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Updated: Jun 12, 2026
06:52
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Early In-Hospital Functional Status Predicts Recovery at Discharge in Older Patients Hospitalized for Acute
Yoshiro Tsuruta1, Shuichi Kitada1, Yu Kawada1
1Department of Cardiology, Nagoya City University Graduate School of Medical Sciences Nagoya Japan.
Circulation Reports
|June 11, 2026
Summary
Older adults with acute decompensated heart failure (ADHF) experiencing poor early functional recovery are at higher risk for inadequate outcomes. Advanced age, dementia, and low Barthel Index scores predict poor recovery.
Area of Science:
- Gerontology
- Cardiology
- Rehabilitation Medicine
Background:
- Acute decompensated heart failure (ADHF) significantly impacts functional status in older adults, often leading to frailty and adverse outcomes.
- Identifying predictors of functional recovery is crucial for improving patient management and outcomes in this population.
Purpose of the Study:
- To identify factors associated with inadequate functional recovery during hospitalization for ADHF.
- To evaluate the predictive value of early in-hospital functional status for recovery at discharge.
Main Methods:
- A cohort of 166 patients aged ≥75 years hospitalized for ADHF with pre-admission basic activities of daily living (Barthel Index [BI] ≥70) were enrolled.
- Functional status was assessed weekly using the BI, and multivariable logistic regression identified factors linked to insufficient BI improvement.
- The association between early functional status and post-discharge outcomes (cardiovascular mortality, rehospitalization for heart failure) was analyzed.
Main Results:
- Advanced age (OR 1.11), concomitant dementia (OR 3.17), and a BI <50 one week post-admission (OR 4.94) were significantly associated with inadequate functional recovery (BI <70) at discharge.
- A BI <50 at one week predicted higher cardiovascular mortality and rehospitalization for heart failure post-discharge.
- Early functional status demonstrated predictive power for both in-hospital recovery and long-term outcomes.
Conclusions:
- In older ADHF patients, advanced age, dementia, and poor early functional recovery (BI <50 at 1 week) predict inadequate recovery at discharge.
- Insufficient early functional recovery is linked to adverse post-discharge outcomes, including mortality and rehospitalization.
- Early Barthel Index assessment can aid in risk stratification for functional recovery in elderly heart failure patients.
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