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In this longitudinal study, we aimed to examine if slowing gait speed preceded cognitive decline and correlated with brain amyloidosis.    Methods  The sample (n = 287) was derived from the Gothenburg H70 Birth Cohort Studies, with follow‐ups between 2000 and 2015. Gait speed was measured by indoor walk, and cognition using the Clinical Dementia Rating (CDR) score. All participants had CDR = 0 at baseline. Some participants had data on cerebrospinal fluid (CSF) amyloid beta (Aβ) 1‐42  concentrations at the 2009 examination.    Results  Gait speed for participants who worsened in CDR score during follow‐up was slower at most examinations. Baseline gait speed could significantly predict CDR change from baseline to follow‐up. Subjects with pathological CSF Aβ 1‐  42  concentrations at the 2009 visit had lost more gait speed compared to previous examinations.    Discussion  Our results indicate that gait speed decline precedes cognitive decline, is linked to Alzheimer's pathology, and might be used for early detection of increased risk for dementia development.

Slowing gait speed precedes cognitive decline by several years