Functional decline and recovery of activities of daily living in hospitalized, disabled older women: the Women's Health and Aging Study I.
OBJECTIVE
To determine, in disabled, older, community-dwelling women who were hospitalized, the rates and predictors of functional decline, the probability and time course of subsequent functional recovery, and predictors of functional recovery.


METHODS
Population-based observational cohort.


METHODS
Woman's Health and Aging Study.


METHODS
A subset of the 1,002 moderately to severely disabled community-dwelling older women who were hospitalized over 3 years (N=457).


METHODS
Functional decline and complete and partial recovery were defined using a 0 to 6 scale of dependencies in activities of daily living (ADLs) evaluated every 6 months over 3 years. Complete recovery was defined as returning to baseline function (function at visit immediately preceding hospitalization) after functional decline; partial recovery was defined as any improvement in the ADL scale after functional decline. Multiple logistic regression analysis was used to determine predictors of functional decline. Kaplan-Meier curves estimate the proportions recovering as a function of time since hospitalization. Discrete-time proportional hazards models regress the time-to-recovery hazards on the predictor variables.


RESULTS
Thirty-three percent of hospitalized women experienced functional decline at the first visit after hospitalization. Frailty, longer length of stay, and higher education were associated with functional decline. Fifty percent fully recovered over the subsequent 30 months, with 33% recovering within 6 months and an additional 14% over the following 6 months. Younger women were more likely to recover (aged 80 to 70, hazard ratio=0.39, 95% confidence interval=0.24-0.64).


CONCLUSIONS
Although most recovery of function occurs by 6 months after the first visit after a hospitalization, a substantial proportion of disabled community-dwelling women recover over the following 2 years.
Boyd
Cynthia M
CM
Division of Geriatric Medicine and Gerontology, School of Medicine and Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland 21224, USA. cboyd1@jhmi.edu
Ricks
Michelle
M
Fried
Linda P
LP
Guralnik
Jack M
JM
Xue
Qian-Li
QL
Xia
Jin
J
Bandeen-Roche
Karen
K
D000203:Activities of Daily Living; D000368:Aged; D006233:Persons with Disabilities; D005260:Female; D006760:Hospitalization; D006801:Humans; D020127:Recovery of Function
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