Predictive Factors of Dependency in Activities of Daily Living Following Limb Trauma in the Elderly

Abstract

Background: Traumatic injuries in the elderly often lead to permanent disabilities and long-term treatments that can adversely influence their activities of daily of living (ADL). The effect on ADL is an important outcome in elderly trauma. Objectives: The present study was designed to evaluate the predictive factors of dependency in ADL following limb trauma in elderly referred to Shahid Beheshti Hospital, Kashan, Iran, in 2013. Patients and Methods: This descriptive study was conducted on 200 traumatic patients admitted to the trauma emergency ward of Shahid Beheshti hospital in 2013. The questionnaire used in this study had three parts: demographic data, information related to trauma, and an independence scale of ADL (ISADL). The ISADL was completed in the emergency ward to declare pre-traumatic status; it was also completed one and three months after trauma. Statistical analysis was conducted by the t-test and analysis of variance (ANOVA). The repeated measure was used to study the trend of the ISADL and other demographic variables. The multiple regression analysis was also used to declare the predictive variables related to the ISADL.

Activities of Daily Living and Determinant Factors among Older Adult Subjects with Lower Body Fracture after Discharge from Hospital: A Prospective Study

“…In our study, age was the determinant factor for ADL activities such as bathing, dressing, toileting, continence and feeding. This finding was consistent with two previous studies that showed increasing dependence with age [ 20 , 54 ]. This may be due to the fact that elders usually have many health problems such as musculoskeletal disorders, visual and hearing impairment which deteriorated with age [ 55 ].…”

“…This study focuses on ADL-related assessments among subjects aged 50 years and above and the evaluations are based on the three main phases after a fracture i.e., pre-fracture phase, ward admission phase and the post-discharge phase (3 months after hospital discharge). In this study, the four variables (age, gender, fracture type and ability to walk before fracture) were chosen in accordance with several previous studies that these variables contribute much influence on ADL [ 20 , 25 , 26 , 27 ]. Thus, this study was performed focusing on the Asian population, particularly in Malaysia.…”

“…Although the decline in ADL activity was usually closely related to age factors [ 20 , 25 ], several previous studies including ours, showed that prior to fracture, most older adult could still be categorized as ‘independent’ for most ADL activities [ 20 , 41 ]. For instance, in our study, majority of the subjects were independent in all ADL activities before getting the fractures.…”

“…Some countries may lack comprehensive programme for prevention, treatment, and long-term rehabilitation for older adult trauma patients. Thus, determinant factors for ADL after trauma should be fully understood to ensure proper planning and strategies in the rehabilitation programme [ 20 ].…”

“…Rehabilitation is the cornerstone in efforts to reduce the rates of ambulatory and functional impairment as well as to improve patient’s activities of daily living (ADL) [ 19 ]. While not all patients may experience full recovery of ADL function at hospital discharge, some may experience impaired ADL even months after discharge from the hospital [ 20 ]. Thus, it is important to evaluate the ability of fractured patients to perform ADL, as it may provide information regarding the outcomes of osteoporotic fracture patients after their hospital discharge.…”