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

Abstract

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. The participants were ambulatory, community-dwelling older adults aged ≥ 65years with disabilities. Comfortable and maximum walking speeds were measured at two timepoints, baseline and 3months later. Furthermore, the change over time at 3months in walking speed was also calculated. If the change in walking speed decreased more than 0.1m/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. A total of 93 people (age 81.8 ± 7.0years, 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. 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.