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Metrics details. Multivariable mixed model analysis was used to investigate sex differences in sensitivity interaction term with sex and in exposure to change of the sex difference when adjusted socio-demographic, lifestyle, social and health determinants of gait speed. Women had a 0. In general, men and women had similar determinants of gait speed. However, higher BMI and lower physical activity were more strongly associated with lower gait speed in women compared to men i.

More often having a lower educational level, living alone and having more chronic diseases, pain and depressive symptoms among women compared to men also contributed to observed lower gait speed in women i.

In contrast, men more often being a smoker, having a lower physical activity and a smaller personal network size compared to women contributed to a lower gait speed among men i. Both a higher sensitivity and higher exposure to determinants of gait speed among women compared to men contributes to the observed lower gait speed among older women. This might require a sex-specific approach in both research and clinical practice, which is currently often lacking.

Peer Review reports. Adequate gait speed is an important determinant of healthy physical aging, since it is protective of hospitalization, functional dependence, poor quality of life, institutionalization, disability and death in middle and old ages [ 1 , 2 ].