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Gait speed as a predictor of outcomes in post‐acute transitional care for older people
Author(s) -
Peel Nancye M,
Navanathan Sukumar,
Hubbard Ruth E
Publication year - 2014
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.12191
Subject(s) - medicine , gait , rehabilitation , acute care , physical therapy , functional independence measure , preferred walking speed , physical medicine and rehabilitation , prospective cohort study , independent living , activities of daily living , transitional care , gerontology , health care , economic growth , economics
Aims Gait speed has been advocated as a marker of vulnerability, but its discriminatory utility and predictive ability in frail older people in a post‐acute community‐based rehabilitation program has not been extensively investigated. The aims of this research were to examine whether there was a meaningful improvement in gait speed in post‐acute care patients, and to determine whether gait speed predicted outcomes at 6‐month follow up. Methods In a prospective cohort study, 351 older persons admitted to a transition care program were comprehensively assessed using the inter RAI H ome C are instrument. This included a timed 4‐m walk at admission and discharge. A telephone interview 6 months after admission determined functional independence, living status and readmissions to hospital. Results Mean ( SD ) gait speed was 0.34 m/s (0.21 m/s) at admission and 0.54 m/s (0.33 m/s) at discharge. The improvement in gait speed over the program was significant ( P < 0.001), and represents a clinically meaningful change. At 6 months postadmission to transition care, a majority of patients (86.9%) were living in the community and 40.5% had at least one readmission to hospital. Higher gait speed at admission was associated with increased likelihood of living in the community ( OR 1.34, P = 0.015) and being functionally independent ( OR 1.19 P = 0.017) at follow up, as well as a reduced risk of hospital readmissions ( OR 1.18, P = 0.006). Conclusions Gait speed is an inexpensive, feasible and objective measure of physical performance in frail older people. It could be a useful tool in community‐based transition care settings to predict outcomes. Geriatr Gerontol Int 2014; 14: 906–910.