Lower extremity performance in nondisabled older persons as a predictor ofsubsequent hospitalization

Background. This study examines, in initially nondisabled older persons, th e impact of reduced lower extremity performance on subsequent hospitalizati ons. Methods. A 4-year prospective cohort study was conducted among 3381 persons , aged 71 years and older, who initially reported no disability. At baselin e, lower extremity performance was measured by an assessment of standing ba lance, a timed 2.4-m walk, and a timed test of rising from a chair five tim es. Data on subsequent hospital admissions and discharge diagnoses over 4 y ears were obtained from the Medicare database. Results. During the follow-up period, nondisabled persons with poor lower e xtremity performance spent significantly more days in the hospital (17.7 da ys) than those with intermediate and high performance (11.6 and 9.7 days, r espectively). Poor lower extremity performance in nondisabled persons signi ficantly predicted subsequent hospitalization over 4 years (relative risk f or hospitalization in those with poor vs high performance: 1.78; 95% confid ence interval, 1.45-2.17). This increased hospitalization risk could not be explained by several indicators of baseline health status. Increased hospi talization risks were especially found for geriatric conditions, such as de mentia, detubitus ulcer, hip fractures, other fractures, pneumonia, dehydra tion, and acute infections. Conclusions. Even in persons who are currently nondisabled, a simple measur e of lower extremity performance is predictive of subsequent hospitalizatio n, especially for geriatric conditions.