Risk factors of functional decline during hospitalization in the oldest old.
OBJECTIVE
The number of hospital admissions of the elderly is increasing and hospitalization often leads to functional decline. The aim of this study was to identify major risk factors for functional decline in the hospitalized oldest old.


METHODS
Prospective, observational, non-randomized study of patients aged >/=80 years, admitted for at least two days to the University Department of Geriatric Medicine of Torino, Italy, between November 2003 and November 2004. For detection of functional decline, the ADL scale was used, referring to the number of dependent ADL.


RESULTS
At discharge, ADL mean scores were significantly higher than on admission (2.5+/-2 vs 2.3+/-1.9, p<0.001). 23.9% of the sample lost at least one ADL function during hospitalization, and 19.2% were transferred to long-term care, compared with 5.4% of those with no functional decline. Length of hospitalization, neoplasm, low level of albumin and high number of drugs prescribed were associated with functional decline. At multivariate analysis, only in-hospital stay was an independent risk factor for functional decline (RR 1.1 per day of hospitalization, CI 1.03-1.14).


CONCLUSIONS
Hospitalization of the oldest old increases the risk of functional decline, especially if prolonged. It is important to identify patients at high risk for functional decline after hospital admission.
Isaia
Gianluca
G
Medical and Surgical Department, Geriatric Section, University of Torino, 10126 Torino, Italy. gianlucaisaia@yahoo.it
Maero
Barbara
B
Gatti
Antonia
A
Neirotti
Massimo
M
Aimonino Ricauda
Nicoletta
N
Bo
Mario
M
Ruatta
Claudia
C
Gariglio
Federico
F
Miceli
Cristina
C
Corsinovi
Laura
L
Fissore
Laura
L
Marchetto
Cristina
C
Zanocchi
Mauro
M
D000203:Activities of Daily Living; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D007558:Italy; D007902:Length of Stay; D008297:Male; D015999:Multivariate Analysis; D009369:Neoplasms; D055553:Prescription Drugs; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012709:Serum Albumin
D055553:Prescription Drugs; D012709:Serum Albumin