Use of an Ambulation Assistive Device Predicts Functional Decline Associated With Hospitalization

Mahoney, Jane; Sager, Mark A.; Jalaluddin, Muhammad

doi:10.1093/gerona/54.2.m83

Cited by 94 publications

(66 citation statements)

References 18 publications

(29 reference statements)

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“…It has been reported that the ability level of movement activity decreases with age, and that it significantly relates to comprehensive ADL ability level [19][20][21] . Lower limb activities representing movement activity are considered to be important assessment tools even in healthy older people.…”

Section: Discussionmentioning

confidence: 99%

“…Dunlop et al 7) , based on longitudinal data, reported that pattern of disability was in the following order: walking, bathing, transferring, dressing, using a toilet and eating, and that probability of having an eating disability was greater when preceded by a decrease in other disabilities in six activities of daily living. Mahoney et al 21) indicated that lower extremity disability was significantly associated with functional decline, and that it is an important predictor of functional loss. This study, based on cross-sectional data, indicated that difficulty ordering of ADL items of dependent older people was similar to the pattern of disability of independent older people, and a significant decrease of ability level in lower limb activities was shown from the 70s group, which was an earlier stage than in other upper limb activities or changing lying posture activities.…”

Section: Discussionmentioning

confidence: 99%

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ADL ability characteristics of partially dependent older people: Gender and age differences in ADL ability

Sato

Demura

Tanaka

et al. 2001

Environ Health Prev Med

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Age and gender differences in ADL ability were investigated using 568 Japanese partially dependent older people (PD, Mean age=82.2± ± ± ±7.76 years) living in welfare institutions. The subjects were asked about 17 ADL items representing 7 ADL domains by the professional staff working at subjects' institutions. Each item was assessed by a dichotomous scale of "possible" or "impossible". Item proportions of "possible" response were calculated for gender and age groups (60s, 70s, 80s and 90s). Two-way analysis of variance (ANOVA) using the arcsine transformation method indicated no gender differences. Significant decreases in ADL ability with aging were found in 13 of the 17 items. The dependency of ADL in the PD significantly increases with aging, and there is no significant difference in this trend between men and women. The dependency of more difficult activities using lower limb increase from the 70s, and independency of lowdifficult activities such as manual activities, feeding and changing posture while lying is maintained until the 80s and over.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

ADL ability characteristics of partially dependent older people: Gender and age differences in ADL ability

Sato

Demura

Tanaka

et al. 2001

Environ Health Prev Med

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“…[4][5][6] However, long lasting use of a walking device poses negative impacts on the patients such as induced abnormal posture and musculoskeletal pain, required high attention demand and energy expenditure, and increased risk of fall. 7,8 Mahoney et al 9 also reported that the use of a walking device was associated with an increased risk of functional decline in the elderly. Therefore, the incorporation of a valid and reliable objective tool relating to the requirements of a walking device is important to monitor the level of independence of patients.…”

Section: Introductionmentioning

confidence: 99%

Reliability and validity of three functional tests in ambulatory patients with spinal cord injury

et al. 2012

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Study design: A cross-sectional study. Objectives: To investigate reliability, discriminative ability and concurrent validity of three functional tests (including the 10-meter walk test (10MWT), timed up and go test (TUGT) and five times sit-to-stand test (FTSST)) using the Functional Independence Measure Locomotor (FIM-L) scores as a standard criterion. Setting: A tertiary rehabilitation center, Thailand. Methods: Subjects were 66 patients with spinal cord injury (SCI), who were able to walk at least 50 m unassisted with or without a walking device (FIM-L scores 6-7). They were tested for functional ability using the 10MWT, TUGT and FTSST. Sixteen subjects also assessed the ability using three assessors to evaluate the inter-tester reliability of the tools. Results:The three functional tests demonstrated excellent inter-tester reliability (intraclass correlation coefficient (3,3) ¼ 0.997-1.00) and could clearly distinguish between subjects who walked with and without a walking device. In addition, the tests showed significant correlation with walking categories or FIM-L scores (r pb ¼ 0.778, À0.692 and À0.595 for the 10MWT, TUGT and FTSST, respectively, Po0.001). Conclusion:The findings support reliability and validity of the 10MWT, TUGT and FTSST to assess levels of independences in ambulatory subjects with SCI.

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“…Elderly people who have been used walkers before hospital admission were at 2.8 times higher risk for ADL limitation by the time of discharge compared to non-walker users. Additionally, 3 months after discharge, seniors who had used a mobility device before hospitalization were more likely to experience functional decline in both ADL and IADL statuses [38].Other factors that may contribute to the development of functional decline in hospitalized seniors include pre-admission physical, social and cognitive statuses of the patient [39], comorbidity and polymedication [40], having had a hospitalization or emergency visit during the last 12 months [41], and iatrogenic conditions. Iatrogenic disability is defined as "avoidable dependence which often occurs during the course of care" [42].…”

Section: ) Functional Decline In Hospitalized Elderly Patientsmentioning

confidence: 99%

“…As people age, the percentage of being dependant increases. For hospitalized elderly patients, the majority of studies reported that age is a principal element and independent risk factor for functional decline during hospitalization [35,41,53], and after discharge [54,55]. For community-dwelling seniors, chronological age is considered the most important demographic risk factor for functional decline.…”

Section: ) Demographic Characteristics 1 Agementioning

confidence: 99%

The most important considerations in the assessment of functional decline in seniors: a literature review

Jahan¹

2017

APJHS

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In recent years, there has been much focus on functional decline associated with aging, but not many studies have examined how functional decline can be effectively evaluated and detected at earlier stages of the aging process. Early detection of functional decline helps to intervene much earlier to avoid many of negative consequences of functional decline and frailty. Late identification of functional decline is problematic to the individuals and the healthcare systems considering that the percentage of the world population represented by people over the age of 65 is increasing rapidly worldwide. The aim of this review was to investigate the most important considerations in the assessment of functional decline in the population of seniors, and to explore relevant literature to provide a ground for an effective functional assessment for this population. Comprehensive literature search of the English-language articles for people aged 65 and over were conducted by searching MEDLINE and PubMed. The literature describes two main segments of elderly population with functional decline that should be assessed in different ways: Hospitalized and community-dwelling elders. When working with elderly clients, it is significantly important to identify all the factors that may contribute to the clinical picture of the client. Identification of risk factors, such as inability to do basic activities of daily living, social isolation, or lack of resources may help healthcare providers to intervene on time to avoid many catastrophic changes that affect seniors' health-related quality of life.

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Use of an Ambulation Assistive Device Predicts Functional Decline Associated With Hospitalization

Cited by 94 publications

References 18 publications

ADL ability characteristics of partially dependent older people: Gender and age differences in ADL ability

ADL ability characteristics of partially dependent older people: Gender and age differences in ADL ability

Reliability and validity of three functional tests in ambulatory patients with spinal cord injury

The most important considerations in the assessment of functional decline in seniors: a literature review

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