Abstract P051: Longitudinal Decline in Gait Speed is Associated with Hospitalization in the AGES Reykjavik Study
Background: Functional decline is a characteristic of old age measured by physical performance, such as gait speed and muscle strength. Poorer cardiovascular health may explain much of the functional decline with age. We studied the association of longitudinal change in gait speed and hospitalization, testing whether any association was secondary to baseline subclinical cardiovascular measurements, or physical function.
Material and methods: Participants were from two phases of the longitudinal AGES Reykjavik Study. A population study of 3316 men and women (58%), who entered both stages 5 years apart, mean age 75.0 (SD 4.9) at baseline. The time in seconds (s) to walk 6m was measured at both visits. Baseline characteristics were Agatston score of coronary artery calcium (CAC), carotid plaque, carotid intima media thickness (IMT), type 2 diabetes mellitus, physical activity, quadriceps strength and activity of daily living (ADL). The study group was divided into two groups; those who were hospitalized during the follow-up and those who were not. Repeated measures models were used to estimate longitudinal change in gait speed.
Results: Mean time to walk 6m was 6.0 (SD=1.2) (s) for men and 6.6 (SD=1.6) (s) for women at baseline and did not differ by hospitalization status. For those hospitalized after the baseline visit (73%) the increase in time to walk 6 m was 0.68 (95%CI: 0.60-0.76) (s) whereas for those not hospitalized the increase in time was significantly smaller (0.39 (95%CI: 0.29 - 0.52) (s), (p<0.0001 for interaction). Those who were not hospitalized had significantly lower levels of CAC, IMT, carotid plaque, ADL, were more physically active, and had greater quadriceps strength (p<0.05 for all measures). After adjustment for these baseline variables, the difference in longitudinal change in gait speed between those who were admitted to hospital and not admitted was still statistically significant. The risk was attenuated only by 7%.
Conclusion: Individuals who were hospitalized showed greater decline in health, reflected in slower gait speed. This was not explained by cardiovascular status or other measured variables in this study related to health although those hospitalized had worse profile. This suggests that there are different trajectories influencing the rate of loss of gait speed explained by other factors than cardiovascular indices.
Author Disclosures: K. Siggeirsdottir: None. T. Aspelund: None. L.J. Launer: None. T.B. Harris: None. V. Gudnason: None.
- © 2014 by American Heart Association, Inc.