Clinical Epidemiology and Ageing

Slow Gait Speed Is an Independent Predictor of Early Death in Older Cancer Outpatients: Results from a Prospective Cohort Study.

Pamoukdjian F, Lévy V, Sebbane G, Boubaya M, Landre T, Bloch-Queyrat C, Paillaud E, Zelek L J Nutr Health Aging. 2017;21(2):202-206.

<p><b>OBJECTIVE: </b>To assess the predictive value of gait speed for early death in older outpatients with cancer.</p><p><b>DESIGN: </b>Prospective bicentric observational cohort study.</p><p><b>SETTING: </b>The Physical Frailty in Elder Cancer patients (PF-EC) study (France).</p><p><b>PARTICIPANTS: </b>One hundred and ninety outpatients with cancer during the first 6 months of follow up in the PF-EC study.</p><p><b>MEASUREMENTS: </b>The association between usual gait speed over 4 m alone (GS) or included in the short physical performance battery (SPPB) and overall survival within 6 months following a comprehensive geriatric assessment (CGA). A Cox proportional-hazard regression model was performed in non-survivors for clinical factors from the CGA, along with c reactive protein (CRP). Two models were created to assess GS alone and from inclusion in the SPPB.</p><p><b>RESULTS: </b>The mean age was 80.6 years, and 50.5% of the participants were men. Death occurred in 11% (n=22) of the participants within the 6 month follow up period. Of these participants, 98% had solid cancers, and 33% had a metastatic disease. A GS < 0.8 m/s (HR=5.6, 95%CI=1.6-19.7, p=0.007), a SPPB < 9 (HR=5.8, 95%CI=1.6-20.9, p=0.007) and a CRP of 50 mg/l or greater (p<0.0001) were significantly associated with early death in the two multivariate analyses. Cancer site and extension were not significantly associated with early death.</p><p><b>CONCLUSION: </b>Walking tests are associated with early death within the 6 month follow up period after a CGA independent of cancer site and cancer extension. GS alone < 0.8 m/s is at least as efficacious as the SPPB in predicting this outcome. GS alone could be used routinely as a marker of early death to adapt oncologic therapeutics. Further studies are needed to validate these preliminary data.</p>

MeSH terms: Aged; Aged, 80 and over; C-Reactive Protein; Female; Follow-Up Studies; France; Geriatric Assessment; Humans; Male; Multivariate Analysis; Neoplasms; Outpatients; Proportional Hazards Models; Prospective Studies; Walking Speed
DOI: 10.1007/s12603-016-0734-x