Objective: To investigate the association of nutritional risk with gait function and activities of daily living (ADLs) in older adult patients with hip fractures. Methods: The retrospective data of older adult patients diagnosed with hip fractures who visited the recovery-phase rehabilitation ward between January 2019 and December 2022 were reviewed. Nutritional risk was evaluated using the Geriatric Nutritional Risk Index; gait function and ADLs were assessed using the modified Harris Hip Score subitem and Functional Independence Measure, respectively. Multivariate linear regression and path analysis with structural equation modeling were used to examine the factors associated with ADLs and the associations among the study variables. Results: This study included 206 participants (172 females and 34 males; mean age, 85.0±7.3 years). In the multivariate analysis, gait function (β=0.488, p<0.001), cognitive function (β=0.430, p<0.001), and surgery (β=-0.143, p<0.001) were identified as independent factors. Pathway analysis revealed that nutritional risk was not directly correlated with ADLs but was directly associated with gait and cognitive functions. Gait and cognitive functions, in turn, were directly related to ADLs. Conclusion Nutritional risk was found to be associated with ADLs through an intermediary of gait and cognitive functions.

Objective：Physical function decline and social frailty are prognostic factors for cardiovascular disease；however, their combined effects remain to be examined. We aimed to investigate the association between post-discharge clinical events and the coexistence of decreased walking speed and social frailty or lack of caregivers in patients with cardiovascular disease.Design：Retrospective cohort study.Patients：Patients aged ≥65 years who participated in inpatient cardiac rehabilitation.Methods：Patients were divided into four groups according to the presence of decreased walking speed (＜1.0 m/sec) and social frailty or lack of caregiver. The association with a composite event risk (mortality or rehospitalization) was evaluated using a multivariate Cox proportional hazards model.Results：This study included 182 patients (median age：75 years). When stratified according to reduced walking speed and social frailty, those with decreased walking speed showed a higher event risk, which further increased with social frailty. When stratified by declining walking speed and lack of caregivers, those with both factors exhibited the highest risk of the event.Conclusion：Decreased walking speed with social frailty or lack of caregivers was associated with a higher poor post-discharge outcome risk. Our findings highlight the importance of adjusting the environment for disease management, including using social resources, when planning rehabilitation interventions after discharge.

Objective：Physical function decline and social frailty are prognostic factors for cardiovascular disease；however, their combined effects remain to be examined. We aimed to investigate the association between post-discharge clinical events and the coexistence of decreased walking speed and social frailty or lack of caregivers in patients with cardiovascular disease.Design：Retrospective cohort study.Patients：Patients aged ≥65 years who participated in inpatient cardiac rehabilitation.Methods：Patients were divided into four groups according to the presence of decreased walking speed (＜1.0 m/sec) and social frailty or lack of caregiver. The association with a composite event risk (mortality or rehospitalization) was evaluated using a multivariate Cox proportional hazards model.Results：This study included 182 patients (median age：75 years). When stratified according to reduced walking speed and social frailty, those with decreased walking speed showed a higher event risk, which further increased with social frailty. When stratified by declining walking speed and lack of caregivers, those with both factors exhibited the highest risk of the event.Conclusion：Decreased walking speed with social frailty or lack of caregivers was associated with a higher poor post-discharge outcome risk. Our findings highlight the importance of adjusting the environment for disease management, including using social resources, when planning rehabilitation interventions after discharge.