title: A prospective cohort study of geriatric syndromes among older medical patients admitted to acute care hospitals.
abstract: OBJECTIVE
  To identify the prevalence of geriatric syndromes in the premorbid for all syndromes except falls (preadmission), admission, and discharge assessment periods and the incidence of new and significant worsening of existing syndromes at admission and discharge.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Three acute care hospitals in Brisbane, Australia.
  
  
  METHODS
  Five hundred seventy-seven general medical patients aged 70 and older admitted to the hospital.
  
  
  METHODS
  Prevalence of syndromes in the premorbid (or preadmission for falls), admission, and discharge periods; incidence of new syndromes at admission and discharge; and significant worsening of existing syndromes at admission and discharge.
  
  
  RESULTS
  The most frequently reported premorbid syndromes were bladder incontinence (44%), impairment in any activity of daily living (ADL) (42%). A high proportion (42%) experienced at least one fall in the 90 days before admission. Two-thirds of the participants experienced between one and five syndromes (cognitive impairment, dependence in any ADL item, bladder and bowel incontinence, pressure ulcer) before, at admission, and at discharge. A majority experienced one or two syndromes during the premorbid (49.4%), admission (57.0%), or discharge (49.0%) assessment period. The syndromes with a higher incidence of significant worsening at discharge (out of the proportion with the syndrome present premorbidly) were ADL limitation (33%), cognitive impairment (9%), and bladder incontinence (8%). Of the syndromes examined at discharge, a higher proportion of patients experienced the following new syndromes at discharge (absent premorbidly): ADL limitation (22%); and bladder incontinence (13%).
  
  
  CONCLUSIONS
  Geriatric syndromes were highly prevalent. Many patients did not return to their premorbid function and acquired new syndromes.
authors.affiliation: The University of Queensland, Brisbane, Australia. p.ramritu@uq.edu.au
authors.forename: Prabha
authors.initials: P
authors.lastname: Lakhan
authors.forename: Mark
authors.initials: M
authors.lastname: Jones
authors.forename: Andrew
authors.initials: A
authors.lastname: Wilson
authors.forename: Mary
authors.initials: M
authors.lastname: Courtney
authors.forename: John
authors.initials: J
authors.lastname: Hirdes
authors.forename: Leonard C
authors.initials: LC
authors.lastname: Gray
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease / Q000453:epidemiology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D011793:Queensland / Q000453:epidemiology; D012307:Risk Factors; D013577:Syndrome