scholarly journals Clinical frailty adds to acute illness severity in predicting mortality in hospitalized older adults: An observational study

2016 ◽  
Vol 35 ◽  
pp. 24-34 ◽  
Author(s):  
Roman Romero-Ortuno ◽  
Stephen Wallis ◽  
Richard Biram ◽  
Victoria Keevil
Keyword(s):  
Older Adults ◽  
Observational Study ◽  
Illness Severity ◽  
Acute Illness ◽  
Hospitalized Older Adults

scholarly journals Predictors of physical activity in older adults early in an emergency hospital admission: a prospective cohort study

2020 ◽  
Author(s):  
Peter Hartley ◽  
Amanda L Dewitt ◽  
Faye Forsyth ◽  
Roman Romero-Ortuno ◽  
Christi Deaton
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cohort Study ◽  
Hospital Admission ◽  
Illness Severity ◽  
Acute Illness ◽  
Functional Mobility ◽  
Early Warning Score ◽  
Accelerometer Data ◽  
Optimal Model

Abstract Background: Reduced mobility may be responsible for functional decline and acute sarcopenia in older hospitalised patients. The drivers of reduced in-hospital mobility are poorly understood, especially during the early phase of acute hospitalisation. We investigated predictors of in-hospital activity during a 24-hour period in the first 48 hours of hospital admission in older adults. Methods: This was a secondary analysis of a prospective repeated measures cohort study. Participants aged 75 years or older were recruited within the first 24 hours of admission. At recruitment, patients underwent a baseline assessment including measurements of pre-morbid functional mobility, cognition, frailty, falls efficacy, co-morbidity, acute illness severity, knee extension strength and grip strength, and consented to wear accelerometers to measure physical activity during the first 7 days (or until discharge if earlier). In-hospital physical activity was defined as the amount of upright time (standing or walking). To examine the predictors of physical activity, we limited the analysis to the first 24 hours of recording to maximise the sample size as due to discharge from hospital there was daily attrition. We used a best subset analysis including all baseline measures. The optimal model was defined by having the lowest Bayesian information criterion in the best-subset analyses. The model specified a maximum of 5 covariates and used an exhaustive search.Results: Seventy participants were recruited but eight were excluded from the final analysis due to lack of accelerometer data within the first 24 hours after recruitment. Patients spent a median of 0.50 hours (IQR: 0.21; 1.43) standing or walking. The optimal model selected the following covariates: functional mobility as measured by the de Morton Mobility Index and two measures of illness severity, the National Early Warning Score, and serum C-reactive protein.Conclusions: Physical activity, particularly in the acute phase of hospitalisation, is very low in older adults. The association between illness severity and physical activity may be explained by symptoms of acute illness being barriers to activity. Interdisciplinary approaches are required to identify early mobilisation opportunities.

scholarly journals Pharmacist medication instructions are associated with continued medication self-management in older adults: a retrospective observational study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Eiji Kose ◽  
Hidetatsu Endo ◽  
Hiroko Hori ◽  
Shingo Hosono ◽  
Chiaki Kawamura ◽  
...  
Keyword(s):  
Older Adults ◽  
Observational Study ◽  
Demographic Data ◽  
Multiple Logistic Regression Analysis ◽  
Laboratory Data ◽  
Final Analysis ◽  
Functional Independence ◽  
Retrospective Observational Study ◽  
Self Management ◽  
Hospitalized Older Adults

Abstract Background Various factors are related to self-management of medication. However, few reports comprehensively examine the factors related to patients, medication levels, and other factors related to the recuperative environment, such as family support. The aim of this study was to investigate factors affecting the continuation of medication self-management among hospitalized older adults receiving convalescent rehabilitation. Methods We conducted a retrospective observational study with 274 consecutive patients newly admitted to the convalescent rehabilitation wards at a single hospital in Japan between January 2017 and May 2018. Participants who were assessed for their ability to take their medication using the Japanese Regimen Adherence Capacity Tests, were deemed to be self-manageable, and were able to successfully continue to self-manage their medication from admission to discharge were categorized as the “continuation group,” and those who were not able to continue were categorized as the “non-continuation group.” We analyzed the groups’ demographic data, laboratory data, and Functional Independence Measure. The primary outcome was the continuation of medication self-management from admission to discharge. Results After enrollment, 134 patients (median age 82 years; 62.7% women) were included in the final analysis. Some 60.4% of eligible patients were able to maintain medication self-management during their hospitalization. The multiple logistic regression analysis for the continuation of medication self-management during hospitalization after adjusting for confounding factors revealed that pharmacist medication instructions were independently and positively correlated with successful continuation of medication self-management (odds ratio: 1.378; 95% confidence interval 1.085–1.831; p = 0.0076). Conclusion Successful continuation of medication self-management is associated with pharmacist medication instructions among hospitalized older adults undergoing rehabilitation. Trail registration The Ethics Committee’s registration number is “TGE01216–066”.

