It takes mere seconds for Jonathan Afilalo to predict an elderly patient's risk of developing complications in the days and weeks after heart surgery—and it involves a test that's about as simple as they come. Afilalo, a cardiologist at the Jewish General Hospital in Montreal, asks a patient to walk five meters down the hallway. If that person doesn't make it to the finish line within six seconds, his or her odds of living another six months are lower than patients who can walk faster, Afilalo has discovered. The chances of surgery complications, a second operation or more time on a mechanical ventilator are higher, too (J. Am. Coll. Cardiol. 56, 1668–1676, 2010).
This gait speed test isn't a direct measurement of heart health, though, like other tests administered by cardiologists. Instead, it's a marker of frailty, a concept that has been around in the English language for centuries but has only recently begun to be described more concretely as a medical syndrome. Now, frailty is being integrated into medical tests, researchers are finding causes at the molecular level of the weakening and slowing of the body during aging, and treatments that reverse or prevent frailty could be on the horizon. In addition to surgical outcomes, how frail someone is has been linked to recovery outcomes following pneumonia, stroke, heart attacks and bone fractures, among other maladies.
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