Decrease in maximum paced walking speed predicts hospitalization in community-dwelling older people with disabilities

• Published in: European geriatric medicine Vol. 14; no. 5; pp. 961 - 968
• Main Authors: Hirai, Tomoya, Kamide, Naoto, Shigeta, Kyo
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.10.2023
• Subjects: Geriatrics/Gerontology; Internal Medicine; Medicine; Medicine & Public Health; Research Paper; Disabled persons; Aged; Hospitalization; Prognosis; Walking speed
• ISSN: 1878-7649; 1878-7657; 1878-7657
• DOI: 10.1007/s41999-023-00801-1

Key summary points Aim We investigated the relationship between walking speed and unexpected hospitalization in community-dwelling older adults with disabilities in activities of daily living. Findings In community-dwelling older people with disabilities in activities of daily living, the amount of change in walking speed over a 3-month period was more strongly associated with unexpected hospitalization than the walking speed at a single time point. Message When assessing the risk of unexpected hospitalization by walking speed in community-dwelling older adults with disabilities in activities of daily living, it is important to evaluate not only a single point in time, but also changes over time. Purpose Walking speed is a useful predictor of hospitalization for community-dwelling older people. However, whether it is an effective predictor for disabled older people has not been clarified. This study aimed to investigate the association of walking speed with unexpected hospitalizations in community-dwelling, disabled, older people. Methods The participants were ambulatory, community-dwelling older adults aged ≥ 65 years with disabilities. Comfortable and maximum walking speeds were measured at two timepoints, baseline and 3 months later. Furthermore, the change over time at 3 months in walking speed was also calculated. If the change in walking speed decreased more than 0.1 m/s, it was defined as walking speed decreased. The primary outcome was unexpected hospitalization during 4-year follow-up. The associations among baseline walking speed, walking speed decline, and hospitalization were analyzed using Cox regression analysis adjusted for potential confounding factors. Results A total of 93 people (age 81.8 ± 7.0 years, 64 female) were included, and unexpected hospitalization occurred in 47 people during 4-year follow-up. On Cox regression analysis adjusted for potential confounding factors, only the maximum walking speed decrease was significantly associated with hospitalization (hazard ratio = 2.53, 95% confidence interval: 1.23–5.21), not baseline walking speed and comfortable walking speed decrease. Conclusion As for the assessment of walking speed for the prediction of unexpected hospitalization in disabled people, measurement at a single timepoint is not useful, whereas change over time is. Monitoring of change over time in maximum walking speed appears to be one of the indicators for the health management of disabled people.