Activities of daily living at hospital admission associated with mortality in geriatric patients with dementia: a Danish nationwide population-based cohort study

Abstract Background Predicting expected survival time in acutely hospitalised older patients is a clinical challenge. Objective To examine if activities of daily living (ADL) assessed by Barthel-Index-100 (Barthel-Index) at hospital admission adds useful information to clinicians on expected survival time in older patients. Methods A nationwide population-based cohort study was used. All patients aged ≥65 years in the National Danish Geriatric Database from 2005 to 2014 were followed up until death, emigration or study termination (31 December 2015). Individual data were linked to national health registers. Barthel-Index was categorised into five-point subcategories with a separate category of Barthel-Index = 0. Kaplan–Meier analysis was used to assess crude survival proportions (95% CI) and Cox regression to examine association of Barthel-Index and mortality adjusting for age, Charlson comorbidity index, medication use, BMI, marital status, prior hospitalisations and admission year. Results In total, 74,589 patients (63% women) aged (mean (SD)) 82.5(7.5) years with Barthel-Index (median (IQR)) 54(29-77) were included. In patients with Barthel-Index = 100-96 crude survival was 0.96(0.95-0.97) after 90-days, 0.88(0.87-0.89) after 1-year, and 0.79(0.78-0.80) after 2-years. Corresponding survival in patients with Barthel-Index = 0 was 0.49(0.47-0.51), 0.35(0.34-0.37) and 0.26(0.24-0.27). Decreasing Barthel-Index was associated with increasing mortality in the multivariable analysis. In women with Barthel-Index = 0, the mortality risk (HR (95% CI)) was 14.74(11.33-19.18) after 90-days, 8.40(7.13-9.90) after 1-year and 6.22(5.47-7.07) after 2-years using Barthel-Index = 100-96 as reference. In men, the corresponding risks were 11.36(8.81-14.66), 6.22(5.29-7.31) and 5.22(4.56-5.98). Conclusions ADL measured by Barthel-Index provides useful, easily accessible and independent information to clinicians on expected survival time in patients admitted to a geriatric department.

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Barthel Index at hospital admission is associated with mortality in geriatric patients: a Danish nationwide population-based cohort study

Clinical Epidemiology ◽

10.2147/clep.s176035 ◽

2018 ◽

Vol Volume 10 ◽

pp. 1789-1800 ◽

Cited By ~ 14

Author(s):

Jesper Ryg ◽

Henriette Engberg ◽

Pavithra Mariadas ◽

Solvejg Gram Henneberg Pedersen ◽

Martin Gronbech Jorgensen ◽

...

Keyword(s):

Cohort Study ◽

Hospital Admission ◽

Barthel Index ◽

Geriatric Patients ◽

Population Based

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Exercise type and activities of daily living disability in older women: An 8-year population-based cohort study

Scandinavian Journal of Medicine and Science in Sports ◽

10.1111/sms.13336 ◽

2018 ◽

Vol 29 (3) ◽

pp. 400-406 ◽

Cited By ~ 3

Author(s):

Yosuke Osuka ◽

Narumi Kojima ◽

Miji Kim ◽

Chang Won Won ◽

Takao Suzuki ◽

...

Keyword(s):

Cohort Study ◽

Activities Of Daily Living ◽

Older Women ◽

Daily Living ◽

Population Based ◽

Exercise Type

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Faculty Opinions recommendation of Association between waiting times and short term mortality and hospital admission after departure from emergency department: population based cohort study from Ontario, Canada.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.11812956.12909054 ◽

2011 ◽

Author(s):

Patrick Ray

Keyword(s):

Emergency Department ◽

Cohort Study ◽

Hospital Admission ◽

Waiting Times ◽

Population Based ◽

Short Term ◽

Short Term Mortality

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Impairment in activities of daily living and readmission in older patients with heart failure: a cohort study

BMJ Open ◽

10.1136/bmjopen-2020-044416 ◽

2021 ◽

Vol 11 (2) ◽

pp. e044416

Author(s):

