Relationship between Hospitalization-Associated Disability and Functional Recovery.

Area of Science:

• Geriatric Medicine
• Rehabilitation Medicine
• Hospital Medicine

Background:

• Hospitalization-associated disability (HAD) is a significant concern for geriatric patients.
• Functional decline during hospitalization impacts recovery and long-term outcomes in older adults.
• Understanding factors influencing HAD is crucial for developing effective interventions.

Purpose of the Study:

• To investigate the relationship between the timing of functional recovery milestones and hospitalization-associated disability (HAD).
• To identify specific functional milestones that predict the development of HAD in geriatric patients.
• To explore the association between delayed initiation of mobility and HAD in older hospitalized individuals.

Main Methods:

• Retrospective cohort study of 195 geriatric patients (≥70 years) admitted for acute medical conditions.
• HAD defined as a ≥5-point decline in Barthel Index from baseline 2 weeks prior to admission.
• Examined the relationship between HAD and days to initiation of sitting, wheelchair transfer, and ambulation.

Main Results:

• HAD occurred in 34.4% of patients, with significant delays in mobility initiation.
• Delayed wheelchair transfer and ambulation initiation were independently associated with HAD.
• Timing of ambulation initiation showed moderate predictive ability for HAD (AUC=0.741).

Conclusions:

• Delayed wheelchair transfer and ambulation initiation increase the risk of HAD in older hospitalized patients.
• Early initiation of ambulation may be a critical target for preventing HAD.
• Interventions focusing on early mobility could mitigate disability in geriatric hospital populations.