Gait speed: a new “vital sign” for older persons in primary care
Subra J, Rougé-Bugeat M-E, Balardy L, et al.
J Frailty Aging 2012;1:90-91.
Publication date: June 1, 2012
The identification of frailty in clinical practice needs to be promoted, and screening tools should be adopted as early as possible in the care of older patients. A multidisciplinary platform for the screening, assessment, and treatment of frail community-dwelling older persons has been developed at the University Hospital of Toulouse, France. This initiative aims at intervening with a multidomain action at the very early onset of frailty symptoms before the disabling process takes place.
General practitioners were instructed to refer their frail patients to the platform in case of evidence of increased vulnerability to stressors. Frailty was identified on the basis of a specifically designed 6-question screening tool evaluating the patient’s health status and the subsequent assessment of a physical performance measure, 4-meter gait speed. The presence of slow gait speed (<1 meter/second) was considered the key criterion for confirming the presence of frailty.
In a survey mailed to a random sample of 50 general practitioners, 34 respondents expressed the feasibility of the screening test in their clinical practice (97.1%) and found no difficulty at implementing it (79.4%). Of the 217 patients evaluated during the survey, 59% were considered frail because simultaneously presenting one or more risk criteria plus usual gait speed slower than 1 meter/second.
Gait speed, the authors conclude, represents a valid and robust instrument to support the identification of older persons at risk of negative health-related events. It is feasible, well accepted and easy to implement in the primary care practice, which represents a key clinical setting for the development of preventive interventions against the onset of physical disability.