Association Between Restricting Symptoms and Disability After Critical Illness Among Older Adults

Area of Science:

• Gerontology
• Critical Care Medicine
• Rehabilitation Science

Background:

• Older adults surviving critical illness face increased disability, impacting independence and quality of life.
• Identifying factors contributing to post-intensive care unit (ICU) disability is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the association between activity-restricting symptoms and increased disability in older adults following ICU hospitalization.
• To determine if the number or presence of restricting symptoms predicts greater functional impairment.

Main Methods:

• Prospective longitudinal study involving community-living adults aged 70 years and older.
• Monthly interviews assessed restricting symptoms and disability (ADLs, IADLs, mobility) for 6 months post-ICU discharge.
• Multivariable Poisson regression models adjusted for pre-ICU disability, frailty, cognitive impairment, mechanical ventilation, and ICU length of stay.

Main Results:

• Each additional restricting symptom was linked to a 5% increase in disability (aRR, 1.05; 95% CI, 1.04-1.06).
• Experiencing two or more restricting symptoms correlated with a 29% greater number of disabilities (aRR, 1.29; 95% CI, 1.22-1.36).
• These associations remained significant after adjusting for known risk factors.

Conclusions:

• Activity-restricting symptoms are independently associated with increased disability in older ICU survivors.
• Targeting and managing these symptoms could be a key strategy to enhance functional recovery.
• Findings highlight the importance of symptom management in the post-ICU care of elderly patients.