Purpose <p>Diabetes (DM) plus hypertension (HTN) is a prevalent multimorbidity pattern. However, it is unclear which other diseases frequently coexist with DM and HTN and their impact on walking speed. Therefore, we identified multimorbidity patterns in community-dwelling older adults with: i) DM, ii) HTN and iii) DM + HTN and we examined the association between multimorbidity patterns and walking speed.</p> Methods <p>This was a cross-sectional study. We included 5090 community-dwelling older adults, from the National Health and Aging Trends Study, a population-based study of older adults (≥ 65&#xa0;years) in the U.S. We performed latent class analysis to identify multimorbidity patterns and then performed ANCOVA to examine the association between these multimorbidity patterns and walking speed.</p> Results <p>We identified 10 unique multimorbidity patterns: low multimorbidity, joint multimorbidity, cardiovascular-joint multimorbidity, psychological-joint multimorbidity, cardiovascular multimorbidity, cardiovascular-joint-respiratory multimorbidity, Metabolic-bone-joint multimorbidity, metabolic-cardiovascular-joint multimorbidity, metabolic-psychological-joint multimorbidity, metabolic-cardiovascular-joint-respiratory multimorbidity and metabolic-joint multimorbidity. Multimorbidity patterns with larger numbers of diseases and those that included psychological conditions (depression or anxiety) were associated with slower walking speeds compared to multimorbidity patterns with somatic conditions alone (e.g., arthritis).</p> Conclusions <p>At a population level, these multimorbidity patterns may help to identify subgroups of older adults with slower walking speed who may benefit from targeted assessment and management to improve their walking speed.</p>