Navigation Links
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 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."


'/>"/>

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

Related medicine news :

1. Motorola Study Shows 80 Percent of Global Healthcare IT Executives Placing Increased Reliance on Mobility
2. Study: Every 1.7 minutes a Medicare beneficiary experiences a patient safety event
3. Breakthrough model for human cancer may improve development of cancer drugs; study in PNAS
4. M. D. Anderson study finds pre-surgical stress management improves mood, quality of life
5. CVS Caremark Study Documents Changes in Prescription Drug Use to Treat High Blood Pressure, High Cholesterol and Diabetes in Children and Adolescents
6. Colon Screenings Dont Follow Guidelines, Study Suggests
7. Sexual behavior at work still a problem shows new study from U of Ts Rotman School
8. First Patients Enrolled in the Access-Europe Study of The MitraClip(R) Therapy
9. Penn study examines power of exercise to prevent breast cancer
10. Treating Complicated Grief -- New NIMH Study Seeks 200 Older Adults Suffering from Unrelenting Symptoms of Complicated Grief for Participation in Non-Drug Clinical Trial
11. Effects of disease severity on autobiographical memory in semantic dementia revealed in new study
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/2/2016)... ... December 02, 2016 , ... ... launch of its 60-day free trial program for all of the company’s desktop ... offer a truly hassle free experience. , FlexiSpot’s unique desktop risers use an ...
(Date:12/2/2016)... ... ... The annual time frame to change Medicare health and prescription drug coverage, known ... Medicare beneficiaries who are looking to switch from their current plan to a Medicare ... during this period order for their new policy to go into effect in 2017. ...
(Date:12/2/2016)... ... December 02, 2016 , ... With the number of pain management programs available ... must find the one that works for them. When an inventor from Suisun City, ... worked and decided to share it with others. , He developed a prototype for ...
(Date:12/2/2016)... ... December 02, 2016 , ... Dr. Raffi Hovsepian, a leading ... the 2016 “Guide to America’s Top Plastic Surgeons” for seven consecutive years. The ... education, experience, and professional associations. , One the most frequently honored surgeons ...
(Date:12/2/2016)... ... December 02, 2016 , ... Mediaplanet is proud to announce ... covers the innovative treatments, therapeutic technologies, and revolutionized nutrition that are helping patients ... life 6 years in the last 3 decades,” says Dr. Valentine Fuster, a ...
Breaking Medicine News(10 mins):
(Date:12/2/2016)... MONMOUTH JUNCTION, N.J. , Dec. 2, 2016 /PRNewswire/ ... critical care immunotherapy leader commercializing its European Union approved ... in critically-ill and cardiac surgery patients worldwide, announced that ... present at the 9th Annual LD Micro Main ... 8 th , 2016 at the Luxe Sunset Boulevard ...
(Date:12/2/2016)... LYME, Conn. , Dec. 1, 2016  Today, ... has announced the honor of being selected as winners ... include: Simpson Healthcare Executives Website at the PLATINUM level, ... Conversations Training Module at the GOLD Level, and our ... At Simpson Healthcare Executives, we are excited ...
(Date:12/2/2016)... YORK , December 2, 2016 ... of its past losses following Trump,s victory early in ... potential, and fund managers are now predicting an uptick ... at four equities to see how they have fared ... CLDX ), Amicus Therapeutics Inc. (NASDAQ: ...
Breaking Medicine Technology: