Picking Up the Pace

I took advantage of the snow day this week to watch “Joan Rivers: A Piece of Work,” the documentary that follows the comedienne as she turns 75. She looks terrific, thanks to the expert application of cosmetics and the perhaps overuse of plastic surgery. However, even as Joan appears to be wrinkle-free and youthfully coiffed, she betrays her age with her gait. Joan Rivers walks like an old lady.

One of my professors of pediatrics taught that if a three year old child can hop on one foot when asked, that child is probably neurologically intact. The evaluation is not so simple in the adult, and certainly not in an older patient. An article in JAMA considers if gait speed can be used to predict survival in the geriatric population. The conclusion: as the speed of walking increased, so did the remaining years of life for each sex and age group. The authors wrote, "Gait speed could be considered a simple and accessible summary indicator of vitality because it integrates known and unrecognized disturbances in multiple organ systems, many of which affect survival. In addition, decreasing mobility may induce a vicious cycle of reduced physical activity and deconditioning that has a direct effect on health and survival."  (JAMA. 2011:305(1):93-94.)

It’s not easy to take a walk when the ground is covered with two feet of snow – I would even caution my patients to stay inside to lessen the chance of falling on ice. However, spring is only nine weeks away and one can get in a lot of miles on the treadmill, up and down the supermarket aisles and at the mall. Shoulders back and pick up the pace!