title: Low mobility during hospitalization and functional decline in older adults.
abstract: OBJECTIVE
  To examine the association between mobility levels of older hospitalized adults and functional outcomes.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  A 900-bed teaching hospital in Israel.
  
  
  METHODS
  Five hundred twenty-five older (≥70) acute medical patients hospitalized for a nondisabling condition.
  
  
  METHODS
  In-hospital mobility was assessed using a previously validated scale. The main outcomes were decline from premorbid baseline functional status at discharge (activities of daily living (ADLs)) and at 1-month follow-up (ADLs and instrumental ADLs (IADLs)). Hospital mobility levels and functional outcomes were assessed according to prehospitalization functional trajectories. Logistic regressions were modeled for each outcome, controlling for functional status, morbidity, and demographic characteristics.
  
  
  RESULTS
  Forty-six percent of participants had declined in ADLs at discharge and 49% at follow-up; 57% had declined in IADLs at follow-up. Mobility during hospitalization was twice as high in participants with no preadmission functional decline. Low versus high in-hospital mobility was associated with worse basic functional status at discharge (adjusted odds ratio (AOR)=18.03, 95% confidence interval (CI)=7.68-42.28) and at follow-up (AOR=4.72, 95% CI=1.98-11.28) and worse IADLs at follow-up (AOR=2.00, 95% CI=1.05-3.78). The association with poorer discharge functional outcomes was present in participants with preadmission functional decline (AOR for low vs high mobility=15.26, 95% CI=4.80-48.42) and in those who were functionally stable (AOR for low vs high mobility=10.12, 95% CI=2.28-44.92).
  
  
  CONCLUSIONS
  In-hospital mobility is an important modifiable factor related to functional decline in older adults in immediate and short-term (1-month follow-up) functional outcomes.
authors.affiliation: Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel.
authors.forename: Anna
authors.initials: A
authors.lastname: Zisberg
authors.forename: Efrat
authors.initials: E
authors.lastname: Shadmi
authors.forename: Gary
authors.initials: G
authors.lastname: Sinoff
authors.forename: Nurit
authors.initials: N
authors.lastname: Gur-Yaish
authors.forename: Einav
authors.initials: E
authors.lastname: Srulovici
authors.forename: Hanna
authors.initials: H
authors.lastname: Admi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007297:Inpatients; D007557:Israel / Q000453:epidemiology; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009069:Movement Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D010351:Patient Discharge; D011446:Prospective Studies