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Hee-Won Jung,1,2,* Il-Young Jang,3,4,* Chang Ki Lee,5 Sang Soo Yu,4 Jae Kyoon Hwang,4 Chawoong Jeon,4 Young Soo Lee,3 Eunju Lee3 1Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea; 2Geriatric Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea; 3Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; 4PyeongChang Health Center & County Hospital, PyeongChang-gun, Gangwon-Do, Republic of Korea; 5Goldman Urology Clinic, Seoul, Republic of Korea *These authors contributed equally to this work Purpose: We aimed to describe the age- and sex-specific distributions of gait speed and to evaluate associations with longitudinal outcomes in Korean rural community-dwelling older adults.Patients and methods: A total of 1,348 people (mean age: 76 years, 55% women) in the population-based, prospective cohort of Aging Study of Pyeongchang Rural Area (ASPRA) between October 2014 and June 2017. All participants underwent a comprehensive geriatric assessment, including 4-m usual gait speed, and were followed annually.Results: Among the 1,348 participants, women had a slower gait speed than men (mean 0.709 m/s vs 0.850 m/s, P < 0.001). Gait speed was inversely associated with age, frailty index; slow gait speed as classified by sex-specific quartile was associated with the prevalence of common geriatric syndromes. During the mean follow-up period of 21.5 months (SD 7.88), future survival without mortality or institutionalization was affected by sex-specific gait-speed quartile (log rank test P < 0.001): the 1st quartile of sex-specific gait speed was associated with increased risk of death or institutionalization.Conclusion: Gait speed was related to age, sex, frailty status, and geriatric health outcomes in Korean rural community-dwelling older adults. Since this gait-speed distribution in an older Korean population differs from previous data on other populations, we should consider a gait-speed cutoff value based on sex-specific quartiles to prevent misclassification in sarcopenia and frailty diagnosis. Keywords: cohort studies, frailty, gait speed, geriatric assessment, physical function