Unclean cooking fuel use and slow gait speed among older adults from six countries

Lee Smith, Guillermo F López Sánchez, Damiano Pizzol, Masoud Rahmati, Dong Keon Yon, Andrew Morrison, Jasmine Samvelyan, Nicola Veronese, Pinar Soysal, Mark A Tully, Laurie Butler, Yvonne Barnett, Jae Il Shin, Ai Koyanagi

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Outdoor air pollution has been reported to be associated with frailty (including slow gait speed) in older adults. However, to date, no literature exists on the association between indoor air pollution (e.g., unclean cooking fuel use) and gait speed. Therefore, we aimed to examine the cross-sectional association between unclean cooking fuel use and gait speed in a sample of older adults from six low- and middle-income countries (China, Ghana, India, Mexico, Russia, South Africa).

METHODS: Cross-sectional, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Unclean cooking fuel use referred to use of kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass based on self-report. Slow gait speed referred to the slowest quintile based on height, age, and sex-stratified values. Multivariable logistic regression and meta-analysis were done to assess associations.

RESULTS: Data on 14,585 individuals aged ≥65 years were analyzed [mean (SD) age 72.6 (11.4) years; 45.0% males]. Unclean cooking fuel use (vs. clean cooking fuel use) was significantly associated with higher odds for slow gait speed [OR=1.45 (95%CI=1.14-1.85)] based on a meta-analysis using country-wise estimates. The level of between-country heterogeneity was very low (I2=0%).

CONCLUSIONS: Unclean cooking fuel use was associated with slower gait speed among older adults. Future studies of longitudinal design are warranted to provide insight into the underlying mechanisms and possible causality.

Original languageEnglish
JournalJournals of Gerontology, Series A
Publication statusPublished (in print/issue) - 24 Apr 2023

Bibliographical note

© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.


  • Unclean cooking fuel
  • Pollutants
  • Indoor air pollution
  • Gait speed
  • Older adults


Dive into the research topics of 'Unclean cooking fuel use and slow gait speed among older adults from six countries'. Together they form a unique fingerprint.

Cite this