title: Mobility-related disability three months after aged care rehabilitation can be predicted with a simple tool: an observational study.
abstract: OBJECTIVE
  What is the prevalence of mobility-related disability 3 months after discharge from inpatient aged care rehabilitation? Can a clinical tool predict which individuals will experience mobility-related disability 3 months after discharge?
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  442 patients newly admitted to two large inpatient rehabilitation units.
  
  
  METHODS
  Predictors were co-morbidities; pre-admission mobility; and discharge cognition, pain, vision, muscle strength, and mobility. The outcome of interest was inability to climb a flight of stairs and walk 800 m without assistance.
  
  
  RESULTS
  157 participants (36%) were unable to climb a flight of stairs and walk 800 m without assistance prior to hospital admission. Three months after discharge, 254 participants (59%) were unable to complete both tasks. A simple clinical prediction tool based on pre-admission ability to complete the two tasks, co-morbidity on admission, and pre-discharge measurement of: leaning while standing (Maximal Balance Range test), low-contrast visual acuity, and knee extension strength, had good discrimination (area under the receiver-operating characteristic curve [AUC] = 0.77, 95% CI 0.72 to 0.81, bootstrap adjusted AUC = 0.77) and was well calibrated. This tool provided substantially better (p < 0-001) discrimination than pre-admission ability alone (AUC = 0.64, 95% CI 0.60 to 0.68, bootstrap adjusted AUC = 0.64). The observed risk of persisting disability ranged from 13% in those with no predictors to 93% in those with 5 predictors.
  
  
  CONCLUSIONS
  Mobility-related disability 3 months after discharge from inpatient rehabilitation is common and can be predicted easily with a clinical tool.
authors.affiliation: The George Institute for International Health, Sydney, NSW, 2050, Australia. csherrington@george.org.au
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Jacqueline C T
authors.initials: JC
authors.lastname: Close
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barraclough
authors.forename: Morag
authors.initials: M
authors.lastname: Taylor
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.forename: Robert D
authors.initials: RD
authors.lastname: Herbert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D019370:Observation; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012307:Risk Factors