Tan Van Nguyen ◽

Huyen Thanh Dang ◽

Mason Jenner Burns ◽

Hiep HH Dao ◽

Tu Ngoc Nguyen

Keyword(s):

Heart Failure ◽

Cohort Study ◽

Activities Of Daily Living ◽

Daily Living ◽

Older Patients ◽

Tertiary Hospital ◽

Logistic Regression Models ◽

Hospitalised Patients ◽

Patients With Heart Failure ◽

The Impact

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

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Lower Levels of Serum Albumin and Total Cholesterol Associated with Decline in Activities of Daily Living and Excess Mortality in a 12-Year Cohort Study of Elderly Japanese

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2007.01549.x ◽

2008 ◽

Vol 56 (3) ◽

pp. 529-535 ◽

Cited By ~ 62

Author(s):

Tomonori Okamura ◽

Takehito Hayakawa ◽

Atsushi Hozawa ◽

Takashi Kadowaki ◽

Yoshitaka Murakami ◽

...

Keyword(s):

Cohort Study ◽

Serum Albumin ◽

Activities Of Daily Living ◽

Total Cholesterol ◽

Daily Living ◽

Excess Mortality ◽

Elderly Japanese

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Functional capability and violence situations against the elderly

Acta Paulista de Enfermagem ◽

10.1590/1982-0194201400066 ◽

2014 ◽

Vol 27 (5) ◽

pp. 392-398 ◽

Cited By ~ 8

Author(s):

Andréa Mathes Faustino ◽

Lenora Gandolfi ◽

Leides Barroso de Azevedo Moura

Keyword(s):

Activities Of Daily Living ◽

Daily Living ◽

Physical Violence ◽

The Elderly ◽

Population Based ◽

Cross Sectional Study ◽

Functional Capability ◽

Cross Sectional ◽

Daily Lives ◽

Partial Dependence

Objective To verify whether there is a connection between the functional capacity of the elderly and the presence of violent situations in their daily lives. Methods A population-based cross-sectional study developed with 237 elderly individuals. Standard and validated research instruments were used. Results Mean age of 70.25 years (standard deviation of 6.94), 69% were female, 76% were independent in basic activities of daily living and 54% had a partial dependence on at least one instrumental activity. The most prevalent violence was psychological and the relation between being dependent on basic activities of daily living and suffering physical violence was statistically significant. Conclusion When the elderly needs assistance to perform self-care activities, there is a greater chance of exposure to a situation of abuse, such as physical violence.

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Anemia and functional capacity in elderly Brazilian hospitalized patients

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2013000700007 ◽

2013 ◽

Vol 29 (7) ◽

pp. 1322-1332 ◽

Cited By ~ 10

Author(s):

Raquel de Macedo Bosco ◽

Elisa Priscila Souza Assis ◽

Renata Rosseti Pinheiro ◽

Luiza Cristina Viana de Queiroz ◽

Leani S. M. Pereira ◽

...

Keyword(s):

Activities Of Daily Living ◽

Functional Capacity ◽

Daily Living ◽

Strong Association ◽

Population Based ◽

Categorical Variables ◽

Fisher Exact Test ◽

Cross Sectional ◽

Belo Horizonte ◽

The Impact

This study evaluated the association between anemia and physical functional capacity in a cross-sectional population-based sample of 709 hospitalized elderly patients aged 60 years and over admitted to the Madre Teresa Hospital, Belo Horizonte, State of Minas Gerais, Brazil. The Mann-Whitney or "t" test, and chi-square or Fisher exact test were used for quantitative and categorical variables, respectively, and hierarchical binary logistic regression was used to identify significant predictors. The presence of anemia was found in 30% of participants and was significantly associated with decreased functionality according to the two measures which were used - ADL (activities of daily living) and IADL (instrumental activities of daily living). Anemia was also independently associated with older age. The results of this study demonstrate a strong association between the presence of anemia and lower levels of functional capacity. Further investigations are needed to assess the impact of anemia treatment on the functionality and independence of older people.

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