PURPOSE: To define the events surrounding mobility change in frail ambulatory elderly. METHODS: We retrospectively studied a cohort of 87 ambulatory residents of a chronic care hospital. Demographic data, medication, chronic condition, the Charlson Comorbidity Index(CCI), and ADLs were recorded. Mobility change was measured by the Timed Up & Go Test(TUGT) at baseline in July 1993 and follow-up in July 1996. This study determined the outcome status(dead, mon-ambulatory, ambulatory) and determined the reasons for ambulatory decline in individual subjects. RESULTS: During this period 31(36%) expired; 16(18%) became nonambulatory(wheel-chair dependent or bed-ridden) and 40(46%) remained ambulatory. Of those remaining ambulatory, TUGT performance was maintained in 26(30%), declined by 2X in 10(11%) and 4(5%) could not follow the test due to mental or behavioral problems. In the 16 nobambulatory subjects, 5(31%) lost mobility after an acute event, 11(69%) lost their mobility by slow decline. Factors associated with becoming nonambulatory include baseline CCI(p=0.01), frequency of medication change(p=0.009) and falls(p=0.004). CONCLUSION: CCI, medication change and falls were found to be associated with loss in mobility. The identification of risk factors for mobility change may be useful to target preventive measure.
Activities of Daily Living ; Aged* ; Cohort Studies ; Comorbidity ; Follow-Up Studies ; Frail Elderly ; Humans ; Nursing Homes* ; Nursing* ; Retrospective Studies ; Risk Factors