Walking speed predicts clinical outcomes in older adults with blood cancers

Blood cancers

By Nicola Garrett

12 Jun 2019

A slower walking pace has been linked to a higher likelihood of death and hospital visits in older people with blood cancers, a study finds.

According to the authors from the Dana-Farber Cancer Institute in Boston, gait speed could be used by clinicians as a simple screening test to assess frailty and ultimately guide treatment plans.

The prospective study published in Blood found that or every 0.1 meter per second decrease in walking speed, the risk of dying, unexpectedly going to the hospital, or ending up in the emergency room increased by 22 percent, 33 percent, and 34 percent, respectively.

The association between slower walking speed and poorer outcomes persisted even after adjusting for cancer type, whether the disease was aggressive or indolent, age, and other demographic factors, as well as traditional measures of frailty and functional status.

“The slower someone walks, the higher their risk of problems,” said Jane A. Driver, MD, MPH, associate director of the Geriatric Research Education and Clinical Center at VA Boston Healthcare System, and co-director of the Dana Farber Older Adult Hematologic Malignancy Program and the study’s senior author.

“There is an unmet need for brief screening tests for frailty that can easily fit into clinic workflow and predict important clinical outcomes. This test can be done in less than a minute and takes no longer than measuring blood pressure or other vital signs,” she said.

“Our study shows that performance status alone may not be good enough. Gait speed appears to be much better at differentiating patients who are at high risk,” explained Driver. “The standard of care is to stratify treatments based on patients’ performance status, and while this works well in younger people, these results show that in older people we need to do more.”

The study involved 448 adults aged over 75 with blood cancers who were asked to walk at a normal pace for 4 meters and their speed was recorded in meters per second using a stopwatch.

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