Walking is a complex activity that involves multiple bodily systems, including the musculoskeletal, cardiovascular, and nervous systems, all of which must function properly together. Gait speed has been widely used as an assessment in rehabilitative and geriatric medicine, and measuring it doesn’t require special equipment, is reasonably efficient, and has value even for patients who use a cane or a walker. Now, there’s a new vital sign for gauging survival and likelihood of having an unplanned hospitalization in older patients with blood cancers: the speed at which they can walk.
In a study published in the journal Blood, researchers at Dana-Farber Cancer Institute and the VA Boston Healthcare System report that for every 0.1 meter per second decrease in how fast patients walk four meters - about 13 feet - the risk of dying, unexpectedly going to the hospital, or using the emergency room increased by 22 percent, 33 percent, and 34 percent, respectively. The association was strongest in patients with non-Hodgkin lymphoma. “The slower someone walks, the higher their risk of problems,” says the study’s senior author, Jane A. Driver, MD, MPH, co-director of the Older Adult Hematologic Malignancy (OHM) Program at Dana-Farber and associate director of the Geriatric Research Education and Clinical Center at VA Boston Healthcare System.
The results support efforts to integrate gait speed as a routine part of medical assessments for older patients with blood cancer, and should be measured over time to guide treatment plans. Measuring gait speed not only helps identify individuals who are frail and may have worse long-term outcomes, but it also can indicate those who are in better-than-expected shape based on their age. “There is an unmet need for brief screening tests for frailty that can easily fit into clinic workflow and predict important clinical outcomes,” Driver continued. “This test can be done in less than a minute and takes no longer than measuring blood pressure or other vital signs. Based on our findings, it is as good as other commonly used methods which take considerably more time and resources and may not be practical for many oncology clinics.”
Gait speed remained an independent predictor of death even after accounting for standard measures of physical health. The new study enrolled 448 adults ages 75 years and older who had hematologic cancers. Participants were 79.7 years old on average and completed several screenings for cognition, frailty, gait, and grip strength. Gait speed was measured using the National Institutes of Health four-meter gait speed test. Patients were asked to walk at a normal pace for four meters and their speed was recorded in meters per second using a stopwatch. The association between slower walking speed and poorer outcomes persisted even after adjusting for cancer type and aggressiveness, patient age and other demographic factors, as well as traditional measures of frailty and functional status.
Patients whose performance status – their general well-being and quality of life – was rated as very good or excellent by their physician were stratified into three groups by gait speed – those at risk or frail, pre-frail, or robust. Of the 314 patients in this group, nearly 20 percent had an unplanned hospital stay unrelated to elective or scheduled treatments, and 16.8 percent visited the emergency department. “Our study reveals that the current standard of care for functional assessment in oncology - performance status - is not sufficient for elders with blood cancers. Gait speed appears to be much better at differentiating those patients at highest risk for poor outcomes,” says Gregory A. Abel, MD, MPH, director of the OHM clinic.
Walking To Reduce The Risk Of Heart Failure
Walking is one exercise associated with different benefits to the body such as lowering fasting blood sugar, improving memory, and reducing stress. It also keeps the heart healthy and prolongs life. Last year, a study that showed that walking can help women at risk of heart failure to maintain a healthy heart. The comprehensive study - comprising more than 137,000 women around the ages of 50 to 79 - showed that older women could live a better life without issues concerning heart health if they incorporate a walking routine in their daily activities.
The study concentrated on reducing overall heart failure and also looked into specifics like the ejection fraction and the preserved ejection fraction - subtypes of heart failure according to blood circulation. The preserved ejection fraction is more concerned with older women for whom the study was targeted. “This is first study to report physical activity levels related to a lower risk of developing heart failure with reduced ejection fraction in older adults, particularly women,” says Michael LaMonte, Ph.D., and the study’s lead author who works with the UB School of Public Health and Health Professions as a research associate professor of epidemiology.
The reduced ejection fraction happens in older individuals who have had a heart attack which then leads to a reduced pumping of the blood and also affects other organs. The preserved ejection fraction happens with those who are yet to have a heart attack, but have health conditions that will affect the heart in the long run such as diabetes or high blood pressure. The heart also reduces its pumping efficiency but not as bad as the reduced ejection fraction.
Women who participated in physical activities for about 30 to 45 minutes, had a lower risk of heart failure which was reduced by nine percent for general heart failure. For reduced ejection fraction, the risk was lowered by 10 percent, and preserved ejection fraction lowered by eight percent. To get effective results, it’s important to concentrate on the amount of walking or other physical activity. It’s the amount and not the intensity that matters. This means that walking for 45 minutes every day will prevent heart failure in the future more than walking for one hour every two days.
Since walking is the most common exercise older people engage in, it helps to focus more on it as compared to other types of physical activities. Walking has numerous benefits and aside from helping older people avoid the costly treatments of heart failure, it also benefits other body functions. Through walking, your brain health is likely to improve. Brain health is another problem with older people because they find it difficult to pay attention or remember certain events. According to a study published in the journal Neurology in 2010, walking increases the volume of gray matter in the brain which helps with better cognitive functions.