Functional decline two weeks before hospitalization in an elderly population.
BACKGROUND
The use of hospital care increases significantly with age. Older people coming to the emergency department have three to seven times higher rates of hospitalization than younger people. Hospitalization can lead to loss of independence and also need for long-term care at discharge.


METHODS
A prospective observational non-randomized study of elderly patients admitted to the Department of Geriatric Medicine, University of Torino, Italy, between October 2006 and May 2007.


RESULTS
The mean age of 123 subjects was 82.2±7.3 years. Among patients with dependence two weeks before admission, as reported by their caregivers, bathing, toileting and dressing were the most compromised ADL functions. In the same patients, shopping and transportation were reported as the most frequent IADL functions lost. Functional decline before hospitalization was significantly associated with a worsening in functional decline during the length of stay (RR 2.2, CI 1.05-4.66) and with discharge to a long-term facility (RR 2.1, CI 1.04-4.44).


CONCLUSIONS
As functional decline two weeks before hospitalization influences hospital discharge and functional outcomes, it is certainly interesting to evaluate the impact of a dedicated early rehabilitation program for elderly patients. A well-structured program involving geriatricians, physiatricians and physiotherapists could be helpful for better short-term prognoses.
Department of Medicine and Surgery, University of Torino,10126 Torino, Italy. gianlucaisaia@yahoo.it
Gianluca
G
Isaia
Mario
M
Bo
Nicoletta
N
Aimonino
Giovanni Carlo
GC
Isaia
Giuliana
G
Michelis
Cristina
C
Miceli
Luisa
L
Balcet
Alessandra
A
Tizzani
Mauro
M
Zanocchi
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D007558:Italy; D008297:Male; D010351:Patient Discharge; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors