Examining the factors associated with community ambulation in an older adult day hospital population.

Abstract

The ability of an older adult to walk independently in their community assists with maintaining independence, a healthy lifestyle and a good quality of life. In clinical practice, outdoor mobility is often one of the first activities, where a decline is observed. The aim of this study was to examine the factors associated with community ambulation in community dwelling older adults attending a day hospital. This was a cross-sectional observational study design. Inclusion criteria were community dwelling older adults, over 65years, attending a day hospital and able to ambulate at least 10m with or without an assistive device. The primary outcome measure was a community ambulation questionnaire. A range of other outcome measures were completed assessing motor, cognitive, executive function and behavioural domains. Multivariate logistic regression was employed to identify independent predictors of community ambulation. 161 participants completed this study. The median age was 83years (IQR 9), 64% were female and 49.1% lived alone. 55.3% of participants were classified as independent community ambulators. Mean gait speed was 0.8m/s, median TUG score was 16.6s and median frailty was 4 (IRQ 2) using the Clinical Frail Scale. Self-efficacy (p < 0.001) and gait speed (p = 0.030) were independently associated with community ambulation. The findings demonstrate the complexity and multifactorial nature of community ambulation in older adults. This suggests the need to adopt a broader approach to the management of older adults, to promote the achievement of independent community ambulation.