Activities of Daily Living and Determinant Factors among Older Adult Subjects with Lower Body Fracture after Discharge from Hospital: A Prospective Study

Abstract

Fracture is a type of musculoskeletal injury that contributes to an inability to perform daily activities. The objective of this study was to evaluate activities of daily living (ADL) of older adult patients with lower body fracture and to determine factors influencing ADL. Patient’s ADL was assessed at pre-fracture, ward admission and post-discharge phases using the Katz ADL questionnaire. There were 129 subjects at pre-fracture and ward phases and 89 subjects at discharge phase. There were four independent variables; age, gender, type of fracture and ability to walk before fracture. Logistic regression models showed that ‘age’ and ‘ability to walk before fracture’ were the determinant factors of dependent for ‘bathing’, ‘dressing’ and ‘toileting’. The ‘ability to walk before fracture’ was the determinant factor of dependent for ‘transferring’. ‘Age’ and ‘gender’ were the determinant factors of dependent for ‘continence’, while ‘age’ was the determinant factor of dependent for ‘feeding’. The ADL score changes were significant across the phases with a reduction in ADL score in the ward admission phase and partial increment during the post-discharge phase. There were improvements in the health outcomes of subjects aged more than 50 years old after 3 months of being discharged from the hospital. In conclusion, age, being female, having a hip fracture and using a walking aid before fracture were the determinants identified in this study.

Activities of Daily Living (ADL) Predicts in-hospital Mortality in Geriatric Patients with Community-acquired Pneumonia (CAP)

“…Even little changes in the ADL function could lead to poor clinical outcomes [30][31] . ADL functional status has been shown to be an independent predictor of mortality in heterogeneous populations [7][8][9][10][11] . In CAP, a worse ADL is directly related to increased immediate and long-term mortality [32] .…”

“…ADL functional status decline can lead to adverse clinical outcomes in pulmonary infections, dementia [7] , heart failure [8] , hip fractures [9][10] , and acute medical patients [11] . The baseline ADL functional status may be one of the determinants for the evolution of pneumonia.…”

Frailty, sarcopenia and health related outcomes among elderly patients in Saudi Arabia

“…The Katz Activities of Daily Living (ADL) scale is an instrument that developed to assesses six primary and psychosocial functions: bathing, dressing, going to toilet, transferring, feeding, and continence ( Ibrahim 2018 ). Katz and collaborators found that these six activities have a hierarchical order in which the most complex functions are lost first.…”

Assessment of Functional Limitation and Associated Factors in Adults with Following Lower Limb Fractures, Gondar, Ethiopia in 2020: Prospective Cross-Sectional Study

“…The data was collected using pretested and structured questionnaire. The structured questionnaire was adopted by an extensive review of related studies, 11 , 16 , 18 WHO's trauma surveillance questionnaire, 19 and LEFS questionnaire. 15 The questionnaire, which included domains like socio-demographic characteristics: age, gender, occupation; medical comorbidity, behavioral characteristics; and fracture-related characteristics, including types of fracture management, types of fracture, and duration of hospitalization.…”