Department of Physical Therapy, University of Pittsburgh, Pennsylvania.
Department of Physical Therapy, University of Delaware, Newark.
J Gerontol A Biol Sci Med Sci. 2020 Nov 13;75(12):2412-2417. doi: 10.1093/gerona/glaa086.
We examined the association between improved mobility and distal health outcomes in older adults using secondary analysis of data from a cluster-randomized controlled group exercise trial.
Participants were 303 men and women aged ≥65 and older in 32 independent living facilities, senior apartments, and community centers who participated in 12-week group exercise interventions. Included were those who completed ≥1 follow-up phone call regarding outcomes assessment in the following year. Gait speed and 6-minute walk distance (6MWD) were assessed at baseline and immediately after 12-week interventions to determine mobility performance change status. Falls, emergency department (ED) visits, and hospitalizations were assessed monthly for 12 months following the end of interventions via interactive voice response phone calls. Incident rate ratios (IRRs) were calculated to quantify incidence of adverse outcomes with respect to mobility performance change.
Each 0.05 m/s increase in gait speed resulted in an 11% reduction in falls (IRR = 0.89; 95% confidence interval [CI], 0.84-0.94; p < .0001); a similar decrease was seen for each 20 m increase in 6MWD (IRR = 0.89; 95% CI, 0.83-0.93; p = .0003). Those who improved gait speed had 61 falls per 1,000 person-months versus 135 in those who had no change/a decline. Those who improved 6MWD had 67 falls per 1,000 person-months versus 110 per 1,000 person-months in those who had no change/a decline. Differences in ED visits and hospitalizations were not statistically significant.
Improvements in mobility performance are associated with lower incidence of future falls. Given the exploratory nature of the findings, further investigation is warranted.
我们通过对一项群组随机对照运动试验的二次数据分析,研究了老年人移动能力改善与远端健康结果之间的关联。
参与研究的是 32 个独立生活设施、老年公寓和社区中心的 303 名年龄在 65 岁及以上的男性和女性,他们参加了为期 12 周的小组运动干预。包括在接下来的一年中完成了至少 1 次关于结果评估的随访电话的参与者。在基线和 12 周干预后立即评估步态速度和 6 分钟步行距离(6MWD),以确定移动性能变化状态。通过交互式语音应答电话,在干预结束后 12 个月内每月评估跌倒、急诊部(ED)就诊和住院情况。为了量化移动性能变化与不良结果的发生率,计算了发生率比(IRR)。
步态速度每增加 0.05m/s,跌倒发生率降低 11%(IRR=0.89;95%置信区间[CI],0.84-0.94;p<0.0001);6MWD 每增加 20m 也观察到类似的下降(IRR=0.89;95%CI,0.83-0.93;p=0.0003)。步态速度改善的患者每 1000 人月有 61 例跌倒,而无变化/下降的患者有 135 例跌倒。6MWD 改善的患者每 1000 人月有 67 例跌倒,而无变化/下降的患者有 110 例跌倒。ED 就诊和住院的差异没有统计学意义。
移动能力的提高与未来跌倒发生率的降低有关。鉴于研究结果的探索性,需要进一步的调查。