Acute hospital care of the elderly: minimizing the risk of functional decline

Between 25% and 60% of older patients in the hospital undergoing care for an acute illness risk some loss of independent physical function. This loss may lead to prolonged hospital stay, nursing-home placement, or death. The risk of functional decline is related to the hospital environment, as well as to the physical frailty of the patient, disease severity, and cognitive impairment. An interdisciplinary approach may prevent functional decline. The aim is to modify the physical environment, prevent iatrogenic illness, detect and treat functional impairments, promote mobility, assess and treat nutritional problems, and address the patient's personal needs and values.