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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
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Performance-based functional impairment and readmission and death: a prospective study.

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Functional impairment in older adults after hospital discharge predicts mortality but not readmission. Simple functional tests can help assess death risk post-hospitalization.

Keywords:
Timed Up and Go testdeathfunctional statusreadmission

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Area of Science:

  • Gerontology
  • Internal Medicine
  • Rehabilitation Medicine

Background:

  • Hospital readmission and mortality are significant concerns for older adults post-discharge.
  • Predicting these outcomes remains challenging, with limited focus on functional status.

Purpose of the Study:

  • To determine if functional impairment at discharge predicts readmission and death in older adults after acute medical hospitalization.

Main Methods:

  • Prospective study of patients aged 50+ admitted to internal medicine.
  • Functional status assessed using the Timed Up and Go (TUG) test (≥15s cutoff) before discharge.
  • Primary outcomes: unplanned readmission and death within 6 months.

Main Results:

  • 31.7% experienced readmission; 9.2% died within 6 months.
  • Functional impairment was linked to a higher risk of death (OR 2.44).
  • No significant association found between functional impairment and unplanned readmission.

Conclusions:

  • Functional impairment at discharge is a significant predictor of mortality in older adults.
  • Performance-based functional assessment may be a more reliable prognostic tool for mortality than for readmission.