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Physical Function Assessment of Older Veterans With Serious Mental Illness
Julia Browne1, Eric B Elbogen2, Kim T Mueser3
1Research Service, VA Providence Healthcare System, Providence, RI; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI; Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC.
Objective:
To characterize the physical function of older veterans with serious mental illness (SMI) across endurance, strength, and mobility domains.
Design:
Retrospective analysis of clinical performance data.
Setting:
Gerofit program, a national outpatient supervised exercise program for older veterans, delivered in Veterans Health Administration sites.
Participants:
Older veterans aged 60 and older (n = 166 with SMI, n = 1,441 without SMI) enrolled across eight national Gerofit sites between 2010 and 2019.
Measurements:
Performance measures of physical function covering endurance (6-minute walk test), strength (chair stands, arm curls), and mobility (10-m walk, 8-foot-up-and-go), were administered at Gerofit enrollment. Baseline data from these measures were analyzed to characterize the functional profiles of older veterans with SMI. One sample t tests were examined to compare functional performance of older veterans with SMI to age- and sex-based reference scores. Propensity score matching (1:3) and linear mixed effects models were used to evaluate differences in function between veterans with and without SMI.
Results:
Older veterans with SMI performed worse on all measures of function (chair stands, arm curls, 10-m walk, 6-minute walk test, 8-foot-up-and-go) compared to age- and sex-based reference scores with statistically significant differences present in the male sample. Functional performance of those with SMI was also worse compared to propensity-score matched older veterans without SMI with statistically significant differences on chair stands, 6-minute walk test, and 10-m walk.
Conclusion:
Older veterans with SMI have compromised strength, mobility, and endurance. Physical function should be a core component of screening and treatment for this population.
