Two older women walking outdoors in a park

Walking Cadence in Frail Older Adults: What a 2025 Study Found

11 min read

A 2025 study in PLOS ONE analysed 102 prefrail and frail older adults, average age about 79, who completed a 4-month supervised walking programme in retirement communities around Chicago. People who stepped faster during their sessions were more likely to make a meaningful gain in how far they walked in 6 minutes.

Frailty means a body less able to cope with stress, with signs such as weakness, exhaustion, weight loss, slow walking and low activity. Prefrail describes an earlier stage with fewer of these signs. This guide covers who took part, what the study found, why researchers use steps per minute as a guide to effort, what the study does not show, and how to try a faster cadence safely. Cadence means the number of steps you take per minute. Every session in the study was supervised, so its results describe what happened under those conditions.

65%
Reached a meaningful 6-minute walk gain with fast walking, against 39% with casual walking
Rubin et al. 2025, the 102 of 165 who finished, 46 and 56 adults
100 vs 77
Median steps per minute, the middle value of the group, in the main phase, fast against casual walking
Rubin et al. 2025, 102 adults
+14
Extra steps per minute above comfortable pace, which the authors estimate went with about 10% higher odds of a meaningful gain
Rubin et al. 2025, model estimate
3 METs
Moderate intensity in metabolic equivalents, matched by about 100 steps per minute in healthy adults aged 61 to 85
Tudor-Locke et al. 2021, 98 adults
Sources: Rubin et al. 2025, PLOS ONE. Tudor-Locke et al. 2021, International Journal of Behavioral Nutrition and Physical Activity.

Who took part and what they did

Daniel Rubin and colleagues analysed data from a trial run in 14 independent living retirement communities around Chicago between 2017 and 2022. To join, residents had to be 60 or over, prefrail or frail on a standard frailty questionnaire, and able to walk at least 10 feet with no more than moderate hands-on help. Of 165 people who enrolled, 102 completed follow-up and were included, 56 in a casual walking group and 46 in a fast walking group, assigned at random.

Many used a walking aid. The paper's baseline table lists about a quarter using a cane and between 27% and 43% using a walker, depending on the group, though the table's counts appear to cover all who enrolled, not the 102 analysed. The same table shows most participants were women and about three in four were white.

Both groups did 48 supervised sessions, 3 a week for about 4 months. Each session lasted about 45 minutes, with 30 minutes of walking and related tasks such as stair stepping, walking with weights and walking in different directions, plus a warm-up and cool-down. Rest breaks were allowed and did not count towards the 30 minutes. The fast group was asked to walk "as fast as they safely could", and the casual group walked at a relaxed, comfortable pace. A research assistant led every session, a sensor worn on the thigh counted steps, and in the build-up weeks staff checked the fast group's heart rate with a wrist monitor.

What the study found

In the main phase of the programme, the fast group walked at a median of 100 steps per minute, against about 77 in the casual group. The paper reports 77 in its text and 76 in one of its tables. The main outcome was a gain of at least 30 metres in the 6-minute walk test. The authors chose this as a cautious threshold, at the upper end of the range suggested as the smallest meaningful change for frail older adults with several health conditions. At the start, both groups walked about 255 metres in 6 minutes. After 4 months, the fast group averaged 315 metres and the casual group 265 metres.

Steps per minute during the main phase Median cadence measured by a thigh-worn sensor Fast walking 100 Casual walking 77 0 60 120
Source: Rubin et al. 2025, PLOS ONE. 46 adults in the fast group and 56 in the casual group, prefrail or frail, average age about 79. The paper's Table 2 gives 76 for the casual group.

By the end, 65% of the fast group (30 of 46) had reached that gain, against 39% of the casual group (22 of 56). That is about 1.7 times as many people. After adjusting for frailty, sex, education and age, the authors report about 3 times the odds of a meaningful gain in the fast group. Odds are not the same as chance, which is why this figure is larger than the plain comparison. The odds ratio was 3.23, with a 95% confidence interval, the range of values the data support, of 1.34 to 7.78. In our view, the wide range reflects the small groups.

Reached a meaningful 6-minute walk gain Percent of each group gaining at least 30 metres after about 4 months Fast walking 65% Casual walking 39% 0% 50% 100%
Source: Rubin et al. 2025, PLOS ONE. Fast walking 30 of 46 adults, casual walking 22 of 56 adults. Only the 102 of 165 people who completed follow-up are included.

The team then looked at each person's own change in cadence, whatever their group. A faster cadence in the main phase went with higher odds of a meaningful gain. In the authors' model, stepping 14 more times per minute than a person's comfortable pace went with odds of improving that were about one tenth higher. This is a small, estimated link, not a measured result for any one person. Once cadence was taken into account, the difference between the groups was no longer significant, which the authors read as a sign that faster stepping explains much of the benefit.

Why researchers use steps per minute as a guide to effort

Heart rate and how hard exercise feels are common ways to judge effort. The Rubin authors note that many older adults take medicines, such as beta blockers, that limit how much heart rate rises, and that older adults find it hard to rate their effort accurately. Cadence is a count of steps per minute, taken by hand or by a device. The authors note that thigh-worn sensors count steps more accurately than wrist-worn devices at the slow speeds common in frail older adults.

