BACKGROUND: Walking speed norms and several risk thresholds for poor health outcomes have been published for community-dwelling older adults. It is unclear whether these values apply to hospitalized older adults. OBJECTIVE: The purpose of this study was to determine the in-hospital walking speed threshold that best differentiates walking-independent from walking-dependent older adults. DESIGN: This was a cross-sectional study. METHODS: This study recruited a convenience sample of 174 ambulatory adults aged 65 years and older who had been admitted to a medical-surgical unit of a university hospital. The participants' mean (SD) age was 75 (7) years. Fifty-nine percent were women, 66% were white, and more than 40% were hospitalized for cardiovascular problems. Usual-pace walking speed was assessed over 2.4 m. Walking independence was assessed through self-report. Several methods were used to determine the threshold speed that best differentiated walking-independent patients from walking-dependent patients. Approaches included a receiver operating characteristic (ROC) curve, sensitivity and specificity, and frequency distributions. RESULTS: The participants' mean (SD) walking speed was 0.43 (0.23) m/s, and 62% reported walking independence. Nearly 75% of the patients walked more slowly than the lowest community-based risk threshold, yet 90% were discharged home. Overall, cut-point analyses suggested that 0.30 to 0.35 m/s may be a meaningful threshold for maintaining in-hospital walking independence. For simplicity of clinical application, 0.35 m/s was chosen as the optimal cut point for the sample. This threshold yielded a balance between sensitivity and specificity (71% for both). Limitations The limitations of this study were the small size of the convenience sample and the single health outcome measure. CONCLUSIONS: Walking speeds of older adults who are acutely ill are substantially slower than established community-based norms and risk thresholds. The threshold identified, which was approximately 50% lower than the lowest published community-based risk threshold, may serve as an initial risk threshold or target value for maintaining in-hospital walking independence.
BACKGROUND: Walking speed norms and several risk thresholds for poor health outcomes have been published for community-dwelling older adults. It is unclear whether these values apply to hospitalized older adults. OBJECTIVE: The purpose of this study was to determine the in-hospital walking speed threshold that best differentiates walking-independent from walking-dependent older adults. DESIGN: This was a cross-sectional study. METHODS: This study recruited a convenience sample of 174 ambulatory adults aged 65 years and older who had been admitted to a medical-surgical unit of a university hospital. The participants' mean (SD) age was 75 (7) years. Fifty-nine percent were women, 66% were white, and more than 40% were hospitalized for cardiovascular problems. Usual-pace walking speed was assessed over 2.4 m. Walking independence was assessed through self-report. Several methods were used to determine the threshold speed that best differentiated walking-independent patients from walking-dependent patients. Approaches included a receiver operating characteristic (ROC) curve, sensitivity and specificity, and frequency distributions. RESULTS: The participants' mean (SD) walking speed was 0.43 (0.23) m/s, and 62% reported walking independence. Nearly 75% of the patients walked more slowly than the lowest community-based risk threshold, yet 90% were discharged home. Overall, cut-point analyses suggested that 0.30 to 0.35 m/s may be a meaningful threshold for maintaining in-hospital walking independence. For simplicity of clinical application, 0.35 m/s was chosen as the optimal cut point for the sample. This threshold yielded a balance between sensitivity and specificity (71% for both). Limitations The limitations of this study were the small size of the convenience sample and the single health outcome measure. CONCLUSIONS: Walking speeds of older adults who are acutely ill are substantially slower than established community-based norms and risk thresholds. The threshold identified, which was approximately 50% lower than the lowest published community-based risk threshold, may serve as an initial risk threshold or target value for maintaining in-hospital walking independence.
Authors: Jama L Purser; Morris Weinberger; Harvey J Cohen; Carl F Pieper; Miriam C Morey; Tracy Li; G Rhys Williams; Pablo Lapuerta Journal: J Rehabil Res Dev Date: 2005 Jul-Aug
Authors: Matteo Cesari; Stephen B Kritchevsky; Brenda W H J Penninx; Barbara J Nicklas; Eleanor M Simonsick; Anne B Newman; Frances A Tylavsky; Jennifer S Brach; Suzanne Satterfield; Douglas C Bauer; Marjolein Visser; Susan M Rubin; Tamara B Harris; Marco Pahor Journal: J Am Geriatr Soc Date: 2005-10 Impact factor: 5.562
Authors: Manuel Montero-Odasso; Marcelo Schapira; Enrique R Soriano; Miguel Varela; Roberto Kaplan; Luis A Camera; L Marcelo Mayorga Journal: J Gerontol A Biol Sci Med Sci Date: 2005-10 Impact factor: 6.053
Authors: L F Berkman; T E Seeman; M Albert; D Blazer; R Kahn; R Mohs; C Finch; E Schneider; C Cotman; G McClearn Journal: J Clin Epidemiol Date: 1993-10 Impact factor: 6.437
Authors: Deepika R Laddu; Betsy C Wertheim; David O Garcia; Nancy F Woods; Michael J LaMonte; Bertha Chen; Hoda Anton-Culver; Oleg Zaslavsky; Jane A Cauley; Rowan Chlebowski; JoAnn E Manson; Cynthia A Thomson; Marcia L Stefanick Journal: J Am Geriatr Soc Date: 2018-02-10 Impact factor: 5.562
Authors: Bret T Howrey; James E Graham; Monique R Pappadis; Carl V Granger; Kenneth J Ottenbacher Journal: Arch Phys Med Rehabil Date: 2017-04-07 Impact factor: 3.966
Authors: Melissa M Markofski; Kristofer Jennings; Kyle L Timmerman; Jared M Dickinson; Christopher S Fry; Michael S Borack; Paul T Reidy; Rachel R Deer; Amanda Randolph; Blake B Rasmussen; Elena Volpi Journal: J Gerontol A Biol Sci Med Sci Date: 2019-09-15 Impact factor: 6.053
Authors: Fang Wang; Erik Stone; Marjorie Skubic; James M Keller; Carmen Abbott; Marilyn Rantz Journal: IEEE J Biomed Health Inform Date: 2013-03 Impact factor: 5.772
Authors: Peggy M Cawthon; Sheena M Patel; Stephen B Kritchevsky; Anne B Newman; Adam Santanasto; Douglas P Kiel; Thomas G Travison; Nancy Lane; Steven R Cummings; Eric S Orwoll; Kate A Duchowny; Timothy Kwok; Vasant Hirani; John Schousboe; Magnus K Karlsson; Dan Mellström; Claes Ohlsson; Östen Ljunggren; Qian-Li Xue; Michelle Shardell; Joanne M Jordan; Karol M Pencina; Roger A Fielding; Jay Magaziner; Rosaly Correa-de-Araujo; Shalender Bhasin; Todd M Manini Journal: J Gerontol A Biol Sci Med Sci Date: 2021-09-13 Impact factor: 6.591