Relationship between the physical functions with hospitalization and mortality in patients with ADL disability

Abstract

Objective: The purpose of this study was to clarify the relationship between physical function and hospitalization, mortality in community-dwelling older people with disabilities, and to determine the cut-off values of the physical function tests that are predictable of the occurrence of hospitalization and mortality events.

Method: We analyzed 143 community-dwelling older people aged 65 years and older who had non-full marks for the Barthel index. The subjects were followed up for 3-years and the cut-off values that identified the occurrence of hospitalization and mortality events for physical function tests were calculated. We also investigated the relationship between the occurrence of hospitalization and mortality events and physical function by Cox regression analysis.

Result: During an average follow-up of 749±386 days, 65 (44%) people were hospitalized or died. The cut-off values of physical function that predict the occurrence of hospitalization and mortality events were grip strength of 15.6 kg, knee extension strength of 15.2 kgf, and comfortable walking speed was calculated as 0.89 m/s. Cox regression analysis showed that grip strength less than 15.6 kg and comfortable walking speed less than 0.89 m/s were significantly associated with the occurrence of hospitalization or mortality events, even if confounding factors were adjusted.

Conclusion: The cut-off values of the physical function tests (grip strength: 15.6 kg, knee extension strength: 15.2 kgf, comfortable walking speed: 0.89 m/s) were calculated, and those could predict hospitalization and mortality events in community-dwelling older people with disability of ADL. Especially, among physical functions, assessment of grip strength and comfortable walking speed has been shown to be useful for the prediction of hospitalization and mortality events.