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Is functional mobility an independent mortality risk factor in subjects with dementia?

  • Rachid Mahmoudi
    Correspondence
    Corresponding author at: Department of Geriatrics and Internal Medicine, Reims University Hospitals, Maison Blanche Hospital, 45 rue cognacq Jay, 51092 REIMS Cedex, France.
    Affiliations
    Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, F-51092, France

    Department of Geriatrics and Internal Medicine, Reims University Hospitals, Maison Blanche Hospital, Reims, F-51092, France
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  • Jean-Luc Novella
    Affiliations
    Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, F-51092, France

    Department of Geriatrics and Internal Medicine, Reims University Hospitals, Maison Blanche Hospital, Reims, F-51092, France
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  • Patrick Manckoundia
    Affiliations
    Department of Geriatric Rehabilitation, Dijon University Hospitals, Champmaillot Hospital, Dijon, F-21079, France

    Inserm/U1093 Cognition Action Plasticity, University of Burgundy Franche-Comté, Dijon, F-21078, France
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  • Faiza Ahssaini
    Affiliations
    Department of Geriatrics and Internal Medicine, Reims University Hospitals, Maison Blanche Hospital, Reims, F-51092, France
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  • Pierre-Olivier Lang
    Affiliations
    Medicine and Geriatric Rehabilitation Department, Lausanne University Hospitals, Lausanne, CH-1011, Switzerland
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  • François Blanchard
    Affiliations
    Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, F-51092, France

    Department of Geriatrics and Internal Medicine, Reims University Hospitals, Maison Blanche Hospital, Reims, F-51092, France
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  • Damien Jolly
    Affiliations
    Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, F-51092, France

    Department of Research and Public Health, Reims University Hospitals, Robert Debré Hospital, Reims, F-51092, France
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  • Moustapha Dramé
    Affiliations
    Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, F-51092, France

    Department of Research and Public Health, Reims University Hospitals, Robert Debré Hospital, Reims, F-51092, France
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      Highlights

      • Patients with dementia are at higher risk of gait disorders in the short to medium term.
      • This study found a significant relation between functional mobility and risk of 12-month mortality in elderly patients with dementia.
      • It seems advisable to screen for gait disorders early in patients with dementia.

      Abstract

      Objective

      To investigate whether functional mobility is a predictor of 12-month mortality in elderly subjects with dementia.

      Study design

      Prospective multicentre study performed in nine French university hospitals. Patients aged 75 years or more and hospitalised in medical wards via the emergency department were eligible. Those with a diagnosis of dementia were considered in the analyses.

      Main outcome measures

      Patients’ characteristics obtained through comprehensive geriatric assessment performed during the first week of hospitalisation. Functional mobility was assessed using the timed “Up & Go” test. The main outcome was time to death within the 12 months of follow-up. Bivariable relationships between each risk factor and mortality were assessed using a Cox regression model with one explanatory variable. For multivariable analysis, the Cox regression model was used in a stepwise method after examining potential confounders and interactions.

      Results

      In all, 589 patients had a diagnosis of dementia, and were considered in the present analyses. Their mean age was 86 ± 6 years and most (69%) were female. The prevalence of functional mobility disorders was 86%. After 12 months, 232 (39%) had died. After adjustment for potential confounders, functional mobility was associated with a significantly higher risk of 12-month mortality (HR = 1.66; 95% CI = 1.02–2.71; p = 0.04).

      Conclusions

      Impaired functional mobility as assessed by the timed Up & Go test identifies subjects with dementia at risk of unfavourable outcome.

      Keywords

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