Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy.
BMC Geriatr. 2022 Aug 13;22(1):668. doi: 10.1186/s12877-022-03358-z.
Mobility deficits are highly prevalent among geriatric patients and have serious impact on quality of life, hospitalizations, and mortality. This study aims to capture predictors of mobility deficits in hospitalized geriatric patients using the International Classification of Functioning, Disability and Health (ICF) model as a framework.
Data were obtained from n = 397 patients (78 ± 7 years, 15 ± 7 ICD-11 diagnoses) on a geriatric ward at time of admission. Mobility was assessed using the Short Physical Performance Battery (SPPB) total score and gait, static balance and transfer subscores. Parameters from an extensive assessment including medical history, neuropsychological and motor examination, and questionnaires were assigned to the five components of the ICF model. Spearman's Correlation and multiple linear regression analyses were calculated to identify predictors for the SPPB total score and subscores.
Use of walking aid, fear of falling (FOF, but not occurrence of previous falls), participation in society, ADL and grip strength were strongly associated with the SPPB total score and all subscores (p < .001). FOF and grip strength were significant predictors for the SPPB total score as well as for gait and transfer subscores. FOF also showed a strong association with the static balance subscore. The clinical parameters of the ICF model could only partially explain the variance in the SPPB total score (24%) and subscores (12-23%), with no parameter from the activities and participation component being significantly predictive.
FOF and reduced grip strength are associated with mobility deficits in a hospitalized geriatric cohort. Further research should focus on interventions to reduce FOF and increase muscle strength in geriatric patients. Moreover, there is a need for ICF-based assessments instruments (especially in the activities and participation components) that allow a holistic view on mobility and further daily life-relevant health aspects in geriatric patients.
行动障碍在老年患者中非常普遍，对生活质量、住院和死亡率都有严重影响。本研究旨在使用国际功能、残疾和健康分类（ICF）模型作为框架，捕捉住院老年患者行动障碍的预测因素。
研究数据来自老年病房 n=397 名患者（78±7 岁，15±7 个 ICD-11 诊断）入院时的情况。使用简短体能表现电池（SPPB）总评分以及步态、静态平衡和转移子评分来评估行动能力。参数来自包括病史、神经心理学和运动检查以及问卷的广泛评估，分配给 ICF 模型的五个组件。使用 Spearman 相关和多元线性回归分析来确定 SPPB 总评分和子评分的预测因素。
使用助行器、对跌倒的恐惧（FOF，但不包括以前跌倒的发生）、参与社会、ADL 和握力与 SPPB 总评分和所有子评分高度相关（p<0.001）。FOF 和握力是 SPPB 总评分以及步态和转移子评分的重要预测因素。FOF 与静态平衡子评分也有很强的关联。ICF 模型的临床参数只能部分解释 SPPB 总评分（24%）和子评分（12-23%）的差异，活动和参与成分的参数没有一个具有显著的预测性。
FOF 和握力下降与住院老年患者的行动障碍有关。进一步的研究应集中于减少 FOF 和增加老年患者肌肉力量的干预措施。此外，需要基于 ICF 的评估工具（特别是在活动和参与成分），以全面了解老年患者的行动能力和进一步与日常生活相关的健康方面。
