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Hospitalization associated with functional impairment in older adults

Hospitalization, especially critical illness hospitalization, is a risk factor for persistent functional impairment in older adults, according to data published in the Journal of the American Geriatrics Society.

William J. Ehlenbach , MD, MS c, division of pulmonary and critical care medicine, department of medicine, School of Medicine and Public Health, University of Wisconsin, and colleagues analyzed the data of 2,926 participants enrolled in the Adult Changes in Thought (ACT) study. The ACT study was a prospective, population-based, longitudinal study of aging and dementia that included participants aged 65 and older.

The researchers assessed grip strength, gait speed and chair stand speed as well as dependence and difficulty in performing activities of daily living to identify any associations between hospitalizations and physical function. Ehlenbach and colleagues stated that the median time between hospital discharge and following study visit was 311 days (interquartile range [IQR] 151-501 days) for acute care hospitalizations and 359 days (IQR 181-420 days) for critical illness hospitalizations.

Results showed that grip strength was weaker after acute care hospitalization (–0.8 kg; 95% CI, –1.0 to –0.6; P < .001) and critical illness hospitalization (–1.2 kg; 95% CI, –2.5 to –0.2; P = .047). Gait speed was slower after acute care hospitalization (–0.05 m/s; 95% CI, 0.01-0.04 m/s slower; P < .001) and critical illness hospitalization (–0.16 m/s; 95% CI, –0.1 to –0.22 m/s; P < .001). Additionally, chair stand speed was slower after acute care hospitalization (–0.04 stands/s; 95% CI, –0.05 to –0.04; P < .001) and critical illness hospitalization (–0.09 stands/s; 95% CI; –0.15 to –0.03; P = .003).

Ehlenbach and colleagues also reported that odds of dependence in (OR = 2; 95% CI, 1.2-3.2, P = .006) or difficulty with (OR = 1.4; 95% CI, 1.2-1.6, P < .001) at least one activity of daily living increased after acute care hospitalization. Odds of dependence in (OR = 7.9, 95% CI = 2.5-25.7, P = .001) or difficult with (OR = 1.9, 95% CI = 1.1-3.6, P = .03) at least one activity of daily living increased after critical illness hospitalization as well.

"This information underscores the importance of studying in-hospital interventions aimed at maintaining physical function, such as early mobility programs for critically ill individuals, as well as posthospitalization interventions, such as rehabilitation programs," Ehlenbach and colleagues wrote. "It also alerts primary care physicians who care for individuals after hospitalization to pay particular attention to declines in physical function and development of new disability." – by Chelsea Frajerman Pardes

Disclosures: The authors report no relevant financial disclosures.