Natural History of Functional Decline 1 Year After Hospital Discharge in Nonagenarian Patients

Formiga, Francesç; Mascaró, Joan; Pujol, Ramón; López‐Soto, Alfonso; Masanés, Ferrán; Sacanella, Emilio

doi:10.1046/j.1365-2389.2003.51323.x

Cited by 23 publications

(12 citation statements)

References 9 publications

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“…Although nonagenarians have experienced long lives, at this age they are at risk of becoming frail patients if exposed to an acute illness needing hospitalization [4] . In our geographic area, previous studies of this age group predominantly involved women, who were usually widows.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Functional Decline in Nonagenarians: A One-Year Follow-Up

et al. 2007

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Background: Disability and a decline in functional capacity are common in old age. Objective: To determine predictors of functional decline in nonagenarians’ basic activities of daily living (ADL) after 1 year of follow-up. Methods: A sample of 97 nonagenarians subjects not previously severely dependent (Barthel Index >59) was evaluated. This sample included 72 women (74.2%) and the mean (SD) age was 93.4 ± 2.7 years. The following data were collected: sociodemographic data, Barthel Index (BI), Lawton-Brody Index (LI), Mental State Examination (MEC), a short version of the Mini-Nutritional Assessment, comorbidity (Charlson Index), lower-extremity function, Gait Rating Scale from the Tinetti Performance-Oriented Mobility Scale and prevalent chronic diseases. Subjects who had a 10-point or higher decline in the BI in 1 year were compared to subjects who had no decline or a maximum decline of 9 points. In addition, subjects whose total BI score fell below 60 were compared to the group of subjects who maintained scores between 60 and 100. The Student’s t test, the χ² or the Fisher’s exact test, and a multiple logistic regression analysis (with the identified risk factors of age and gender) were performed. Results: 39 nonagenarians experienced a 10-point or higher decline in the BI in 1 year. A lower LI score (p = 0.003) and visual impairment (p = 0.01) were associated with functional decline. The multiple regression analysis showed that there was a significant association with LI (odds ratio (OR) 0.74, confidence interval 95% 0.60–0.91, p < 0.005). The 18 nonagenarians who had a BI <60 had a BI >60 at baseline. Lower scores on the LI (p = 0.004) and on the MEC (p = 0.01), a history of a previous stroke (p = 0.009) and higher Charlson Index scores (p = 0.03) were associated with recently acquired, severe dependency. A multiple regression analysis showed a significant association between LI (OR 0.65, 0.47–0.89, p < 0.008) and a history of previous strokes (OR 3.39, 1.01–11.34, p < 0.04). Conclusions: According to the definition used to describe functional basic ADL decline, poor performance in instrumental ADL at baseline and a history of a stroke appear to be independent risk factors. Prevention strategies could be intensified in this subgroup of nonagenarians.

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Section: Introductionmentioning

confidence: 99%

“…In our geographic area, previous studies of this age group predominantly involved women, who were usually widows. In addition, a large proportion of these subjects were functionally independent [4,5] . Being male and having lower comorbidity has been associated with more successful aging in nonagenarians [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Functional Decline in Nonagenarians: A One-Year Follow-Up

et al. 2007

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“…Relative to younger patients on an RU, they seem to have very different and special issues related to disposition and community reintegration. 13 Those patients with hip or femur fractures a P Ͻ 0.05-differences between age groups. b P Ͻ 0.001-differences between age groups.…”

Section: Discussionmentioning

confidence: 99%

Nonagenarians on a Rehabilitation Unit

Kevorkian¹,

Ergeletzis²,

Rintala³

2004

American Journal of Physical Medicine & Rehabilitation

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“…Le déclin fonctionnel est défini comme une diminution des capacités à réaliser les taches de la vie quotidienne pour des raisons physiques, psychiques ou cognitives [8]. Les méthodes de mesure sont hétérogènes, elles s'appuient souvent sur des échelles telles que l'ADL et/ou l'IADL ou encore l'OARS (Older American Ressources and Services) ADL, l'index de Barthel (IB), [9][10][11][12][13] ou la MIF (Mesure de l'Indépendance Fonctionnelle) [14] mais aussi sur des critères indirects tels que l'institutionnalisation, les ré hospitalisations, les décès, voire sur des scores composites utilisant ces mêmes critères. Les points de mesure diffèrent selon les études à la fois pour l'identification du temps 0 et pour les périodes de suivi.…”

Section: Déclin Fonctionnel Lors D'une Hospitalisation Retentissemenunclassified