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

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Key Summary Points

AbstractSection Aim

To examine the factors associated with community ambulation in community dwelling older adults attending a day hospital.

AbstractSection Findings

Self-efficacy and gait speed were found to be independently associated with community ambulation in community dwelling older adults attending a day hospital. The associations between an individual’s physical ability, psychological well-being and their participation in community ambulation, highlight the importance of completing a holistic assessment of this population.

AbstractSection Message

The findings demonstrate the complexity and multifactorial nature of community ambulation suggesting the need to adopt a broader approach to the management of older adults, to promote the achievement of independent community ambulation.

Abstract

Purpose

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.

Methods

This was a cross-sectional observational study design. Inclusion criteria were community dwelling older adults, over 65 years, attending a day hospital and able to ambulate at least 10 m 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.

Results

161 participants completed this study. The median age was 83 years (IQR 9), 64% were female and 49.1% lived alone. 55.3% of participants were classified as independent community ambulators. Mean gait speed was 0.8 m/s, median TUG score was 16.6 s 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.

Conclusions

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.

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Availability of data and materials

The data sets used for this study are available upon reasonable request from the corresponding author.

Code availability

Codes and statistical analysis are available upon reasonable request from the corresponding author.

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Acknowledgements

The authors would like to thank all study participants.

Funding

This research study was supported by a small educational Grant from Medicine for the Elderly Directorate and Centre for Learning and Development, St James’s Hospital, Dublin 8, Ireland.

Author information

Authors and Affiliations

  1. Physiotherapy Department, St James’s Hospital, Dublin 8, Ireland

    Bronagh Conroy & Niamh Murphy

  2. Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland

    Roman Romero-Ortuno

  3. Mercer’s Institute for Successful Ageing (MISA), St James’s Hospital, Dublin 8, Ireland

    Roman Romero-Ortuno & Conal Cunningham

  4. School of Physiotherapy, Royal College of Surgeons in Ireland, 123 St Stephen’s Green, Dublin, Ireland

    Frances Horgan

Authors
  1. Bronagh Conroy
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  2. Niamh Murphy
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  3. Roman Romero-Ortuno
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  4. Conal Cunningham
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  5. Frances Horgan
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Contributions

BC and FH conceptualised and designed the study. Data collection was performed by BC. Data analysis was performed by BC, FH, CC and RRO. The first draft of the manuscript was written by BC. FH, CC, RRO and Niamh Murphy (NH) contributed to the editing and reviewing the paper. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Bronagh Conroy.

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Conflict of interest

We declare there are no conflicts of interest or copyright conflict. We declare that this work arises from an MSc Research thesis completed by the lead author BC, this thesis is available in the Royal College of Surgeons Ireland thesis repository as follows https://repository.rcsi.com/articles/thesis/Examining_the_Factors_Associated_with_Community_Ambulation_in_an_Older_Adult_Day_Hospital_Population/15035445.

Ethical approval

This study was approved by St James’s Hospital and Tallaght University Hospital Joint Research Ethics Committee (Rec 2017-06) and the Royal College of Surgeons in Ireland (RCSI) Research Ethics Committee (REC 1513).

Consent to participate

Written informed consent was obtained from all participants.

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Consent for dissemination/publication was obtained. The manuscript does not contain individual case sensitive information.

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Conroy, B., Murphy, N., Romero-Ortuno, R. et al. Examining the factors associated with community ambulation in an older adult day hospital population. Eur Geriatr Med 13, 1137–1147 (2022). https://doi.org/10.1007/s41999-022-00666-w

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  • DOI: https://doi.org/10.1007/s41999-022-00666-w

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