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 The Great Unknown: Risk-Taking Behavior in Adolescents
19.01.2017 | Max-Planck-Institut für Bildungsforschung

nachricht A sudden drop in outdoor temperature increases the risk of respiratory infections
11.01.2017 | University of Gothenburg

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: Traffic jam in empty space

New success for Konstanz physicists in studying the quantum vacuum

An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Sustainable Water use in Agriculture in Eastern Europe and Central Asia

19.01.2017 | Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

 
Latest News

Helmholtz International Fellow Award for Sarah Amalia Teichmann

20.01.2017 | Awards Funding

An innovative high-performance material: biofibers made from green lacewing silk

20.01.2017 | Materials Sciences

Ion treatments for cardiac arrhythmia — Non-invasive alternative to catheter-based surgery

20.01.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>