Slow gait speed is associated with frailty, activities of daily living and nutritional status in in-patient pulmonology patients

Abstract

Background and aim The 4-meter gait speed (4MGS), a functional performance test, is increasingly used to predict health outcomes. This study investigated 4MGS, nutritional status, frailty, and daily living activities in tertiary care pulmonary diseases ward patients. Methods Patients were assessed for nutritional status, activities of daily living, and frailty using the Mini Nutritional Assessment (MNA) Test, Barthel Questionnaire, and FRAIL scale. Those with 4MGS < 1 m/sec were classified as having slow gait speed. Results 80 patients (F/M: 21/59, mean age 58 +/- 19) were included. Diagnoses included pneumonia, chronic obstructive pulmonary disease, pleural effusion, and interstitial lung disease. Patients had a 4MGS of 0,74 +/- 0,24 m/sn, MNA score of 14.0 [IQR 25-75:11.0-19.8] points, Barthel index of 95 [IQR 25-75:70-100] points, FRAIL scale of 3 [IQR 25-75:1.0-4.0], and a hand-grip strength of 18.8 [IQR 25-75:15.7-25.9] kg. Slow gait speed patients had lower MNA, FRAIL scores, and handgrip strength. Multivariable regression analysis showed that slower gait speed was associated with lower serum protein level (B = 0.013, SE = 0.005, 95% CI: 0.004 to 0.022, p = 0.004), lower hand grip strength (B = -0.002, SE = 0.001, 95% CI: -0.003 to -0.00006, p = 0.041) and malnutrition risk (B = 0.024, SE = 0.007, 95% CI: 0.011 to 0.038, p < 0.001). Discussion and conclusion 4MGS correlates with comorbidities, frailty, grip strength, and nutritional status in hospitalized pulmonary patients. Slow gait patients are more malnourished despite similar age, sex, BMI, and comorbidities.