Chest
Volume 123, Issue 2, February 2003, Pages 387-398
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Clinical Investigations
EXERCISE
The 6-min Walk Test*: A Quick Measure of Functional Status in Elderly Adults

https://doi.org/10.1378/chest.123.2.387Get rights and content

Objectives:

To determine the correlates of the total 6-min walk distance (6MWD) in a population sample of adults ≥ 68 years old.

Methods:

The standardized 6-min walk test (6MWT) was administered to the Cardiovascular Health Study cohort during their seventh annual examination.

Results:

Of the 3,333 participants with a clinic visit, 2,281 subjects (68%) performed the 6MWT. There were no untoward events. The mean 6MWD was 344 m (SD, 88 m). Independent general correlates of a shorter 6MWD in linear regression models in women and men included the following: older age, higher weight, larger waist, weaker grip strength, symptoms of depression, and decreased mental status. Independent disease or risk factor correlates of a shorter 6MWD included the following: a low ankle BP, use of angiotensin-converting enzyme inhibitors, and arthritis in men and women; higher C-reactive protein, diastolic hypertension, and lower FEV1 in women; and the use of digitalis in men. Approximately 30% of the variance in 6MWD was explained by the linear regression models. Newly described bivariate associations of a shorter 6MWD included impaired activities of daily living; self-reported poor health; less education; nonwhite race; a history of coronary heart disease, transient ischemic attacks, stroke, or diabetes; and higher levels of C-reactive protein, fibrinogen, or WBC count.

Conclusions:

Most community-dwelling elderly persons can quickly and safely perform this functional status test in the outpatient clinic setting. The test may be used clinically to measure the impact of multiple comorbidities, including cardiovascular disease, lung disease, arthritis, diabetes, and cognitive dysfunction and depression, on exercise capacity and endurance in older adults. Expected values should be adjusted for the patient’s age, gender, height, and weight.

Section snippets

Study Population

Participants in the CHS were selected using a Medicare eligibility list provided by the US Health Care Financing Administration for the four participating communities: Forsyth County, North Carolina; Pittsburgh, PA; Sacramento County, California; and Washington County, Maryland. These communities are diverse in proportion of minorities, education and income levels, degree of urbanization, death rates, and availability of medical care. The initial study cohort of 5,201 participants was recruited

6MWT Exclusions and Safety

Of the 3,333 participants who attended the 1996 through 1997 clinic visit, approximately one third were excluded or chose not to try the 6MWT (Table 1). The 164 participants who started the walk but stopped walking before 6 min had elapsed (partial completers) were included in the analyses for this report. Those who completed the walk (n = 2,117) were significantly healthier in many respects when compared to the partial completers, or to those who did not perform the test (Table 2). Those with

Discussion

We found that most elderly persons can safely perform the 6MWT to quickly measure their functional status. We may be the first investigators to describe associations of 6MWD with impaired ADL; self-reported health; education; race; a history of coronary heart disease, TIA, stroke, or diabetes; and indexes of inflammation: (C-reactive protein, fibrinogen, and WBC count).

The 12-min walking test was introduced in 1968 as a guide to physical fitness,28 and later applied to patients with COPD.29 It

Participating Institutions and Principal Investigators

Wake Forest University School of Medicine, Gregory L. Burke, MD; ECG Reading Center, Wake Forest University, Pentti Rautaharju, MD, PhD; University of California, Davis, John Robbins, MD, MHS; The Johns Hopkins University, Linda P. Fried, MD, MPH; MRI Reading Center, The Johns Hopkins University, Nick Bryan, MD, PhD, and Norman J. Beauchamp, MD; University of Pittsburgh, Lewis H. Kuller, MD; Echocardiography Reading Center (baseline), University of California, Irvine, Julius M. Gardin, MD;

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    This research was supported by contracts N01-HC-85079 through N01-HC-85086, N01-HC-35129, and N01-HC-15103 from the National Heart, Lung, and Blood Institute.

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