Hospitalization-associated change in gait speed and risk of functional limitations for older adults

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.