Impaired mobility in older persons attending a geriatric assessment clinic: causes and management.
OBJECTIVE
To study the profile of older persons with impaired mobility.


METHODS
A retrospective observational study that reviewed the case records of patients with impaired mobility at a geriatric assessment clinic. Data on mobility status, duration of decline in mobility, functional status, causes, intervention and short-term outcome (up to 16 weeks) were extracted and analysed.


RESULTS
The study included 78 patients (42 males) with the median age of 78 years (61 to 96). About 80% had independent premorbid mobility. At presentation, this declined to 45%. Delayed consultations (more than 2 years) were found in 17% of patients. One third had associated decline in transfer, dressing, toileting or bathing, while 19% also had decline in feeding. In each patient, cause(s), many which were potentially reversible, were identified to have contributed to the immobility. More than one cause was identified in half of the patients. Interventions were prescribed in 88% of these patients. Short-term follow-up (median 7 weeks) showed that 21 had an improvement, 35 had the same and 8 had decline in mobility. There was a significant trend towards better outcome when patient presented early during their course of decline in mobility (p=0.005, linear by linear association = 0.013).


CONCLUSIONS
Impaired mobility is a common pathway for many diseases, and is associated with significant functional decline. With proper evaluation, the offending causes can be identified. Early consultation is important for the application of appropriate intervention and can result in better outcome.
Tan
T L
TL
Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore. thai_lian_tan@notes.ttsh.gov.sg
Ding
Y Y
YY
Lee
A
A
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010044:Outpatient Clinics, Hospital; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking