Your Health: Experts view impaired walking as a disorder
By Kim Painter, USA TODAY
December 13, 2009
Find this article at: http://www.usatoday.com/news/health/painter/2009-12-13-your-health_N.htm
Geriatrician Daniel Mendelson has many ways to assess the health of his elderly patients, but one of the best, he says, is to watch them walk in from the waiting room.
“A patient who can do that quickly and comfortably is probably doing pretty well,” says the Rochester, N.Y., physician. “But if someone has trouble doing that, they are going to have trouble getting around their own homes.”
And trouble walking is often a sign of worse things to come, say experts in aging. “Looking at somebody’s gait is a keyhole into everything that’s going on with them,” says John Murphy, a geriatrician in Providence and board chairman of the American Geriatrics Society. Falls, bone fractures, heart disease, chronic pain and other health problems become more common as people become less sure on their feet, Murphy says. So do hospitalizations, lost independence and death.
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One study, published in November in the British Medical Journal, found that the slowest elderly walkers were three times more likely than their faster peers to die of heart disease within five years.
Of course, slow walking is often the result of existing health problems, such as arthritis or clogged blood vessels. But doctors increasingly see impaired walking itself as a disorder. And they are asking: Is it treatable? “In older folks who we know are vulnerable, the question is: Can we pull them back from the brink?” says Jack Guralnik, a researcher at the National Institute on Aging.
His agency has just been given $29.5 million to find out. The grant (part of $5 billion in federal stimulus money awarded to the National Institutes of Health) will pay for two years of the Lifestyles Interventions and Independence for Elders (LIFE) trial.
The study will enroll 1,600 people ages 70 to 89 who, because of health problems and inactivity, could lose the ability to walk a short distance (four blocks) over the next few years. That describes about 40% of people in that age group, says study leader Marco Pahor, director of the University of Florida’s Institute on Aging.
And it could soon describe more: A recent study found that people who were in their 60s in the early 2000s already were more disabled than sixtysomethings surveyed a decade earlier. “It’s scary news,” a direct result of our “increasingly immobile society,” says Cheryl Phillips, a San Francisco geriatrician and president of the geriatrics society.
Health and mobility
In the LIFE study, participants will be put in two groups. One group will come to study centers twice weekly for a program that will include brisk walking, balance and stretching exercises and light weight-training. They’ll also be asked to exercise at home three days a week. The comparison group will attend a general health-education program.
Researchers want to see whether those in the activity program will stay mobile in larger numbers. They also want to see whether increased mobility will translate into fewer falls, heart attacks and strokes and better cognition, Pahor says.
In a pilot study, people in the activity group did remain more mobile, he says. The larger study will start recruiting participants in eight sites nationwide in a few months.
For now, no one can promise seniors that working hard to stay on their feet will pay off. But rocking chairs are looking less attractive all the time.
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