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Logo for the Journal of Rehab R&D
Volume 42 Number 4, July/August 2005
Pages 535 — 546


Abstract - Walking speed predicts health status and hospital costs for frail elderly male veterans

Jama L. Purser, PT, PhD;1-3* Morris Weinberger, PhD;4-5 Harvey J. Cohen, MD;1,3,6-7 Carl F. Pieper, DrPH;3,7-8 Miriam C. Morey, PhD;1,3,6-7 Tracy Li, PhD;9 G . Rhys Williams, PhD;9 Pablo Lapuerta, PhD9

1Division of Geriatrics, Department of Medicine, Duke University Medical Center (DUMC), Durham, NC; 2Department of Physical Therapy, Department of Community and Family Medicine, DUMC, Durham, NC; 3Center for the Study of Aging and Human Development, DUMC, Durham, NC; 4Department of Health Policy and Administration, University of North Carolina, Chapel Hill, NC; 5Center for Health Services Research in Primary Care, Department of Veterans Affairs (VA) Medical Center, Durham, NC; 6Geriatric Research, Education and Clinical Center (GRECC), VA Medical Center, Durham, NC; 7Claude D. Pepper Older Americans Independence Center, DUMC, Durham, NC; 8Department of Biometry and Bioinformatics, DUMC, Durham, NC; 9Bristol-Myers Squibb, Princeton, NJ
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.
Key words: acute care, functional status, gait speed, geriatric evaluation and management, healthcare costs, health services use, health status, hospitalized older adults, physical function, walking ability.

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