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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
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Published on: September 30, 2020

Functional decline two weeks before hospitalization in an elderly population.

Gianluca Isaia1, Mario Bo, Nicoletta Aimonino

  • 1Department of Medicine and Surgery, University of Torino,10126 Torino, Italy. gianlucaisaia@yahoo.it

Aging Clinical and Experimental Research
|December 1, 2010
PubMed
Summary
This summary is machine-generated.

Functional decline in elderly patients before hospitalization predicts worse outcomes and need for long-term care. Early rehabilitation programs may improve prognosis for older adults.

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Area of Science:

  • Geriatric Medicine
  • Internal Medicine
  • Rehabilitation Medicine

Background:

  • Hospital care utilization significantly increases with age.
  • Elderly patients have higher hospitalization rates and face risks like loss of independence.
  • Hospitalization can necessitate long-term care upon discharge.

Purpose of the Study:

  • To investigate the impact of pre-hospitalization functional status on elderly patients' outcomes.
  • To identify factors associated with functional decline during hospitalization and discharge destination.
  • To highlight the potential benefits of early rehabilitation interventions for geriatric patients.

Main Methods:

  • Prospective observational study of 123 elderly patients admitted to a Geriatric Medicine department.
  • Data collected on functional status (Activities of Daily Living - ADL, Instrumental ADL - IADL) two weeks prior to admission.
  • Analysis of associations between pre-admission functional decline and in-hospital functional worsening or discharge to long-term care.

Main Results:

  • Pre-admission dependence affected ADL functions like bathing, toileting, and dressing.
  • Loss of IADL functions such as shopping and transportation was common in dependent patients.
  • Functional decline before hospitalization was linked to increased risk of functional worsening during stay (RR 2.2) and discharge to long-term facilities (RR 2.1).

Conclusions:

  • Pre-hospitalization functional decline significantly influences hospital discharge and functional outcomes in the elderly.
  • Evaluating early, dedicated rehabilitation programs for elderly patients is warranted.
  • Multidisciplinary programs involving geriatricians, physiatricians, and physiotherapists may improve short-term prognoses.