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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Physical disability is associated with increased odds for hospitalization in older adults: analysis from NHANES
Guilherme Porto1, Saulo Gil2, Eduardo Ferriolli1
1Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Background:
Physical disability significantly impacts health outcomes and is linked to higher mortality in older adults. However, research on its association with hospitalization rates remains limited.
Objective:
To assess whether physical disability is a predictive measure of hospitalization (yes/no) in older individuals. Additionally, we tested whether physical disability predicts the frequency of hospitalizations (≤ 3 or >3).
Methods:
This is a cross-sectional analysis of a dataset from the National Health and Nutrition Examination Survey (NHANES). We analyzed data from 2009-2018 from participants older than 65 years. Hospitalization status was determined using the Hospital Utilization and Access to Care questionnaire. Physical disability was assessed (yes/no) with the 4-item physical functioning questionnaire during an in-home interview to assess the participant's level of physical disability. The questionnaire asked about difficulty in walking from room to room (on the same level), standing up from an armless chair, eating, and dressing. Multivariable logistic regression model adjusted for age, sex, race/ethnicity, number of medications, number of comorbidities, and poverty index was used.
Results:
A total of 4346 participants met our inclusion criteria. The adjusted logistic regression model revealed that older adults with physical disability have greater odds to be hospitalized than those without physical disability (adjusted odds ratio [OR]: 2.13; 95% confidence interval [CI]: 1.74, 2.62). Secondary analysis also showed that older people with physical disability have greater odds to have 4 or more hospitalizations in one year in comparison with older adults who do not show physical disability (adjusted OR: 5.81; 95% CI: 2.40, 14.05).
Conclusion:
The results reveal that physical disability is strongly associated with higher odds of hospitalization among older individuals. These data reinforce the importance of health policies and programs to prevent physical disability in this population.
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