scholarly journals Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective Observational Study

2020 ◽  
Vol 21 (7) ◽  
pp. 928-932.e1 ◽  
Author(s):  
Robert De Smet ◽  
Bea Mellaerts ◽  
Hannelore Vandewinckele ◽  
Peter Lybeert ◽  
Eric Frans ◽  
...  
Keyword(s):  
Older Adults ◽  
Observational Study ◽  
Retrospective Observational Study ◽  
Hospitalized Older Adults

scholarly journals Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study

2017 ◽  
Vol 33 (3) ◽  
pp. 298-304 ◽  
Author(s):  
Alexia M. Torke ◽  
Christopher M. Callahan ◽  
Greg A. Sachs ◽  
Lucia D. Wocial ◽  
Paul R. Helft ◽  
...  
Keyword(s):  
Older Adults ◽  
Observational Study ◽  
Well Being ◽  
Communication Quality ◽  
Psychological Well Being ◽  
Hospitalized Older Adults

scholarly journals Physical activity among hospitalized older adults – an observational study

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Sigurd Evensen ◽  
Olav Sletvold ◽  
Stian Lydersen ◽  
Kristin Taraldsen
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Observational Study ◽  
Hospitalized Older Adults

scholarly journals US Physicians with Recent Experience Managing Hospitalized Older Adults: an Observational Study

2020 ◽  
Vol 35 (12) ◽  
pp. 3747-3749
Author(s):  
Kira L. Ryskina ◽  
Anjali Bhatla ◽  
Rachel M. Werner
Keyword(s):  
Older Adults ◽  
Observational Study ◽  
Recent Experience ◽  
Hospitalized Older Adults

scholarly journals Predictors of physical activity in older adults experiencing an emergency hospital admission: a prospective cohort study

2020 ◽  
Author(s):  
Peter Hartley ◽  
Amanda L Dewitt ◽  
Faye Forsyth ◽  
Roman Romero-Ortuno ◽  
Christi Deaton
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cohort Study ◽  
Hospital Admission ◽  
Illness Severity ◽  
Acute Illness ◽  
Functional Mobility ◽  
Early Warning Score ◽  
Accelerometer Data ◽  
Optimal Model

Abstract BackgroundReduced mobility may be responsible for functional decline and acute sarcopenia in older hospitalised patients. The drivers of reduced in-hospital mobility are poorly understood, especially during the early phase of acute hospitalisation. We investigated predictors of in-hospital activity during the first 24 hours of hospital admission in older adults. MethodsThis was a secondary analysis of a prospective repeated measures cohort study. Participants aged 75 years or older were recruited within the first 24 hours of admission. At recruitment, patients underwent a baseline assessment including measurements of pre-morbid functional mobility, cognition, frailty, falls efficacy, co-morbidity, acute illness severity, knee extension strength and grip strength, and consented to wear accelerometers to measure physical activity during the first 7 days (or until discharge if earlier). In-hospital physical activity was defined as the amount of upright time (standing or walking). To examine the predictors of physical activity, we used a best subset analysis including all baseline measures. The optimal model was defined by having the lowest Bayesian information criterion in the best-subset analyses. The model specified a maximum of 5 covariates and used an exhaustive search.ResultsSeventy participants were recruited but eight were excluded from the final analysis due to lack of accelerometer data within the first 24 hours after recruitment. Patients spent a median of 0.50 hours (IQR: 0.21; 1.43) standing or walking. The optimal model selected the following covariates: functional mobility as measured by the de Morton Mobility Index and two measures of illness severity, the National Early Warning Score, and serum C-reactive protein.ConclusionsPhysical activity, particularly in the acute phase of hospitalisation, is very low in older adults. The association between illness severity and physical activity may be explained by symptoms of acute illness being barriers to activity. Interdisciplinary approaches are required to identify early mobilisation opportunities.

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