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Transitions in Functional Status and Frailty Among Post-Hospitalized COVID-19 Oldest-Old Adults: An 18-Month
Rafael Saavedra-Palacios1, Alejandro Álvarez-Bustos2, Lucía Furones-Fernández3
1Geriatrics Department, Hospital del Río, Av. 24 de Mayo, Cuenca 010150, Ecuador.
Journal of Clinical Medicine
|January 10, 2026
Summary
Older adults discharged after COVID-19 showed varied recovery patterns. Baseline frailty, functional status, and longer hospital stays predicted worsening physical function and frailty over 18 months.
Area of Science:
- Gerontology
- Infectious Diseases
- Rehabilitation Medicine
Background:
- Older adults are vulnerable to severe outcomes following COVID-19 hospitalization.
- Post-hospitalization recovery trajectories for physical function and frailty in this demographic remain incompletely understood.
Purpose of the Study:
- To analyze physical function and frailty transitions in older adults post-COVID-19 discharge.
- To identify risk factors associated with these functional and frailty changes over 18 months.
Main Methods:
- Observational, longitudinal study of COVID-19 survivors aged ≥80 years.
- Assessed physical function (Barthel Index, Functional Ambulation Category) and frailty (FRAIL scale) at baseline, 1, 12, and 18 months post-discharge.
- Evaluated clinical, sociodemographic, and functional parameters as covariates.
Main Results:
- Three patterns of change were identified: no change, improvement, and worsening.
- Worse baseline frailty and longer hospital stay predicted increased frailty impairment.
- Older age, longer hospital stay, and poorer baseline physical function and frailty scores predicted physical status decline at 18 months.
Conclusions:
- Distinct patterns of functional and frailty changes exist in older adults after COVID-19.
- Baseline health status (frailty, physical function) and hospital length of stay are key predictors of long-term outcomes.
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