«Locomotive syndrome» in patients in the geriatric hospital

Abstract

The study aim was to analyze the prevalence and course of locomotive syndrome in patients in the geriatric hospital.Materials and methods. This work was a cross-sectional study performed on the basis of the Moscow War Veterans Hospital N3. The study enrolled 58 patients – 43 women (74.1%) and 15 men (25.9%) hospitalized in the geriatric department of the hospital. The mean age of study patients was 82.7+5.9 years, varying from 75 to 96 years. A comprehensive geriatric assessment was performed, including the Age Is Not a Barrier Questionnaire, the Basic Daily Activity Scale (Bartel Index), the Instrumental Activities of Daily Living (IADL) Scale, and the Morse Falls Scale. Questionnaires were filled out to assess the locomotive syndrome – GLFS‑5 and GLFS‑25. A 2 step test was carried out.Results. In 48 out of 58 patients (82.8%), locomotive syndrome was found: in 88.4% of women and in 66.7% of men (p=0.05). Locomotive syndrome was diagnosed in all centenarians, in 82.7% of patients aged 80 to 89 years and in 75% of patients aged 75–79 years. The main cause of the locomotive syndrome was degenerative-dystrophic changes in the spine and joints observed in all patients. Only 1 patient had stage I locomotive syndrome, all the rest had stage II. Patients with locomotive syndrome had lower levels of activity in everyday life – 84.3±11.2 and 93.0±6.3 points according to the Barthel index, respectively (p=0.01), greater severity of pain syndrome according to VAS – 4.2±1.8 and 1.7±1.6 points, respectively (p=0.003) and a shorter distance of 2 steps (123.3±30.9 and 148.1±20.7 cm, respectively (p=0.003). Direct correlations were established between the values of the GLFS‑5 locomotive function scale and the age of patients (r=0.33; p=0.01), as well as the severity of chronic pain syndrome according to VAS (r=0.55; p=0.00007). Inverse relationships were registered between the indicators of the GLFS‑5 scale and the Barthel index (r= –0.44; p=0.0005), the IADL scale (r= –0.41; p=0.001) and the distance traveled in the «2 steps» test (r= –0.52; p=0.0007). Inverse correlations were observed between the values of the GLFS‑25 scale and the Barthel index (r= –0.41; p=0.008), the IADL scale (r= –0.59; p=0.00008), the Mini-COG test (r= –0.37; p=0.02), as well as indicators of bone mineral density in the proximal femur (r= –0.39; p=0.04 – r= –0.54; p=0.002). Conclusions. The study results indicate that patients in the geriatric hospital very often have locomotive syndrome associated with the pathology of the musculoskeletal system. The severity of the locomotive syndrome correlates with the indicators of the functional activity of patients, the intensity of the pain syndrome and the bone mineral density.