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Updated: Jul 25, 2025
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Intrinsic capacity in acutely hospitalized older adults
Masaaki Nagae1, Hiroyuki Umegaki2, Hitoshi Komiya2
1Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan; Department of Emergency Room and General Medicine, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.
Objectives:
We aimed to examine the association between intrinsic capacity (IC) and adverse outcomes of hospitalization.
Design:
A prospective observational cohort study.
Setting And Participants:
We recruited patients aged 65 years or older who were admitted to the geriatric ward of an acute hospital between Oct 2019 and Sep 2022.
Measurements:
Each of the five IC domains (locomotion, cognition, vitality, sensory, and psychological capacity) was graded into three levels, and the composite IC score was calculated (0, lowest; 10, highest). Hospital-related outcomes were defined as in-hospital death, hospital-associated complications (HACs), length of hospital stay, and frequency of discharge to home.
Results:
In total, 296 individuals (mean age 84.7 ± 5.4 years, 42.7 % males) were analyzed. Mean composite IC score was 6.5 ± 1.8, and 95.6 % of participants had impairment in at least one IC domain. A higher composite IC score was independently associated with lower frequency of in-hospital death (odds ratio [OR] 0.59) and HACs (OR 0.71), higher frequency of discharge to home (OR 1.50), and shorter length of hospital stay (β = -0.24, p < 0.01). The locomotion, cognition, and psychological domains were independently associated with the occurrence of HACs, discharge destination, and length of hospital stay.
Conclusion:
Evaluating IC was feasible in the hospital setting and was associated with outcomes of hospitalization. For older inpatients with decreased IC, integrated management may be required to achieve functional independence.
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