title: Are health assets associated with improved outcomes for hospitalised older adults? A systematic review.
abstract: Health assets are protective factors that support health and wellbeing, rather than risk factors that are associated with disease. This concept was developed in the community setting. In hospitalised older adults, the dominant approach has been to identify risk factors, with little examination of health assets. The purpose of this systematic review was to determine whether, in hospitalised older people, individual health assets decrease the risk of post hospital mortality, functional decline, new need for residential care, readmission or longer length of stay.
  
  
  
  MEDLINE, EMBASE, CINAHL and PsycINFO were searched to identify studies examining outcomes for hospitalised older adults. Included studies examined at least one potential individual health asset, which was a psychosocial characteristic or health characteristic. Study quality was assessed, and findings are narratively described.
  
  
  
  Nine prospective cohort and two retrospective cohort studies were identified. subjective, functional and biological health assets were identified. Health assets were associated with decreased risk of post-hospital mortality, functional decline, new need for residential care and readmission.
  
  
  
  The complex interplay between health status and psychological and social factors is incompletely understood. Health assets are associated with improved outcomes for hospitalised older adults. The small number of studies suitable for inclusion indicates the need for further research in this area.
authors.affiliation: Northern Hospital, 185 Cooper St., Epping, Victoria 3076, Australia; NorthWest Academic Centre, Department of Medicine, University of Melbourne, 185 Cooper St., Epping, Victoria 3076, Australia. Electronic address: kate.gregorevic@gmail.com.
authors.forename: Kate J
authors.initials: KJ
authors.lastname: Gregorevic
authors.affiliation: Northern Hospital, 185 Cooper St., Epping, Victoria 3076, Australia. Electronic address: kwang.lim@nh.org.au.
authors.forename: Wen Kwang
authors.initials: WK
authors.lastname: Lim
authors.affiliation: Centre for Research in Geriatric Medicine, School of Medicine, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, Queensland 4102, Australia. Electronic address: n.peel@uq.edu.au.
authors.forename: Nancye M
authors.initials: NM
authors.lastname: Peel
authors.affiliation: Northern Hospital, 185 Cooper St., Epping, Victoria 3076, Australia. Electronic address: ruth.martin@nh.org.au.
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Martin
authors.affiliation: Centre for Research in Geriatric Medicine, School of Medicine, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, Queensland 4102, Australia. Electronic address: r.hubbard1@uq.edu.au.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Hubbard
mesh_terms: D000368:Aged; D004522:Educational Status; D005191:Family Characteristics; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008603:Mental Health; D009909:Oral Health; D065840:Protective Factors; D012307:Risk Factors; D058992:Social Participation; D012944:Social Support
keywords: Aged; Frailty; Health assets; Health status; Healthy aging; Hospitalisation