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:6/25/2016)... ... June 25, 2016 , ... ... issues and applications at AcademyHealth’s Annual Research Meeting June 26-28, 2016, at the ... several important health care topics including advance care planning, healthcare costs and patient ...
(Date:6/25/2016)... ... June 25, 2016 , ... As a lifelong Southern ... Laude and his M.D from the David Geffen School of Medicine at UCLA. He ... Los Angeles to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program ...
(Date:6/24/2016)... ... 2016 , ... Those who have experienced traumatic events may suffer from a ... such as drug or alcohol abuse, as a coping mechanism. To avoid this pain ... following a traumatic event. , Trauma sufferers tend to feel a range of emotions, ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... for accelerated orthodontic treatment. Dr. Cheng has extensive experience with all areas of ... AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary adjunct to ...
(Date:6/24/2016)... ... June 24, 2016 , ... The Haute Beauty ... Barry M. Weintraub as a prominent plastic surgeon and the network’s newest partner. ... and the most handsome men, look naturally attractive. Plastic surgery should be invisible.” ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... VEGAS , June 26, 2016 ... to value-based care operating models within the health care ... enable greater financial efficiency , Deloitte offers a ... the key business issues impacting efficient cost optimization: labor ... , These services facilitate better outcomes and better ...
(Date:6/24/2016)... , June 24, 2016   Bay ... Rehabilitation Network,s Dean Center for Tick Borne ... Medicine and Rehabilitation, MIT Hacking Medicine, University of ... Innovation, today announced the five finalists of ... Lyme disease.  More than 100 scientists, clinicians, researchers, ...
(Date:6/24/2016)... BEIJING , June 24, 2016 Dehaier ... or the "Company"), which develops, markets and sells medical ... China , signed a strategic cooperation agreement with ... as "Hongyuan Supply Chain") on June 20, 2016, to ... Under the strategic cooperation agreement, Dehaier will leverage Hongyuan ...
Breaking Medicine Technology: