Hospitalization-Associated Change in Gait Speed and Risk of Functional Limitations for Older Adults

Wei Duan-Porter, Tien N. Vo, Kristen Ullman, Lisa Langsetmo, Elsa S. Strotmeyer, Brent C. Taylor, Adam J. Santanasto, Peggy M. Cawthon, Anne B. Newman, Eleanor M. Simonsick, Teresa Waters, Kristine E. Ensrud

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1657-1663
Number of pages7
JournalThe journals of gerontology. Series A, Biological sciences and medical sciences
Volume74
Issue number10
DOIs
StatePublished - Sep 15 2019

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Mobility Limitation
Hospitalization
Activities of Daily Living
Confidence Intervals
Odds Ratio
Health
Independent Living
Walking Speed
Bandages
Body Composition
Medical Records
Body Mass Index
Eating
Demography
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Aging
  • Geriatrics and Gerontology

Cite this

Hospitalization-Associated Change in Gait Speed and Risk of Functional Limitations for Older Adults. / 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; Ensrud, Kristine E.

In: The journals of gerontology. Series A, Biological sciences and medical sciences, Vol. 74, No. 10, 15.09.2019, p. 1657-1663.

Research output: Contribution to journalArticle

Duan-Porter, W, Vo, TN, Ullman, K, Langsetmo, L, Strotmeyer, ES, Taylor, BC, Santanasto, AJ, Cawthon, PM, Newman, AB, Simonsick, EM, Waters, T & Ensrud, KE 2019, 'Hospitalization-Associated Change in Gait Speed and Risk of Functional Limitations for Older Adults', The journals of gerontology. Series A, Biological sciences and medical sciences, vol. 74, no. 10, pp. 1657-1663. https://doi.org/10.1093/gerona/glz027
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 ; Ensrud, Kristine E. / Hospitalization-Associated Change in Gait Speed and Risk of Functional Limitations for Older Adults. In: The journals of gerontology. Series A, Biological sciences and medical sciences. 2019 ; Vol. 74, No. 10. pp. 1657-1663.
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abstract = "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.",
author = "Wei Duan-Porter and Vo, {Tien N.} and Kristen Ullman and Lisa Langsetmo and Strotmeyer, {Elsa S.} and Taylor, {Brent C.} and Santanasto, {Adam J.} and Cawthon, {Peggy M.} and Newman, {Anne B.} and Simonsick, {Eleanor M.} and Teresa Waters and Ensrud, {Kristine E.}",
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AU - Duan-Porter, Wei

AU - Vo, Tien N.

AU - Ullman, Kristen

AU - Langsetmo, Lisa

AU - Strotmeyer, Elsa S.

AU - Taylor, Brent C.

AU - Santanasto, Adam J.

AU - Cawthon, Peggy M.

AU - Newman, Anne B.

AU - Simonsick, Eleanor M.

AU - Waters, Teresa

AU - Ensrud, Kristine E.

PY - 2019/9/15

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N2 - 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.

AB - 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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