Walking Ability of the Elderly Predicts Death

For septuagenarians, the ability to walk 400 meters and the speed at which they walk are independent prognostic factors for mortality, cardiovascular disease, and disability, according to a new study.

The long-distance corridor walk was developed as an alternative to treadmill testing in medically ill subjects by researchers from the University of Pittsburgh (PA, USA). They hypothesized that this test would also predict outcomes among older adults who have no known difficulty in performing mobility-related tasks.

To test their hypothesis, the researchers enrolled 3,075 subjects aged 70 to 79. The subjects were eligible if they reported that they could walk a quarter of a mile, climb a flight of stairs without resting, and perform basic activities of daily living. The subjects were instructed to walk as quickly as you can, without running, at a pace you can maintain.” Thirteen percent of the eligible subjects did not complete the 400-meter walk, either because of fatigue, symptoms, or persistent tachycardia. Surveillance was conducted every six months for an average of almost five years to determine incident cardiovascular disease, persistent mobility limitation, disability, or death.

After adjustment for chronic health conditions, extent of long-term disease, cardiovascular risk factors, and lower-extremity function, exclusion from or inability to complete the test was associated with higher risk for each outcome, with hazard ratios ranging from 1.17 to 1.95, when compared with subjects who completed the 400 meters. Those who required longer time to complete the walk were also at higher risk than those who were quicker, with each additional minute associated with a 29% higher rate of mortality, 20% higher rate of cardiovascular disease, and 52% higher rates of mobility limitation and disability. The findings were reported in the May 3, 2006, edition of the Journal of the American Medical Association (JAMA).

"This test may be useful in clinical practice for the identification of early decline in function,” said Dr. Anne B. Newman and colleagues.



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