Mobility during walking and incidence and risk factors for mobility decline among institutionalized older adults: A two-year longitudinal study

Objective: To analyze the trajectory of changes in mobility during walking (i.e., maintenance and recovery) of institutionalized older adults and verify the incidence and risk factors for mobility decline. Methods: A two-year longitudinal prospective study was conducted with 358 participants aged > 60 years and institutionalized in ten nursing homes in Natal-RN (Brazil). Mobility was assessed using the walking item of the Barthel index. Sociodemographic, institution-related, and health-related variables were considered at baseline. Poisson regression was used to build a multiple model. Results: The incidence of mobility decline during walking was 10.6% (95% confidence interval [95% CI] = 7.4 to 13.8) after 12 months and 37.7% (95% CI = 18.0 to 26.6) after 24 months. Age > 83 years (relative risk = 1.58; 95% CI = 1.24 to 2.02; p < 0.001) and hospitalization (relative risk = 3.16; 95% CI = 1.55 to 6.45; p = 0.002) were predictors of mobility decline. The rate of mobility maintenance was 31.8% after 12 months (95% CI = 31.8 to 42.9) and 23.2% after 24 months (95% CI = 26.8 to 38.5). Also, the rate of recovery was 2.5% (95% CI = 1.0 to 5.0) and 1% (95% CI = 0.2 to 2.6) after 12 and 24 months, respectively. Conclusion: The trajectory of mobility during walking of institutionalized older adults in northeastern Brazil was dynamic (i.e., increasing incidence of mobility decline after 24 months) and associated with advanced age and hospitalization. The chances of recovering walking performance are minimal, and maintenance of independent mobility is challenging.

Automated summary

This study analyzed the changes in mobility during walking for institutionalized older adults in northeastern Brazil and found that the incidence of mobility decline increased over time. Advanced age and hospitalization were identified as risk factors for mobility decline. The chances of recovering walking performance were minimal, and maintaining independent mobility was challenging.