Related Experiment Video
Updated: Oct 13, 2025
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study
Tomohiro Hosoda1, Shota Hamada2,3,4
1Department of Infectious Disease, Kawasaki Municipal Kawasaki Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, 210-0013, Japan. ottotto723@gmail.com.
Insights
Over half of hospitalized older patients experienced functional decline after COVID-19 recovery. Female sex, pre-existing limitations, and high D-dimer levels increased this risk.
Area of Science:
- Gerontology
- Infectious Diseases
- Clinical Medicine
Background:
- Hospitalized older patients with coronavirus disease 2019 (COVID-19) face risks of functional decline.
- Understanding the frequency and predictors of this decline is crucial for geriatric care and post-COVID-19 recovery strategies.
Purpose of the Study:
- To determine the incidence of functional decline in older adults hospitalized with COVID-19.
- To identify demographic and clinical factors associated with an increased risk of functional decline.
Main Methods:
- Retrospective review of medical records for patients aged over 65 admitted for COVID-19.
- Functional decline defined as a decrease in Barthel Index score from pre-COVID-19 to discharge.
- Multivariable logistic regression used to identify risk factors; sensitivity analyses performed.
Main Results:
- 72 out of 132 (54.5%) older patients developed functional decline post-COVID-19.
- Significant risk factors included female sex (aOR 3.14), pre-COVID-19 Barthel Index < 100 (aOR 13.73), and elevated D-dimer on admission (aOR 3.19).
- COVID-19 severity did not significantly differ between groups.
Conclusions:
- More than half of older patients experience functional decline after hospitalization for COVID-19.
- Baseline functional status, female sex, and elevated D-dimer levels are key predictors of decline.
- These findings highlight the need for targeted interventions to mitigate functional loss in this vulnerable population.
Background:
This study aimed to determine the frequency of functional decline and to identify the factors related to a greater risk of functional decline among hospitalized older patients with coronavirus disease 2019 (COVID-19).
Methods:
We reviewed the medical records of patients aged over 65 years who were admitted to a tertiary care hospital for COVID-19 over 1 year from February 2020. We evaluated the proportion of functional decline, which was defined as a decrease in the Barthel Index score from before the onset of COVID-19 to discharge. Multivariable logistic regression analyses were performed to evaluate the associations between the demographic and clinical characteristics of patients at admission and a greater risk of functional decline. Two sensitivity analyses with different inclusion criteria were performed: one in patients without very severe functional decline before the onset of COVID-19 (i.e., limited to those with Barthel Index score ≥ 25), and the other with a composite outcome of functional decline and death at discharge.
Results:
The study included 132 patients with COVID-19; of these, 72 (54.5%) developed functional decline. The severity of COVID-19 did not differ between patients with functional decline and those without (P = 0.698). Factors associated with a greater risk of functional decline included female sex (adjusted odds ratio [aOR], 3.14; 95% confidence interval [CI], 1.25 to 7.94), Barthel Index score < 100 before the onset of COVID-19 (aOR, 13.73; 95% CI, 3.29 to 57.25), and elevation of plasma D-dimer level on admission (aOR, 3.19; 95% CI, 1.12 to 9.07). The sensitivity analyses yielded similar results to those of the main analysis.
Conclusions:
Over half of the older patients who recovered from COVID-19 developed functional decline at discharge from a tertiary care hospital in Japan. Baseline activities of daily living impairment, female sex, and elevated plasma D-dimer levels at admission were associated with a greater risk of functional decline.
More Related Videos
05:53Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
05:16Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Related Concept Videos
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
01:15Drug Dosing: Geriatric Patients
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption