BACKGROUND: Hospitalization-associated functional decline is a common problem for older adults, but it is unclear how hospitalizations affect physical performance measures such as gait speed. We sought to determine hospitalization-associated change in gait speed and likelihood of new limitations in mobility and activities of daily living (ADLs).
METHODS: We used longitudinal data over 5 years from the Health, Aging and Body Composition Study, a prospective cohort of black and white community-dwelling men and women, aged 70-79 years, who had no limitations in mobility (difficulty walking 1/4 mile or climbing 10 steps) or ADLs (transferring, bathing, dressing, and eating) at baseline. Gait speed, and new self-reported limitations in mobility and ADLs were assessed annually. Selected participants (n = 2,963) had no limitations at the beginning of each 1-year interval. Hospitalizations were self-reported every 6 months and verified with medical record data. Generalized estimating equations were used to examine hospitalization-associated change in gait speed and odds of new limitations over each 1-year interval. Fully adjusted models included demographics, hospitalization within the past year, health conditions, symptoms, body mass index, and health-related behaviors.
RESULTS: In fully adjusted models, any hospitalization was associated with decrease in gait speed (-0.04 m/s; 95% confidence interval [CI]: -0.05 to -0.03) and higher odds of new limitations in mobility or ADLs (odds ratio = 1.97, 95% CI: 1.70-2.28), and separately with increased odds of new mobility limitation (odds ratio = 2.22, 95% CI: 1.90-2.60) and new ADL limitations (odds ratio = 1.84, 95% CI: 1.53-2.21). Multiple hospitalizations within a year were associated with gait speed decline (-0.06 m/s; 95% CI: -0.08 to -0.04) and greater odds of new limitations in mobility or ADLs (odds ratio = 2.96, 95% CI: 2.23-3.95).
CONCLUSIONS: Functionally independent older adults experienced hospitalization-associated declines in gait speed and new limitations in mobility and ADLs.
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This work was supported by Minneapolis VA Center for Care Delivery and Outcomes Research (CCDOR) Locally Initiated Projects Fund.
The Health ABC Study was funded by the National Institute on Aging (NIA). The access to Health ABC Study data and decision to submit the article for publication were approved by NIA.
Duan-Porter, Wei; Vo, Tien N.; Ullman, Kristen; Langsetmo, Lisa; Strotmeyer, Elsa S.; Taylor, Brent C.; Santanasto, Adam J.; Cawthon, Peggy M.; Newman, Anne B.; Simonsick, Eleanor M.; Waters, Teresa M.; and Ensrud, Kristine E., "Hospitalization-Associated Change in Gait Speed and Risk of Functional Limitations for Older Adults" (2019). Health Management and Policy Faculty Publications. 18.