In hospital functional assessments in the elderly and their association to post discharge health outcomes

The purpose of this study was to investigate the functional status of a sample of older adults during hospitalization for acute illness and to examine associations between functional status measures assessed during hospitalization and post discharge community participation and rehospitalization. Data employed were from a convenience sample of men and women aged 65 years or older admitted to the UTMB Acute Care for Elderly (ACE) during 2007 with a follow up telephone interview at 3 months post discharge. Physical Function was assessed using standard measures that have been used extensively in studies of older persons living in the community: hand grip and knee extensor strength, gait speed, the Short Physical Performance Battery, and self report activities of daily living (ADL) disability. The use of many of these measures among older adults in context of acute illness and hospitalization is relatively novel, however. \r\nThis study showed that multiple measures of physical function can be quickly and easily collected in a broad sample of older adults hospitalized for acute illness. Overall, the functional status of the sample was low when compared to healthy adults of comparable ages. Descriptive analyses showed poor physical function was associated with increased age in all measures. Multivariate analyses showed that slow gait speed and poor performance on the Short Physical Performance Battery were significantly associated with more adverse clinical measures of health status than hand grip strength, knee extensor strength, or ADL disability. Longitudinal analyses showed that only slow gait speed and poor performance on the Short Physical Performance Battery were significantly associated with less post discharge community participation and there was a trend (though not statistically significant) toward decreased functioning and rehospitalizations within 90 days of discharge. \r\n\r\nThis study provides important insight into the functioning of hospitalized elders. With rising health-care costs, the benefits of routinely assessing the functional status of older patients in the hospital environment are potentially enormous. Considering the expected growth of the older population in the coming decades and their high use of hospital services, further research is warranted, especially among those at high risk for loss of functional independence. \r\n

Name thesis:degree_name

PhD

Level thesis:degree_level

Doctoral

Grantor

The University of Texas Medical Branch

Year dc:date.issued

2008

Author dc:creator

• Steve Fisher

Advisor dc:contributor.advisor

• Glenn Ostir

Committee members dc:contributor.committeemember

• Yong-fang Kuo
• Kenneth Ottenbacher
• Kathy Lucke
• Jean Herzog
• Elizabeth Protas

• hospitalization
• funciton
• aging

Statement dc:rights

• Copyright © is held by the author. Presentation of this material on the TDL web site by The University of Texas Medical Branch at Galveston was made possible under a limited license grant from the author who has retained all copyrights in the works.

Language dc:language.iso

eng

Dc Identifier Other

etd-06302008-103633

OAI identifier oai:identifier

oai:utmb-ir.tdl.org:2152.3/134