A 2021 study by Catrine Tudor-Locke and colleagues tested 98 healthy adults aged 61 to 85 on a treadmill. A cadence of about 100 steps per minute matched moderate intensity, defined as 3 METs (metabolic equivalents, multiples of the energy you use at rest). That is the same threshold found in earlier studies of younger adults. Cadences of about 110 and 120 steps per minute matched 4 and 5 METs. Individuals varied widely, with predicted values for moderate intensity from about 70 to 114 steps per minute, and the study did not include people who use a walker.

The Rubin authors add that the increase from a person's own comfortable pace might matter more than reaching a fixed number such as 100. They say future studies need to test which approach works better.

What this study does not show

The fast and casual groups were assigned at random, but the link between each person's cadence and their gain is an association, and it does not prove cause and effect. The participants were volunteers from retirement communities who were motivated to exercise, and the authors note they might not represent all prefrail and frail older adults in retirement communities. More people in the casual group completed the programme than in the fast group, which the authors say might have introduced bias.

Every session was supervised by a research assistant who gave scripted encouragement. The authors say it is unclear whether people walking on their own would reach the same cadence or get the same benefit. The sessions also included stair stepping and walking with weights as well as walking, and 63 of the 165 people who enrolled were not included because they lacked complete follow-up.

Who should take care

The NHS (National Health Service) advises speaking to a GP (general practitioner) first if you have not exercised for some time, or if you have medical conditions or concerns. In the study, people with uncontrolled heart, lung, kidney or metabolic disease, or a resting blood pressure above 180/110, were excluded, and every session had a trained leader present.

In our view, get advice from your GP or a physiotherapist before you walk faster if you use a walking aid, have fallen in the past year, have a heart or lung condition, or have joint pain that gets worse when you walk. If you use a walker, need another person's hands-on help to walk, or have fallen in the past year, do not try faster walking alone. Also in our view, stop at once if you feel chest pain, dizziness, faintness, a racing or irregular heartbeat, or breathlessness that stops you speaking. Call 999 straight away if chest pain feels tight or heavy, spreads to your arm, neck, jaw or back, comes with sweating or sickness, or has not eased after 5 minutes of rest. If any of these signs settle, do not walk fast again until you have seen your GP.

How to try a faster cadence

These steps are ours, adapted from the study. They are not a tested programme, and the study was supervised. Have someone with you if you are unsure, wear well-fitting shoes, carry a phone or alarm, use your usual walking aid, and plan a flat, well-lit route that passes places to sit.

1
Warm up and find your pace
Walk for between 5 and 10 minutes at your usual pace. Then ask someone to count your steps for 1 minute, or count them yourself on a clear, flat path with your eyes ahead. That is your starting cadence.
2
Add a few steps at a time
In short blocks of 2 or 3 minutes, step about 5 steps per minute quicker than your starting cadence, then return to your usual pace to recover. Set any metronome app before you start and keep the phone in a pocket.
3
Build up slowly
Start with between 5 and 10 minutes of quicker blocks in total and add more only if you feel steady. In the study, the fast group's median rose from about 86 to 100 steps per minute over the programme.
4
Cool down and add strength
Finish with 5 minutes of slow walking. The study used 3 sessions a week. The NHS also advises strength, balance and flexibility activities on at least 2 days a week.

In our view, take shorter, quicker steps rather than longer strides, and slow down at once if you feel unsteady. In the study, the fast group was asked to walk "as fast as they safely could".

Frequently asked questions

Should I aim for 100 steps per minute?
In the 2025 study, the fast group reached a median of 100 steps per minute. The authors suggest the increase from your own comfortable pace might matter more than a fixed number, and say this still needs testing.
How long did the programme take?
About 4 months, with 3 supervised sessions a week and 48 sessions in total. Each session included about 30 minutes of walking and related tasks.
I use a walker. Is this for me?
Among those who enrolled, roughly a quarter to two-fifths in each group used a walker, and every session was supervised. In our view, ask your GP or a physiotherapist before you walk faster with a walking aid, and do not try it alone.
Do I need a special device?
In our view, no. The study used a thigh-worn sensor, but counting your steps for a minute, or a metronome app, is enough to find and keep a target cadence at home.
Does faster walking replace strength work?
In our view, no. The NHS advises adults aged 65 and over to do strength, balance and flexibility activities on at least 2 days a week, and to be active every day, even if it is light activity.

The bottom line

In a 2025 study of 102 prefrail and frail older adults in supervised walking programmes, 65% of the fast walking group made a meaningful 6-minute walk gain, against 39% of the casual group. The authors estimate that stepping about 14 more times per minute than a comfortable pace went with about one tenth higher odds of that gain. The study shows an association under supervision, not proof that faster walking alone causes the benefit. A separate 2021 study linked about 100 steps per minute with moderate intensity in healthy adults aged 61 to 85, with wide variation between people. In our view, once your GP or physiotherapist agrees, a gradual rise in cadence is a simple way to make your walks more demanding.

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