Gait speed can predict survival, hospital use in older patients with blood cancers

Gait speed is a marker of frailty and can independently predict survival and hospital use among older patients with blood cancers, according to a study of 314 patients followed for at least 6 months.

All patients, 75 or older, who presented for an initial consultation at the MDS/leukemia, myeloma, or lymphoma clinics of a large tertiary hospital, and agreed to assessments of gait speed and grip strength were eligible. Mean follow up was 13.8 months

After adjustment for age, sex, Charlson comorbidity index, cognition, treatment intensity, and cancer aggressiveness/type, every 0.1 meter/second decrease in gait speed was associated with a 22% increase in mortality (95% CI:1.15-1.30), a 33% increase in unplanned hospitalizations (95% CI 1.16-1.51) and a 34% increase in ED visits (95% CI 1.17-1.53). Gait speed remained an independent predictor of outcomes in a subset of patients with good (0-1) Eastern Cooperative Oncology Group performance scores (p=0.03). 

When grip strength was assessed, every 5 kg decrease in grip strength was associated with a 24% increase in mortality (95% CI: 1.07-1.43), but not hospital or ED use.

The researchers concluded that “gait speed is an easily obtained ‘vital sign’ that accurately identifies frailty and predicts outcomes independent of performance status among older patients with blood cancers.”

Liu MA, et al. Blood