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Journal of General Internal Medicine
Published in: Journal of General Internal Medicine 5/2007

01-05-2007 | Populations at Risk

Characteristics of Nondisabled Older Patients Developing New Disability Associated with Medical Illnesses and Hospitalization

Authors: Stefano Volpato, MD, MPH, Graziano Onder, MD, PhD, Margherita Cavalieri, MD, Gianluca Guerra, MD, Fotini Sioulis, MD, Cinzia Maraldi, MD, Giovanni Zuliani, MD, PhD, Renato Fellin, MD, PhD, Italian Group of Pharmacoepidemiology in the Elderly Study (GIFA)

Published in: Journal of General Internal Medicine | Issue 5/2007

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Abstract

OBJECTIVE

To identify demographic, clinical, and biological characteristics of older nondisabled patients who develop new disability in basic activities of daily living (BADL) during medical illnesses requiring hospitalization.

DESIGN

Longitudinal observational study.

SETTING

Geriatric and Internal Medicine acute care units.

PARTICIPANTS

Data are from 1,686 patients aged 65 and older who independent in BADL 2 weeks before hospital admission, enrolled in the 1998 survey of the Italian Group of Pharmacoepidemiology in the Elderly Study.

MEASUREMENTS

Study outcome was new BADL disability at time of hospital discharge. Sociodemographic, functional status, and clinical characteristics were collected at hospital admission; acute and chronic conditions were classified according to the International Classification of Disease, ninth revision; fasting blood samples were obtained and processed with standard methods.

RESULTS

At the time of hospital discharge 113 patients (6.7%) presented new BADL disability. Functional decline was strongly related to patients’ age and preadmission instrumental activities of daily living status. In a multivariate analysis, older age, nursing home residency, low body mass index, elevated erythrocyte sedimentation rate, acute stroke, high level of comorbidity expressed as Cumulative Illness Rating Scale score, polypharmacotherapy, cognitive decline, and history of fall in the previous year were independent and significant predictors of BADL disability.

CONCLUSION

Several factors might contribute to loss of physical independence in hospitalized older persons. Preexisting conditions associated with the frailty syndrome, including physical and cognitive function, comorbidity, body composition, and inflammatory markers, characterize patients at high risk of functional decline.
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Metadata
Title
Characteristics of Nondisabled Older Patients Developing New Disability Associated with Medical Illnesses and Hospitalization
Authors
Stefano Volpato, MD, MPH
Graziano Onder, MD, PhD
Margherita Cavalieri, MD
Gianluca Guerra, MD
Fotini Sioulis, MD
Cinzia Maraldi, MD
Giovanni Zuliani, MD, PhD
Renato Fellin, MD, PhD
Italian Group of Pharmacoepidemiology in the Elderly Study (GIFA)
Publication date
01-05-2007
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 5/2007
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-007-0152-1

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