Hospitalization-Associated Change in Gait Speed and Risk of Functional Limitations for Older Adults
Hospitalization-Associated Change in Gait Speed and Risk of Functional Limitations for Older Adults
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DOI：
10.1093/gerona/glz027
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发表时间：
2019-10-01
影响因子：
5.1
通讯作者：
Ensrud, Kristine E.
中科院分区：
文献类型：
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作者：
Duan-Porter, Wei;Vo, Tien N.;Ensrud, Kristine E.
背景资料：住院相关的功能下降是老年人的一个常见问题，但目前尚不清楚住院如何影响身体性能指标，如步态速度。我们试图确定住院治疗相关的步态速度变化以及移动性和日常生活活动（ADL）新限制的可能性。我们使用了来自健康、衰老和身体成分研究的5年以上纵向数据，该研究是一项前瞻性队列研究，对象是70-79岁的黑人和白色社区居民男性和女性，在基线时，受试者的活动能力（行走1/4英里或爬10步困难）或ADL（转移、洗澡、穿衣和进食）没有限制。每年评估步态速度和新的自我报告的活动和ADL限制。选定的参与者（n = 2，963）在每个1年间隔开始时没有限制。每6个月自我报告一次住院情况，并使用病历数据进行验证。广义估计方程被用来检查住院相关的变化步态速度和新的限制在每个1年的时间间隔的几率。完全校正的模型包括人口统计学、过去一年内的住院情况、健康状况、症状、体重指数和健康相关行为。结果：在完全校正的模型中，任何住院情况都与步态速度的降低相关（-0.04 m/s; 95%置信区间[CI]：-0.05至-0.03）和新的活动或ADL限制的几率更高（比值比= 1.97，95%CI：1.70-2.28），并且分别增加新的活动受限（比值比= 2.22，95%CI：1.90-2.60）和新的ADL受限（比值比= 1.84，95%CI：1.53-2.21）的比值。一年内多次住院与步态速度下降相关（-0.06 m/s; 95% CI：-0.08至-0.04），以及新的活动或ADL限制的几率更大（比值比= 2.96，95%CI：2.23-3.95）。功能独立的老年人经历了住院相关的步态速度下降和新的限制，在移动性和ADL。
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.