Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

VA/UAB Study Looks at Functional Decline in Older Patients After Hospitalization

09.04.2009
• Hospitalization causes functional decline in older adults.
• Surgical patients regain more function than non-surgical patients.
• Suggests changes in management of hospitalized seniors.

Motivation and expectation may be factors in helping older adults regain lost functional ability after hospitalization, say researchers with the Birmingham Veterans Administration Medical Center and UAB (University of Alabama at Birmingham).

In findings published in March in the Annals of Internal Medicine, researchers found that patients hospitalized for surgery returned to normal baseline function more quickly and more completely than did patients hospitalized for illness.

Researchers used UAB's Study of Aging Life-Space Assessment, a measure of mobility developed at UAB's Center for Aging, to determine the functional level of seniors before and after hospitalization. On average, patients hospitalized for surgery had a sharp decline in life-space scores immediately after surgery, but returned to or exceeded pre-surgical scores within one year. Patients hospitalized for illness or other medical reasons experienced a lower post-hospitalization decline but did not return to pre-hospitalization scores, experiencing a marked functional decline following hospitalization even after two years.

"The difference may be caused by the presence of increased expectations of recovery and increased motivation in patients presenting for surgery," said Cynthia Brown, M.D., an investigator with the VA's Geriatric Research, Education and Clinical Center and assistant professor in UAB's Division of Gerontology, Geriatrics and Palliative Care. "Patients who undergo surgery expect their medical condition to be fixed and thus to be able to function as well as or better than before. Our analysis indicates that, by and large, that occurs."

The problem, said Brown, are the non-surgical older patients hospitalized for medical issues such as pneumonia or heart disease. The findings show this group on average does not return to baseline, but experiences a permanent decline in their level of mobility.

One hypothesis is that there is no real expectation of full recovery of function by the patient, family or health care providers. Additionally, patients tend to remain immobile in a hospital bed during their stay and may have multiple ailments that complicate treatment. Increased medication also may promote confusion and depression.

"All of these factors can start patients down a slippery slope of functional decline," said Brown. "Our findings suggest that surgical patients return to function, those hospitalized for illness do not. We need to look at our hospital culture to understand why that happens, and to develop interventions to prevent that decline."

Brown said concepts such as Acute Care for Elders (ACE) units, which use patient-centered care, discharge planning, medication review and a specialized environment have shown promise in reducing the decline. Efforts to boost physical and cognitive activity should also be examined.

"Mental status and physical function are targets for intervention during hospitalization," she said. "We need to see about getting these patients up and out of their hospital beds. If we can get these people up faster, perhaps we can reduce hospitalization stays and reduce the risk of falls."

The Life-Space Assessment, developed by Richard Allman, M.D., and Patricia Baker, Ph.D., of UAB's Center for Aging, measures an individual's mobility and degree of independence. Life-space is based upon the distance a person routinely travels to perform activities. The Life-Space Assessment measures how often a person leaves his or her residence, the distance from the residence traveled and how much assistance is needed from other individuals or from assistive devices.

"It is a measure of community mobility and participation in everyday life," Brown said. "Can the individual go to church, go out to dinner, and go to the doctor's office. A life-space decrease may result in a decrease in the distance and frequency of travel from home, thus limiting participation in society. Mobility is a core function that reflects the lifestyle of community-dwelling adults and is an important predictor of morbidity and mortality."

Primary funding for the study came from the National Institute on Aging.

The UAB Center for Aging is a world leader in optimizing function, enhancing management of illness and reducing health disparities among older adults. The Center involves an interdisciplinary community of more than 200 faculty members and staff working together to promote the health and well-being of older persons and their families. For more information, go to www.aging.uab.edu/.

Media Contact
Bob Shepard
(205) 934-8934
bshep@uab.edu

Bob Shepard | EurekAlert!
Further information:
http://www.uab.edu

More articles from Studies and Analyses:

nachricht New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)

nachricht Reusable carbon nanotubes could be the water filter of the future, says RIT study
30.03.2017 | Rochester Institute of Technology

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

7th International Conference on Crystalline Silicon Photovoltaics in Freiburg on April 3-5, 2017

03.04.2017 | Event News

 
Latest News

Molecular libraries for organic light-emitting diodes

24.04.2017 | Life Sciences

Research sheds new light on forces that threaten sensitive coastlines

24.04.2017 | Earth Sciences

Making lightweight construction suitable for series production

24.04.2017 | Machine Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>