Ostir et al1 provide compelling evidence that simple performance measures of function, like gait speed, are powerful indicators of important health care outcomes, even in acutely ill older persons. Much of the prior work on performance measures was based in community-dwelling older populations, in which the assumption that performance measures were reliable in medically stable people was central to assumptions about predictive ability. Ostir et al show that performance measures in acutely ill, medically unstable older adults retain their ability to provide important clinical information.