INVESTIGATING GAIT AND COGNITION IN ELDERLY COPD PATIENTS HOSPITALISED WITH AN ACUTE EXACERBATION

Abstract Ref: 
0109

Gavin Bennett1, Breda Cushen2, Isabelle Killane1,2, Fiachra Maguire1, Richard W Costello2, Richard B Reilly1

1Trinity Centre for Bioengineering, Trinity Biomedical Sciences Institute, Trinity College, University of Dublin, Dublin, Ireland. 2Clinical Research Centre, Smurfit Building Beaumont Hospital, Royal College of Surgeons Ireland, Dublin, Ireland

Background: With advancing age, Chronic Obstructive Pulmonary Disease (COPD)
can place an individual at greater risk of reduced participation in society and mortality
(1). Survival in older adults increases with gait speed but little is known about gait in
COPD (2). The objective of this study was to monitor gait of patients admitted to hospital
with an acute exacerbation of COPD (AECOPD), their cognitive performance and
to examine the relationships with clinical improvement.
Methods: Gait speed was acquired in 29 patients admitted to hospital with an
AECOPD, with a mean age of 71.6 ±8.1 years. Gait speed was acquired employing the
4-metre gait speed test on day 1 of hospitalisation, day of hospital discharge and at
30 days follow-up. Montreal Cognitive assessment (MOCA) scores were recorded on day
of admission. Linear regression was performed to assess correlations and between-group
differences were assessed using student t-tests.
Results: Gait speed improved significantly from day 1 of hospitalisation (0.69 ±0.29 ms-
1) to follow-up at day 30 (1.01 ±0.31 ms-1) (p = 0.0031). Slower gait speeds on day 1 of
hospitalisation were significantly correlated with longer durations of hospital stay (p =
0.0014). There was no significant correlation between gait speed and MOCA score.
Conclusions: These results illustrate that gait speed is significantly slower during an
exacerbation at admission to hospital, compared to 30 day follow-up. Furthermore, the
novelty of these results is that gait speed at hospital admission predicts length of hospital
stay. Future work should investigate if objective lung function and gait measures are more
sensitive at predicting changes during hospitalisation and at 30 day follow-up.
 

References:
1. Gooneratne NS, Patel NP, Corcoran A. Chronic obstructive pulmonary disease diagnosis
and management in older adults. JAGS 2010; 58(6):1153–62.
2. Studenski S, Perera S, Patel K et al. Gait Speed and Survival in Older Adults. JAMA
2011; 305(1):50–8.