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  1. Lusardi, Michelle M. PT, DPT, PhD


Health care professionals use vital signs routinely in caring for older adults. Because vital signs reflect the interaction of many physiological systems, they are effective indicators of general health. Vital signs can be quickly and accurately measured using commonly available equipment. Because normal values have been established, vital signs can be used to identify those individuals who require further evaluation and differential diagnosis to identify possible contributors when vital signs are abnormal, as well as those who would benefit from intervention to restore health and reduce risk of adverse health events. In rehabilitation, vital signs serve as an index of activity and exercise tolerance and are frequently used as an outcome measure to assess efficacy of intervention. This article begins by defining the characteristics of a "good" vital sign, reviews how classical vital signs (heart rate, respiratory rate, blood pressure, and body temperature) are used to guide clinical practice, evaluates how pain has come to be considered the fifth vital sign, and proposes that walking speed meets criteria as an effective vital sign in later life. Walking speed not only is a robust outcome measure but is also a powerful predictor of functional decline, risk of development of frailty, and risk of mortality. Drawing on current best evidence from epidemiologic and clinical research literature, the goal of this article was to motivate readers to adopt measurement of walking speed as a vital sign for all older adults in their care across all physical therapy practice settings.