Physical performance measures and hospital outcomes among Italian older adults: results from the CRIME project

Background: Older adults are a complex population, at risk of adverse events during and after hospital stay. Aim: To investigate the association of walking speed (WS) and grip strength (GS) with adverse outcomes, during and after hospitalization, among older individuals admitted to acute care wards. Methods: Multicentre observational study including 1123 adults aged ≥ 65 years admitted to acute wards in Italy. WS and GS were measured at admission and discharge. Outcomes were length-of-stay, in-hospital mortality, 1-year mortality and rehospitalisation. Length-of-stay was defined as a number of days from admission to discharge/death. Results: Mean age was 81 ± 7 years, 56% were women. Compared to patients with WS ≥ 0.8 m/sec, those unable to perform or with WS < 0.8 m/sec had a higher likelihood of longer length-of-stay (OR 2.57; 95% CI 1.63–4.03 and 2.42; 95% CI 1.55–3.79) and 1-year mortality and rehospitalization (OR 1.47, 95% CI 1.07–2.01; OR 1.57, 95% CI 1.04–2.37); those unable to perform WS had a higher likelihood of in-hospital mortality (OR 9.59; 95% CI 1.23–14.57) and 1-year mortality (OR 2.60; 95% CI 1.37–4.93). Compared to good GS performers, those unable to perform had a higher likelihood of in-hospital mortality (OR 17.43; 95% CI 3.87–28.46), 1-year mortality (OR 3.14; 95% CI 1.37–4.93) and combination of 1-year mortality and rehospitalisation (OR 1.46; 95% CI 1.01–2.12); poor GS performers had a higher likelihood of 1-year mortality (OR 1.39; 95% CI 1.03–2.35); participants unable to perform GS had a lower likelihood of rehospitalisation (OR 0.59; 95% CI 0.39–0.89). Conclusion: Walking speed (WS) and grip strength (GS) are easy-to-assess predictors of length-of-stay, in-hospital and post-discharge death and should be incorporated in the standard assessment of hospitalized patients.