title: Walking speed predicts health status and hospital costs for frail elderly male veterans.
abstract: This study evaluated the use of walking speed as an indicator of function and health status in acutely ill, hospitalized, older male veterans. Hospital inpatients in a Department of Veterans Affairs (VA) study of Geriatric Evaluation and Management (GEM) (n = 1,388, age 74.2 +/- 5.7, 98% male) were followed for 1 year. The results indicate that each 0.10 m/s reduction in baseline walking speed was associated with poorer health status (36-item short form [SF-36] beta = 4.5 [95% confidence interval (CI) 2.8 to 6.1]), poorer physical functioning (beta = 2.1 [6.9 to 14.8]), more disabilities (beta = 0.63 [0.53 to 0.73]), additional rehabilitation visits (2.0 [1.4 to 2.5]), increased medical-surgical visits (2.8 [1.9 to 3.7]), longer hospital stays (2.2 [1.4 to 2.9]), and higher costs ($1,334 [$869 to $1,798]). In addition, each 0.10 m/ s/yr increase in walking speed resulted in improved health status (SF-36 beta = 8.4 [6.0 to 10.7]), improved physical function (beta = 2.9 [2.5 to 3.3]), fewer basic disabilities (0.30 [0.2 to 0.4]), fewer instrumental disabilities (0.7 [0.6 to 0.8]), fewer hospitalization days (2.3 [1.3 to 3.3]), and 1-year cost reductions of $1,188 [-$65 to $2,442]. Walking speed is useful for the functional assessment of acutely ill, hospitalized older adults. Measurement of walking speed over time may help predict those who will need and use more health-related services.
authors.affiliation: Division of Geriatrics, Department of Medicine, Duke University Medical Center (DUMC), Durham, NC 27710, USA. jlp@geri.duke.edu
authors.forename: Jama L
authors.initials: JL
authors.lastname: Purser
authors.forename: Morris
authors.initials: M
authors.lastname: Weinberger
authors.forename: Harvey J
authors.initials: HJ
authors.lastname: Cohen
authors.forename: Carl F
authors.initials: CF
authors.lastname: Pieper
authors.forename: Miriam C
authors.initials: MC
authors.lastname: Morey
authors.forename: Tracy
authors.initials: T
authors.lastname: Li
authors.forename: G Rhys
authors.initials: GR
authors.lastname: Williams
authors.forename: Pablo
authors.initials: P
authors.lastname: Lapuerta
mesh_terms: D000368:Aged; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D005684:Gait / Q000502:physiology*; D006304:Health Status; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data*; D016138:Walking / Q000502:physiology*