BACKGROUND: Gait is one of the optimal indicators of functional status in older adults. Gait parameters are associated with adverse health outcomes in older adults. OBJECTIVE: To summarize and compare the practical value of gait parameters, and to review the progress of research on spatio-temporal parameters and the risk of adverse health outcomes in older adults. METHODS: PubMed, Web of Science, and CNKI were searched for relevant literature published from January 2010 to June 2023 using the search terms of “gait speed, walking speed, step length, cadence, step frequency, step time, walking base, aged and elderly” in English and Chinese, respectively. A total of 52 papers were finally included for the systematic review. RESULTS AND CONCLUSION: Currently, researchers have focused on three basic temporal-spatial parameters, namely, step speed, step length and step frequency, to explore their association with adverse health outcomes in older adults. Reduced gait speed in older adults may increase the risk of falls, all-cause mortality, and may be an independent predictor of all-cause mortality. Older adults with slow gait speed are at higher risk of cognitive decline, and may be the preferred gait parameter in assessing cognitive impairment in older adults. Older adults with slow gait speed are more likely to have debilitating or common chronic illnesses, and are at higher risk of hospitalization and public care. Step length is positively correlated with individual height and lower limb length, but age-induced shortening of step length is not related to height or lower limb length, and shortening of step length reflects reduced physical function in older adults, and shortening of step length is a risk factor for falls and cognitive decline in older adults. Stride frequency is often used as a measure of exercise intensity, and a stride frequency of ≥ 100 steps/minute is predictive of all-cause mortality, and slowing of step frequency may lead to a higher risk of falls, hospitalization and all-cause mortality in older adults. Changes in gait parameters are closely related to the level of physical fitness in older adults, and there may be a bidirectional relationship between the two. The results of the study will provide a theoretical basis for further improving risk screening in clinical populations, refining health risk assessment in the elderly, improving health protection and promoting active health in the elderly. [ABSTRACT FROM AUTHOR]