Trajectories of Community Mobility Recovery After Hospitalization in Older Adults

Abstract

Objectives: To identify trajectories of recovery of community mobility in acutely ill older adults using the University of Alabama at Birmingham Life-Space Assessment (LSA). Design: Prospective observation cohort study. Setting: Central Alabama, Birmingham Veterans Affairs Medical Center. Participants: Community-dwelling adults aged 65 and older hospitalized for nonsurgical medical reasons (N=173). Measurements: We determined LSA scores for the month before and monthly for 6 months after hospitalization (composite scores ranging from 0–120, with 120 reflecting completely unrestricted mobility). Results: In the month after hospitalization, 92 (53%) participants had a clinically significant decrease in life-space mobility, while 42 (24%) were unchanged, and 39 (23%) had an increase from the month preceding hospitalization. Of participants with a life-space decrease, the majority recovered their prehospitalization mobility status during 6 months of follow-up, whereas 34% did not recover. Participants whose life-space decreased were hospitalized significantly longer (P=.01) and, on average, had higher prehospital life-space scores (P=.01) than those who maintained or increased their life-space. Conclusion: A clinically significant loss of community mobility was common after hospitalization, but most participants recovered to prehospitalization mobility within 6 months of discharge. Research examining in-hospital and posthospitalization interventions to achieve faster recovery of community mobility is needed.