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

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An Editorial to this article was published on 30 May 2023

Key summary points

AbstractSection Aim

We investigated the relationship between walking speed and unexpected hospitalization in community-dwelling older adults with disabilities in activities of daily living.

AbstractSection Findings

In community-dwelling older people with disabilities in activities of daily living, the amount of change in walking speed over a 3-month period was more strongly associated with unexpected hospitalization than the walking speed at a single time point.

AbstractSection Message

When assessing the risk of unexpected hospitalization by walking speed in community-dwelling older adults with disabilities in activities of daily living, it is important to evaluate not only a single point in time, but also changes over time.

Abstract

Purpose

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.

Methods

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

Results

A total of 93 people (age 81.8 ± 7.0 years, 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.

Conclusion

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.

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Data availability

The data that support the results of this study are available at reasonable request from the corresponding author.

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Acknowledgements

The authors would like to express their deepest gratitude to the staff of the Department of Rehabilitation at Kitasato Institute Hospital for their support.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Rehabilitation, Kitasato University Kitasato Institute Hospital, Minato-Ku, Tokyo, 108-8642, Japan

    Tomoya Hirai & Kyo Shigeta

  2. School of Allied Health Sciences, Kitasato University, Sagamihara, Japan

    Naoto Kamide

  3. Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan

    Naoto Kamide

Authors
  1. Tomoya Hirai
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Correspondence to Tomoya Hirai.

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All procedures that involved human participants in this study were performed in accordance with the ethical standards of Kitasato Institute Hospital Research Ethics Committee (approval no. 18034) and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Hirai, T., Kamide, N. & Shigeta, K. Decrease in maximum paced walking speed predicts hospitalization in community-dwelling older people with disabilities. Eur Geriatr Med 14, 961–968 (2023). https://doi.org/10.1007/s41999-023-00801-1

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