Many Paths to Recovery: Comparing Basic Function and Participation in High-Functioning Older Adults After Acute...

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Health Outcomes Research

Background:

• Functional recovery after hospitalization is typically assessed using Basic Activities of Daily Living (BADL), which may not fully capture post-discharge functional status.
• Participation, encompassing instrumental, social, and recreational activities, is vital for older adults' quality of life and health post-hospitalization.
• High-functioning older adults may exhibit preserved BADL despite substantial losses in broader participation.

Purpose of the Study:

• To compare the assessment of Basic Activities of Daily Living (BADL) with the assessment of participation in high-functioning older adults following acute hospitalization.
• To examine functional recovery trajectories at one and three months post-discharge in relation to pre-hospitalization levels.
• To determine if participation is a more sensitive measure of functional change than BADL in this demographic.

Main Methods:

• Quantitative study involving 72 hospitalized older adults (65-74 years and ≥75 years).
• Functional status assessed using BADL and participation measures at one month (home visits) and three months (telephone interviews) post-discharge.
• Comparison of functional changes with pre-hospitalization baseline data.

Main Results:

• Both age groups showed a significantly greater decline in participation compared to BADL.
• Basic Activities of Daily Living (BADL) were largely preserved across both groups.
• Participation decline was evident at one month and persisted at three months post-discharge.

Conclusions:

• A comprehensive assessment of participation provides a better understanding of functional changes in high-functioning older adults after hospitalization.
• Early identification of withdrawal from participation is critical for implementing interventions to prevent disability.
• Focusing solely on BADL may underestimate the functional impact of hospitalization on older adults.