Slow gait speed is an independent predictor of early death in older cancer outpatients: Results from a prospective cohort study

• DOI: 10.1007/s12603-016-0734-x
• Publication Date: 2016-04-27T09:51:38Z
• Authors: Frédéric Pamoukdjian; V. Lévy; G. Sebbane; M. Boubaya; T. Landre; C. Bloch-Queyrat; E. Paillaud; L. Zelek
• Keywords: Aged, 80 and over; Male; 16. Peace & justice; Walking Speed; 3. Good health; 03 medical and health sciences; C-Reactive Protein; 0302 clinical medicine; Neoplasms; Multivariate Analysis; Outpatients; Humans; Female; France; Prospective Studies; Geriatric Assessment; Aged; Follow-Up Studies; Proportional Hazards Models

To assess the predictive value of gait speed for early death in older outpatients with cancer.Prospective bicentric observational cohort study.The Physical Frailty in Elder Cancer patients (PF-EC) study (France).One hundred and ninety outpatients with cancer during the first 6 months of follow up in the PF-EC study.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.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.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.