Mobility limitation as a predictor of inpatient care in the last year of life among community-living older people.

Background And Aims: Need for inpatient care increases toward the end of life. We studied whether mobility limitation assessed approximately 5.8 years prior to death predicts the number of days in care during the last year of life.

Methods: A population-based, prospective study with interviews conducted, on average, 5.8 years prior to death. Data on vital status and health care use were register-based. Participants consisted of 846 persons who had died between 1989 and 2004 at the age of 66-98 years. Participants were categorized as having mobility limitation if, at baseline, they reported difficulties in walking 2 km or climbing one flight of stairs.

Results: Mean ± standard deviation of age at death for men was 81.6 ± 6.2 years and the median number of days in inpatient care in the last year of life was 38.5 days. For women, the corresponding figures were 84.1 ± 6.1 years and 66.0 days. Only 11% of men and 7% of women had no inpatient care in the last year of life. The adjusted incidence rate ratio for all-cause inpatient care in the last year of life was 1.53 (95% CI 1.09-2.16) among men with mobility limitation compared to those with intact mobility. Among women, mobility limitation did not increase the risk for all-cause inpatient care.

Conclusion: Mobility limitation (vs. intact mobility) at 5.8 years prior to death markedly increases the need of inpatient care in the last year of life among men.