Results:

Ten studies were included in the analysis; nine studies were conducted prospectively and another was performed retrospectively. A range of lower extremity performance measures was examined, and these could be grouped into the following three general categories: lower limb strength, objectively measured walking performance, and the walking impairment questionnaire. Shorter maximum walking distance was associated with increased 5-year cardiovascular (unadjusted relative risk [RR], 2.54; 95% confidence interval [CI], 1.86-3.47; p < 0.00005) and all-cause mortality (unadjusted RR, 2.23; 95% CI, 1.85-2.69; p < 0.00005). Two studies reported strong associations between walking distance and mortality after adjustment for ankle-brachial index (ABI). The association between lower limb strength and outcomes was variable. Poor isometric strength for the following was associated with increased cardiovascular and all-cause mortality: hip extension, knee flexion, knee extension power, and plantar flexion.