MONROE, Ga. – A recent study suggests that doctors can learn a great deal simply by timing how long it takes an older person to walk a set distance at a normal pace. In fact, they can gain some idea of how long that person will live.
Researchers who analyzed walking speed and survival for nearly 35,000 seniors concluded that gait speed could become a new “vital sign” that can be used to predict how long people will live.
“Walking is the result of proper functioning of a complex network of organs, systems and apparati,” said Dr. Matteo Cesari, a geriatric specialist in Rome whose editorial accompanied the study in the January 5th issue of the Journal of the American Medical Association.
“We do not know whether a person walks fast because he or she is healthy, or vice versa,” said Cesari, “this is not trivial because in medicine you need to treat the cause to have a significant effect, not the consequence.”
These observations ring true for Vicki Gasaway, who sees the correlation between walking pace and health in her clients at the Walton County Senior Citizen’s Council, Inc.
You notice people moving a little slower and those are the people who start participating less and eventually die, said Gasaway, who has worked with elderly people for 10 years and is executive director of the Center.
Researchers analyzed information about gait speed from nine large studies collected between 1986 and 2001. Although methods varied slightly from study to study, all timed walking speed over a measured distance.
This is a quick, easy and inexpensive assessment for caregivers or health providers to perform and monitor over time: all it takes is a four-meter walkway and a stopwatch.
Energy, movement control, and multiple organ systems are all involved in walking, which is why slower walking may be a warning signal in older patients – especially those who say they are doing fine.
Aging and diseases are primary contributors to a slowing gait speed, said Cesari. A decreasing gait speed could provide a warning sign for caregivers, pointing to underlying health conditions before they become clinically evident.
The assessment for gait speed aids physicians in determining a patient’s biological age, in other words, moving away from birth dates to determining how old their body is.
At Walton County Senior Citizen’s Council, birth age takes a back seat to biological age for citizens who exercise weekly, do chair exercises with a nutritionist, and even line dance.
“We have a few 90-something year olds who are still very active,” said Gasaway, “they have some health issues but they keep coming and their mobility is quite good.”
The team of researchers found that remaining years of life for each sex and age increased as walking speed increased, with gait speeds of one meter per second or higher consistently signifying survival that was longer than expected by sex and age alone.
Still, Cesari stresses the importance of gait speed as only a complementary guideline to improve routine clinical assessments.
“You should not consider gait speed as a condition to treat, but only as a marker of wellbeing,” said Cesari.
Felicia Harris is a graduate student at the University of Georgia. With a concentration in Mass Media, she is interested in the media’s effects on people’s well-being and livelihood.
Approximately 38 million Americans are now over 65, and their numbers increase with every Boomer birthday. Georgia has more than its share, ranking 9th in the nation for people over the age 65: one in 10 state residents falling in this category.
While the soaring need for healthcare in general has been in the headlines since the first Boomers turned 60, less attention is paid to the fact that many older folks are depressed. And their depression may well be ignored or mistaken for signs of dementia.
Because Alzheimer’s disease and other forms of dementia are so frightening to aging people, they worry constantly about this. In fact, depression is the most common mood disorder in older adults. The last chapters of life are filled with potential triggers for depression: the death of a spouse, loneliness, decreased mobility, financial challenges, chronic pain or frustration related to memory loss.
Winder gerontologist, Rasha Samara, says that she has seen patients with depression, lose motivation, abandon their interests, and stop being active.
“They may not only neglect their own interests but their own well being too. They will come into the office and may not have bathed for a couple of days or cut their fingernails in months.” said Dr. Samara.
In her office, she uses two different tests to try and identify what is going with a patient: the mini-mental status exam (MMSE) and the geriatric depression scale.
The MMSE tests cognitive function and screens for cognitive loss. The depression scale involves asking patients how they feel about their quality of life, whether life seems worthless to them, and whether they still take pleasure in favorite activities or pastimes?
Because dementia and depression can have some of the same initial symptoms Dr. Samara believes it’s important to use the two tests together.
Depending on whether the patient is depressed or showing signs of dementia she may prescribe medication as needed. But she also encourages people to act on their own behalf.
“I tell my patients to do whatever mental exercises they enjoy, whether it is crosswords puzzles, reading the newspaper every day, word searches, or chess,” said Dr. Samara.
Dr. Kerstin Gerst, Associate Professor of Gerontology at the University of Georgia, also recommends that people get out and socialize in addition to engaging in intellectually challenging activities. Social interactions require listening, processing information, and formulating and expressing ideas. All are key activities for the brain.
“It’s important to create new neurons by learning something new whether it’s trying a new language or playing a musical instrument,” Dr. Gerst said.
Mental illness not only influences an individual’s psychological state but also may undermine their overall physical health.
“It’s a much worse outcome if someone has a combination of medical and mental conditions such as diabetes and depression,” Dr. Gerst said.
Dr. Samara says emotional problems may affect physical health in several ways.
Inability to understand and address one’s medical condition, follow doctors’ directions, take the correct amount of medicine, or eat a healthy diet, can lead to or worsen hypertension, diabetes or other conditions. Physical and mental health are closely related.
Unfortunately, depression is not like physical ailments in which a person develops symptoms, takes notice, and reports the problem to a health provider. Mental health issues are also easily mistaken for signs of physical illness, by provider and patient, which allows the real problem to go untreated.
“Mental health problems are mostly first reported from family, friends, or caretakers because they recognize a person’s behavior changing,” said Dr. Samara.
Many mood and cognitive problems are treatable but not curable.
“It’s important to distinguish between treatable and curable, especially for families and friends who think dad is going to be cured of Alzheimer’s,” said Dr. Samara.
It may not be possible to truly cure depression or other mood disorders, either, but individuals and families can take steps to improve the situation.
Getting a depressed older person out of the house and into a social situation is one of these, and adult day programs help fill this need.
Two facilities in Barrow County that provide services for seniors are the Winder Adult Day Health Center and The Barrow County Senior Center. An adult day health center is facility that provides a planned program of activities daily to promote individual’s well being through social and health services. A senior center is a place in a community where seniors can gather for support, socialization, fitness, and other activities provided for older people.
The Winder Adult Day Health Center serves 30 adults whose mental and physical functions have been diminished by Alzheimer’s disease or other forms of dementia, stroke, depression or other emotional conditions, or developmental disabilities. The center offers a therapeutic activity program, nutritious meals, medical monitoring and physical and occupational therapy.
The center tries to provide activities that are educational and mentally stimulating for patients. They have brain-centered activities in the morning and physically active games in the afternoon.
In addition to helping keep clients active mentally and physically, the center’s programs also encourage social interactions among people.
About once a week Keith Adams, program coordinator at Winder Adult Day Center, comes up with a short questionnaire called, “get to know your neighbor”.
“I ask simple questions like, what do you like to do better, ride on a train or fly on a plane? It gets people to think about other things like their fears or past stories, that lead to discussion,” said Mr. Adams.
The Barrow County Senior Center is a multipurpose center that offers meals, some health-related services, and activities. On weekdays, 25 -to 30 people participate in senior center activities.
“Basically it is for their mental health, with all the activities we provide including puzzles, exercise, cards, computer games, and outside outings,” said Karen Townley, director of Barrow Senior Center.
Since they see the same people daily, the staff are alert to changes of mood in regular clients.
“We are here for them, sometimes they just want to talk, and of course if it’s something more we refer them to outside sources,” Ms. Townley said.
Experts agree that older adults who socialize, and who limber up with their brains with regular activity, will be better off in terms of mental and physical health.