Hospitalized older adult: predictors of functional decline

Abstract

Objective: to identify the predictors of functional decline in hospitalized individuals aged 70 or over, between: baseline and discharge; discharge and follow-up, and baseline and three-month follow-up. Method: a prospective cohort study conducted in internal medicine services. A questionnaire was applied (clinical and demographic variables, and predictors of functional decline) at three moments. The predictors were determined using the binary logistic regression model. Results: the sample included 101 patients, 53.3% female, mean age of 82.47 ± 6.57 years old. The predictors that most contributed to decline in hospitalization were the following: previous hospitalization (OR=1.8), access to social support (OR=4.86), cognitive deficit (OR=6.35), mechanical restraint (OR=7.82), and not having a partner (OR=4.34). Age (OR=1.18) and medical diagnosis (OR=0.10) were the predictors between discharge and follow-up. Being older, delirium during hospitalization (OR=5.92), and presenting risk of functional decline (OR=5.53) were predictors of decline between the baseline and follow-up. Conclusion: the most relevant predictors were age, previous hospitalization, cognitive deficit, restraint, social support, not having a partner, and delirium. Carrying out interventions aimed at minimizing the impact of these predictors can be an important contribution in the prevention of functional decline.

The Role of Frailty in Predicting 3 and 6 Months Functional Decline in Hospitalized Older Adults: Findings from a Secondary Analysis

“…The results confirm, in part, our hypotheses that functional decline post-hospitalization can be predicted by frailty. In the univariable model, frailty was a predictor for functional decline at all timepoints alongside with other factors previously reported in other studies of functional decline, such as, being female, unmarried status, higher age, lower social support and previous hospitalization [29][30][31]. However, after adjustment for co-variates, frailty continued to be a significant predictor of risk for functional decline at discharge (OR = 1.07) and 3-month follow-up (OR = 1.05).…”

Validation of Screening Tools for Predicting the Risk of Functional Decline in Hospitalized Elderly Patients

“…The aforementioned studies showed that the proportion of functional decline 30 days after discharge may be higher than that at 3 months after discharge. Functional changes among the hospitalized elderly is a dynamic process that may continue to occur from admission to discharge [ 29 , 30 , 31 ]. Therefore, it is very important to identify a tool that can predict functional decline within 30 days of discharge for early intervention programs to reverse the progression of functional decline.…”

Nursing in face of (I) mobility of hospitalized elderly people: Study of social representations

“…Durante a hospitalização de pessoas idosas, o declínio funcional é um evento frequente e que necessita prevenção (Tavares et al, 2021;Carvalho et al, 2018). Estudo mostrou que ao menos 34% destas pessoas perdem a sua independência, como consequência não intencional da permanência hospitalar Valenzuela et al, 2018).…”

“…Entre os motivos para a baixa mobilidade de pessoas idosas hospitalizadas, destacam-se: a prescrição de repouso no leito, a polifarmácia, o uso de drogas psicotrópicas e de dispositivos, a má nutrição, o medo de quedas, a incapacidade da pessoa idosa, algias, além de aspectos relacionados a própria infraestrutura hospitalar, recursos humanos e materiais inadequados (Dermody et al, 2018;Resnick & Boltz., 2019;Tavares et al, 2021;Kirk et al, 2019).…”