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VA/UAB study looks at functional decline in older patients after hospitalization
Date:4/7/2009

BIRMINGHAM, Ala. 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 th
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Contact: Bob Shepard
bshep@uab.edu
205-934-8934
University of Alabama at Birmingham
Source:Eurekalert

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