TY - JOUR
T1 - Gait Speed and Instrumental Activities of Daily Living in Older Adults after Hospitalization
T2 - A Longitudinal Population-Based Study
AU - Sprung, Juraj
AU - Laporta, Mariana
AU - Knopman, David S.
AU - Petersen, Ronald C.
AU - Mielke, Michelle M.
AU - Weingarten, Toby N.
AU - Vassilaki, Maria
AU - Martin, David P.
AU - Schulte, Phillip J.
AU - Hanson, Andrew C.
AU - Schroeder, Darrell R.
AU - Vemuri, Prashanthi
AU - Warner, David O.
N1 - Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Background: Hospitalization can impair physical and functional status of older adults, but it is unclear whether these deficits are transient or chronic. This study determined the association between hospitalization of older adults and changes in long-term longitudinal trajectories of 2 measures of physical and functional status: gait speed (GS) and instrumental activities of daily living measured with Functional Activities Questionnaire (FAQ). Method: Linear mixed-effects models assessed the association between hospitalization (nonelective vs elective, and surgical vs medical) and outcomes of GS and FAQ score in participants (older than 60 years) enrolled in the Mayo Clinic Study of Aging who had longitudinal assessments. Results: Of 4902 participants, 1879 had ≥1 hospital admission. Median GS at enrollment was 1.1 m/s. The slope of the annual decline in GS before hospitalization was -0.015 m/s. The parameter estimate (95% CI) for additional annual change in GS trajectory after hospitalization was -0.009 (-0.011 to -0.006) m/s, p <. 001. The accelerated GS decline was greater for medical versus surgical hospitalizations (-0.010 vs -0.003 m/s, p =. 005), and nonelective versus elective hospitalizations (-0.011 vs -0.006 m/s, p =. 067). The odds of a worsening FAQ score increased on average by 4% per year. Following hospitalization, odds of FAQ score worsening further increased (multiplicative annual increase in odds ratio per year [95% CI] following hospitalization was 1.05 [1.03, 1.07], p <. 001). Conclusions: Hospitalization of older adults is associated with accelerated long-term decline in GS and functional limitations, especially after nonelective admissions and those for medical indications. However, for most well-functioning participants, these changes have little clinical significance.
AB - Background: Hospitalization can impair physical and functional status of older adults, but it is unclear whether these deficits are transient or chronic. This study determined the association between hospitalization of older adults and changes in long-term longitudinal trajectories of 2 measures of physical and functional status: gait speed (GS) and instrumental activities of daily living measured with Functional Activities Questionnaire (FAQ). Method: Linear mixed-effects models assessed the association between hospitalization (nonelective vs elective, and surgical vs medical) and outcomes of GS and FAQ score in participants (older than 60 years) enrolled in the Mayo Clinic Study of Aging who had longitudinal assessments. Results: Of 4902 participants, 1879 had ≥1 hospital admission. Median GS at enrollment was 1.1 m/s. The slope of the annual decline in GS before hospitalization was -0.015 m/s. The parameter estimate (95% CI) for additional annual change in GS trajectory after hospitalization was -0.009 (-0.011 to -0.006) m/s, p <. 001. The accelerated GS decline was greater for medical versus surgical hospitalizations (-0.010 vs -0.003 m/s, p =. 005), and nonelective versus elective hospitalizations (-0.011 vs -0.006 m/s, p =. 067). The odds of a worsening FAQ score increased on average by 4% per year. Following hospitalization, odds of FAQ score worsening further increased (multiplicative annual increase in odds ratio per year [95% CI] following hospitalization was 1.05 [1.03, 1.07], p <. 001). Conclusions: Hospitalization of older adults is associated with accelerated long-term decline in GS and functional limitations, especially after nonelective admissions and those for medical indications. However, for most well-functioning participants, these changes have little clinical significance.
KW - Activity of daily living
KW - Gait speed
KW - Hospitalization admission
KW - Mayo Clinic Study of Aging
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U2 - 10.1093/gerona/glab064
DO - 10.1093/gerona/glab064
M3 - Article
C2 - 33650631
AN - SCOPUS:85116953375
SN - 1079-5006
VL - 76
SP - E272-E280
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 10
ER -