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. 2026 Feb 25;17(3):102908.
doi: 10.1016/j.jgo.2026.102908. Online ahead of print.

Getting the right measure: Gait speed assessment and outcomes in older patients with cancer

Evelien R A Spruijt  1 , Ajay T Bakas  2 , Aniel Sewnaik  2 , Christian Oudshoorn  2 , Francesco Mattace-Raso  2 , Rob J Baatenburg de Jong  2 , Harmke A Polinder-Bos  3
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Free article

Getting the right measure: Gait speed assessment and outcomes in older patients with cancer

Evelien R A Spruijt et al. J Geriatr Oncol. .
Free article

Abstract

Introduction: Gait speed (GS) reflects an individual's physical capacity and is often used to assess the level of fitness in older individuals with cancer. Importantly, GS can be measured in various ways. This study examined the association between several GS measurements and one-year mortality in older patients with head and neck cancer.

Materials and methods: This prospective cohort study included 227 patients. GS was measured at usual and fast pace using a 5-m walkway. GS reserve (fast-usual GS) and GS ratio (fast/usual GS) were calculated. GS measurements were analyzed both as continuous and categorical variables. For the categorical analyses, two categorical GS variables were created: '1 m/s' and '25th percentile.' Each variable included three categories: for '1 m/s': usual and fast GS <1 m/s, usual GS <1 m/s and fast GS ≥1 m/s, and usual and fast GS ≥1 m/s; for '25th-percentile': usual and fast GS < p25, usual GS < p25 and fast GS ≥ p25, and usual and fast GS ≥ p25. Cox regression survival analyses were performed.

Results: Median age was 76 [IQR 72-80] years, 71% were men and 51 patients died within one year. Mean usual and fast GS were 1.08 ± 0.27 and 1.41 ± 0.39 m/s, respectively. A higher usual (HR 0.23, 95%CI 0.07-0.76) or fast GS (HR 0.36, 95%CI 0.14-0.91) were associated with lower mortality. Patients with usual and fast GS <1 m/s (HR 2.66, 95%CI 1.29-5.50) had a higher mortality risk compared to patients with usual and fast GS >1 m/s. The association of 25th percentile group with mortality attenuated after adjustment for treatment (HR 2.07, 95%CI 0.91-4.73). Neither GS reserve nor GS ratio were associated with mortality.

Discussion: Lower usual and fast gait speeds are associated with higher one-year mortality in patients with head and neck cancer. A simple guideline is that patients with usual and fast GS <1 m/s or < p25 have a twofold higher risk of dying within one year compared to patients who walk faster.

Keywords: Gait speed; Gait speed reserve; Geriatric oncology; Head and neck cancer; Physical functioning.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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