to walk three meters twice at a usual pace, with the best of the two outcomes recorded.

The headline finding is sobering. Usual gait speed in the Colombian sample ranged from 0.6 to 1.4 meters per second, with a mean of 0.79 meters per second and a median of 0.76 meters per second. That mean sits just below the widely used clinical threshold of 0.8 meters per second, the cutoff that defines slow gait speed and marks increased risk for falls, sarcopenia, frailty, and disability. For comparison, previous studies in other populations have reported usual gait speeds of roughly 0.94 to 1.34 meters per second, meaning the Colombian cohort walks considerably slower than many European and Asian reference populations.

Slow gait speed, defined as less than 0.8 meters per second, was far from rare. Of the 11,945 participants, 7,229 fell below the threshold, compared with 4,716 above it. The burden was unevenly distributed: 56 percent of those with slow gait speed were female, while men dominated the fastest values, accounting for 61 percent of participants above the cutoff. Participants with slow gait speed were also older on average, 69.21 years versus 67.53 years for those who walked faster. In a multivariate logistic model, slow gait speed was significantly associated with older age, female sex, shorter height, lower calf circumference, higher waist circumference, and living in a rural area.

To move beyond simple averages, the researchers built a percentile model using Generalized Additive Models for Location, Scale, and Shape, or GAMLSS. Unlike conventional linear regression, GAMLSS can model up to four parameters of a distribution, the mean, variance, skewness, and kurtosis, and can accommodate non-linear relationships between gait speed and its covariates. The team tested several distribution families, including Box-Cox t, Box-Cox Cole and Green, and Box-Cox power exponential variants, with model selection guided by Q statistics and the Generalized Akaike Information Criterion. The best-fitting family was the Box-Cox power exponential original, or BCPEo, for both male and female groups.

Anthropometry turned out to matter enormously. The full model initially included age, sex, height, weight, and calf circumference, but calf circumference and weight were not statistically significant and were dropped. Height, however, emerged as a key determinant, particularly among men. In the male model, each additional year of age reduced gait speed by about 0.005 meters per second, while each additional meter of height increased it by roughly 0.15 meters per second, equivalent to 0.015 meters per second for every 10 centimeters of height. This biomechanical relationship makes intuitive sense: taller people have longer stride lengths and lower cadence for a given pace, so they cover ground faster. Intriguingly, height was not a significant predictor among female participants in the multivariate model, possibly because women showed a narrower and more concentrated height distribution, but stratified analyses by height groups did reveal meaningful differences in gait speed within both sexes.

The percentile tables reveal how gait speed declines with each passing decade. For men aged 60 to 70, the 50th percentile value is 0.80 meters per second, while for women of the same age it is 0.73 meters per second, a 9 percent sex difference. By ages 81 to 90, the median falls to 0.72 meters per second for men and 0.68 meters per second for women. Notably, the decade-by-decade decline was more pronounced in men, whose median dropped about 5 percent per decade, compared with 3 percent in women. The researchers also found that height accounted for a substantial proportion of the sex-related differences in gait speed, particularly among the oldest participants, suggesting that some of the apparent female disadvantage reflects shorter stature rather than sex itself.

Why does this matter clinically? A growing body of longitudinal evidence shows that slow gait speed is a powerful predictor of future functional limitation. In a nine-year follow-up study of community-dwelling older adults, slow gait speed independently predicted subsequent dependence in basic activities of daily living. More recently, an analysis of the English Longitudinal Study of Ageing found that low physical performance, defined as gait speed at or below 0.8 meters per second, was more effective than the broader constructs of frailty and sarcopenia at identifying the risk of incident disability in both basic and instrumental activities of daily living. Gait speed has also been linked to falls, cardiovascular disease, cognitive decline, and mortality, and repeated measurements over time can dynamically refine survival predictions.

The Colombian findings also underscore why reference values must be population-specific. Mean heights in the Colombian sample, 1.71 meters for men and 1.58 meters for women, are shorter than European averages of 1.76 and 1.63 meters, and since height directly influences walking speed, comparing Colombian percentile values with non-comparable populations would be misleading. The study’s authors addressed this by incorporating height as a covariate in the GAMLSS models and presenting stratified percentile curves by height categories, an approach that aligns with how gait speed is typically used in practice. They also developed a web application that allows clinicians to locate a patient’s gait speed percentile using age- and sex-specific cutoff points, a screening tool designed for real-world primary care.

Like any study, this one has limitations. The reference values derive from the 2015 SABE Colombia survey, and cohort and generational changes in health, lifestyle, anthropometrics, and physical functioning may shift gait speed distributions over time, so the values should be periodically reassessed with more recent cohorts. The researchers also had to balance statistical modeling constraints with visualization feasibility, exploring contour plots and height-stratified groups to retain two crucial variables, age and height, alongside sex. Still, the study delivers something Colombian geriatric medicine has lacked: clinically valuable, easy-to-use reference values that may facilitate early identification of older adults whose gait performance falls below what is expected for their demographic characteristics, and who may be at increased risk of functional decline and frailty. Given that gait speed costs nothing to measure and takes seconds to administer, these percentile curves could soon become a routine part of healthy aging assessment in Colombia and a template for other Latin American populations.

Subject of Research: Gait speed reference values in Colombian older adults

Article Title: Percentile model and usual gait speed reference values in Colombian older adults: a secondary analysis of the Survey on Health, Wellbeing, and Aging in Latin America and the Caribbean (SABE)

Article References: Tadger-Viloria, P., Alfonso-Mora, M. L., Díaz-Vidal, D., Quino-Ávila, A. C., Andrew, J., Sandoval-Cuellar, C., Monsalve-Jaramillo, E., & Giné-Garriga, M. (2026). Percentile model and usual gait speed reference values in Colombian older adults: a secondary analysis of the Survey on Health, Wellbeing, and Aging in Latin America and the Caribbean (SABE). Frontiers in Aging, 7, Article 1965961. https://doi.org/10.3389/fragi.2026.1965961

Image Credits: AI Generated

DOI: 10.3389/fragi.2026.1965961

Keywords: gait speed, older adults, Colombia, SABE, GAMLSS, percentile model, frailty, healthy aging, Percentile, model, usual, gait