Zisberg A, Shadmi E, Gur-Yaish N, Tonkikh O, Sinoff G
J Am Geriatr Soc 2015;63:55-62
Publication date: January 1, 2015
Hospitalizations often lead to functional loss in older people. There are many factors (e.g. patient characteristics) that may explain this functional decline. Zisberg and colleagues investigated the combined contribution of process of hospitalization and preadmission individual risk factors in explaining functional decline at discharge and at 1-month follow-up in older adults with non-disabling conditions.
The authors used data from 684 older adults aged 70 years and over who were admitted to two Israeli medical centers for a non-disabling condition. Functional decline was measured according to change in modified Barthel Index. Various personal and hospital process risk factors were studied, such as comorbidity, cognitive status, nutritional status, in-hospital mobility, in-hospital continence care and hospital environment. Of the participants, 282 persons (41.2%) reported functional decline at discharge, and 317 persons (46.3%) at one month after discharge. All the included risk factors together explained 64% of functional decline at discharge, and 32% of functional decline at 1 month after discharge.
The conclusion was that in-hospital low mobility, suboptimal continence care, and poor nutrition were the main factors explaining immediate and 1-month post-hospitalization functional decline. These factors are all modifiable, and can be targeted in practice and policy to prevent functional decline after hospitalization.