Abstract P162: Maintenance of Gait Speed in Elderly Men and Women Reduces Risk of Hospitalization Irrespective of the Extent of Coronary Artery Calcium

Abstract

Introduction: Coronary artery disease (CAD) is a major contributor to medical costs in old age, including risk of hospitalization and risk of disability. Coronary artery calcium (CAC) is an accepted biomarker for CAD. Individuals lose their functionality with increasing age at different pace due to various reasons including chronic disease, such as CAD. Functional impairment, measured by gait speed, may be an important indicator of risk for hospitalization. We assessed the hypothesis that elderly people who maintain their gait speed are less likely to be hospitalized independent of CAD defined by CAC. Methods: Data from the population based AGES Reykjavik Study included 1208 men and 1660 women walking without aid, mean age 76.4 years (SD 4.9), were examined between 2002-2006 and 2007-2011. CAC was measured at visit one and gait speed at both visits. Hospital records were obtained for all participants. Hospital admission rates were estimated using age adjusted survival models according to baseline gait speed at [0.1-0.8), [0.8-1.0), [1.0-2.0) m/sec; change in gait speed (reduced, maintained or increased) and by CAC categories (0-300, and more than 300 Agatston units). Analysis was performed for men and women separately and the effect of adjusting for knee strength evaluated. Results: Both lower baseline and decreasing gait speed were associated with increased rate of hospitalization over five years follow-up. The rate ratio was slightly attenuated after adjustment for knee extension. When change in gait speed over five years period was examined, those who maintained or increased their gait speed had significantly lower age adjusted hospitalization rate for both men and women (Figure). This effect of gait speed was statistically significant for both CAC categories in all categories of gait speed (p< 0.05). Conclusion: These results show that maintenance of gait speed even in those who walk at a slow gait speed benefit by less hospitalization even if they have considerable CAD and thus potentially reduce health care cost.