Glenn V Ostir1, Ivonne M Berges2, Kenneth J Ottenbacher3, Steve R Fisher4, Erik Barr2, J Richard Hebel2, Jack M Guralnik2. 1. Department of Epidemiology and Public Health, Division of Gerontology, University of Maryland School of Medicine, Baltimore, MD. Electronic address: gostir@epi.umaryland.edu. 2. Department of Epidemiology and Public Health, Division of Gerontology, University of Maryland School of Medicine, Baltimore, MD. 3. School of Health Professions, Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX. 4. Department of Physical Therapy, University of Texas Medical Branch, Galveston, TX.
Abstract
OBJECTIVES: To classify hospitalized older patients with slow gait speed, and test the hypothesis that slow gait speed or dismobility is associated with increased mortality risk. DESIGN: Prospective study. SETTING: Acute care geriatric hospital unit. PARTICIPANTS: Older patients (N=289) admitted to a geriatric hospital unit. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Two-year survival determined by medical record review and a search of the National Death Index. RESULTS: Most of the older patients were women (61.6%) and non-Hispanic white (72.3%). A total of 213 older patients (73.7%) had gait speeds ≤0.6 m/s and were classified with dismobility; 17% (49/289) of the sample died during the 2-year follow-up. All but 5 deaths occurred in older patients with dismobility. Older patients with dismobility were more than 2.5 times as likely to die than those with gait speeds >.60 m/s (hazard ratio, 2.60; 95% confidence interval, 1.01-6.77), after adjusting for age, sex, race/ethnicity, and comorbidity. CONCLUSIONS: A simple and quick screen for gait speed was evaluated in this study of hospitalized older patients. A clinical classification of dismobility could provide the inpatient health care team with meaningful information about the older patients' underlying health conditions and future prognosis, and provides an opportunity to discuss and implement treatment options with patients and their families.
OBJECTIVES: To classify hospitalized older patients with slow gait speed, and test the hypothesis that slow gait speed or dismobility is associated with increased mortality risk. DESIGN: Prospective study. SETTING: Acute care geriatric hospital unit. PARTICIPANTS: Older patients (N=289) admitted to a geriatric hospital unit. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Two-year survival determined by medical record review and a search of the National Death Index. RESULTS: Most of the older patients were women (61.6%) and non-Hispanic white (72.3%). A total of 213 older patients (73.7%) had gait speeds ≤0.6 m/s and were classified with dismobility; 17% (49/289) of the sample died during the 2-year follow-up. All but 5 deaths occurred in older patients with dismobility. Older patients with dismobility were more than 2.5 times as likely to die than those with gait speeds >.60 m/s (hazard ratio, 2.60; 95% confidence interval, 1.01-6.77), after adjusting for age, sex, race/ethnicity, and comorbidity. CONCLUSIONS: A simple and quick screen for gait speed was evaluated in this study of hospitalized older patients. A clinical classification of dismobility could provide the inpatient health care team with meaningful information about the older patients' underlying health conditions and future prognosis, and provides an opportunity to discuss and implement treatment options with patients and their families.
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