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Abstract: PO1178

Serum Bicarbonate and Gait Abnormalities in Older Adults

Session Information

Category: Fluid, Electrolyte, and Acid-Base Disorders

  • 902 Fluid, Electrolyte, and Acid-Base Disorders: Clinical


  • Ho, Jim Q., Albert Einstein College of Medicine, Bronx, New York, United States
  • Verghese, Joe, Albert Einstein College of Medicine, Bronx, New York, United States
  • Abramowitz, Matthew K., Albert Einstein College of Medicine, Bronx, New York, United States

Low serum bicarbonate levels are associated with slow gait speed in older adults. However, the association between serum bicarbonate and other quantitative gait markers is unknown.


Quantitative gait assessments were performed on 330 community-dwelling, nondisabled adults ≥65 years old. Serum bicarbonate was categorized into tertiles (≤24, 25-27, ≥28 mEq/L). The relationship between bicarbonate and gait markers was investigated with multivariable linear regression adjusting for demographics, comorbidities including COPD, medication use, smoking status, BUN, and eGFR (CKD-EPI). Factor analysis on eight gait markers was performed to synthesize individual gait characteristics into unifying domains. CKD was defined as eGFR<60 mL/min/1.73 m2.


There were 116 (35%), 146 (44%), and 68 (21%) participants in the low (mean bicarbonate 22 mEq/L), middle (26 mEq/L), and high (29 mEq/L) bicarbonate tertiles, respectively. After multivariable adjustment, compared with participants in the middle tertile, those in the low tertile had significantly slower speed (8.4 cm/s [95% CI 3.1-13.8]), shorter stride length (7.7 cm [95% CI 3.4-12.1]), and longer time in the double support phase of the gait cycle (0.03 s [95% CI 0.002-0.05]). Within the lowest tertile, there was a graded association of lower bicarbonate with greater severity of gait deficits (Figure 1). Associations were similar when limited to participants with CKD. Associations remained significant after additional adjustment for muscle strength, cognitive function, sensory nerve function, and balance. No significant associations were found for the high tertile or for other gait markers (e.g., cadence). Factor analysis produced 3 independent gait domains: pace, rhythm, and variability. Compared with the middle tertile, the low tertile had significantly poorer performance in the pace domain (0.3 standard deviation [95% CI 0.1-0.6]).


Low serum bicarbonate is associated with gait abnormalities in older adults.


  • Other NIH Support