ADL recovery trajectory after discharge and its predictors among baseline-independent older inpatients

Li, Xiuyue; Zheng, Tingting; Guan, Yaqi; Li, Hui; Zhu, Kexin; Shen, Lu; Yin, Zhiqin

doi:10.1186/s12877-020-1481-8

Cited by 16 publications

(7 citation statements)

References 27 publications

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“…Our approach was aimed at determining the current state of functional disability, as well as the validity and reliability of the chosen measuring instrument, while the study provided by Li et al (2020) used the self-assessment method as a way to monitor the recovery of functional independence in elderly hospitalised persons after discharge from treatment. A similar purpose was found in a study by Covinsky, Palmer, Fortinsky and Counsell (2003), who successfully applied the self-assessment of ADLs and IADLs in determining changes in functional abilities before and after hospitalisation, simultaneously describing the impact of age on functional capacity loss.…”

Section: Resultsmentioning

confidence: 99%

Detecting functional disabilities in elderly persons with cardiovascular diseases using the self-reporting method

Babić¹,

Bertić

Križanec³

et al. 2020

Hrvat. rev. rehabil. istraž. (Online)

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The ability to perform basic activities of daily living (ADL) and instrumental ADL (IADL) is an essential indicator of the level of functional capacity in old age. The purpose of this paper was to evaluate reliability and validity of the self - reporting method in detecting functional difficulties among elderly persons with cardiovascular diseases. The Groningen Activity Restriction Scale was used to assess the limitations in functional capacity. The sample consisted of patients over the age of 65 with hypertensive disease, angina pectoris, ischaemic heart disease, degenerative valvular disorders, peripheral arterial disease, cardiac arrhythmias, cardiomyopathy and heart failure. The Cronbach’s alpha internal consistency coefficient was calculated for the total result. Differences in outcome with respect to age, educational level, marital status, and medical diagnoses of participants were compared by means of a t-test or one-way ANOVA. In the group of ADL, participants reported difficulties in climbing stairs (M=2.14, SD=1.07) and caring for feet and toenails (M=2.17, SD=1.27), while in the group of IADL, difficulties were present in performing heavier household chores (M=2.51, SD=1.31) as well as ironing and washing clothes (M=2.20, SD=1.29). Calculation of the Cronbach’s alpha coefficient points to a high degree of internal consistency for this scale on a chosen sample (α=0.95). The use of a validated self-reporting tool may be a valuable and reliable way for assessing the functional capacity of elderly persons with chronic diseases. The findings of this study indicate the possibility of using this method for prognostic purposes in patients with cardiovascular diseases. Introduction of instrumental support measures in a timely manner has a crucial role in delaying the progression of functional dependence.

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Section: Resultsmentioning

confidence: 99%

Detecting functional disabilities in elderly persons with cardiovascular diseases using the self-reporting method

Babić¹,

Bertić

Križanec³

et al. 2020

Hrvat. rev. rehabil. istraž. (Online)

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“…Previous studies generally concluded that disability is an outcome indicator of intrinsic ability loss. The de nitions of the two indicators of activities of daily living (ADL) and instrumental activities of daily living (IADL) measure individuals' ability to independently satisfy their individual functions and use tools to meet them, re ecting to some extent the performance of their functions in their environments [39,40]. Therefore, the sum of ADL and IADL scores is applied to comprehensively re ect a patient's FA.…”

Section: Key Variablesmentioning

confidence: 99%

Value shift in response to aging: A longitudinal study based on healthy aging

Shen,

Cheng,

Sang

et al. 2024

Preprint

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Objective Healthy aging is considered an effective way to deal with the challenges of aging. Intrinsic capacity(IC) and functional ability (FA) are the key elements of this concept. However, the relationship between the two has not been explored in detail. Methods A theoretical model was constructed by analyzing the concept of “health aging quantification.” A national database (China Health and Retirement Longitudinal Study, CHARLS) was used as the data source for the study. A range of physical and mental measures were employed to construct intrinsic abilities using factor analysis, and a measure of disability was used as a proxy for FA. Descriptive and regression analyses were also conducted to preliminarily assess the distribution of the variables on the IC). This study used cross-lagged models to examine structural and effect differences between IC and FA in the longitudinal manner, along with mediation analysis to analyze the mechanism of the two. Results IC showed normal distribution and an increasing trend in education and income. In the structural analysis, IC and FA indicate significant cross-lagged effects in the longitudinal direction. The effect of IC on FA is also greater than that of FA on IC; such an effect also tends to intensify over time. Furthermore, multimorbidity mediates the effect of IC on FA, but the mediating effect is not very large. Finally, social participation did not significantly mediate the effect of FA on IC. Conclusion The study provides novel insights into the evolution of disability, in which the discovery of the disease is only a process of the outcome of disability. This suggests that policymakers should not only focus on identifying a disease, but also on assessing, maintaining, and providing intervention before the disease. The authorities should also promote the implementation of people-centered rather than disease-centered measures in the health delivery system to achieve value transformation.

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“…In-hospital characteristics and risk factors were chosen according to the well-documented predictors of acute hospitalization outcomes described in previous studies [4,44]. In the present study these factors include cognitive status at admission, emotional status, functional status in BADL during hospitalization, Length of Hospital Stay (LOS), severity of the acute illness, and symptoms severity.…”

Section: Predictorsmentioning

confidence: 99%

The contribution of functional cognition screening during acute illness hospitalization of older adults in predicting participation in daily life after discharge

et al. 2022

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Background Cognitive assessment in acutely hospitalized older adults is mainly limited to neuropsychological screening measures of global cognition. Performance-based assessments of functional cognition better indicate functioning in real-life situations. However, their predictive validity has been less studied in acute hospital settings. The aim of this study was to explore the unique contribution of functional cognition screening during acute illness hospitalization in predicting participation of older adults one and three months after discharge beyond traditional neuropsychological measures. Methods This prospective longitudinal study included 84 older adults ≥ 65 years hospitalized in internal medicine wards due to acute illness, followed by home visits at one month and telephone interviews at three months (n = 77). Participation in instrumental activities of daily living, social and leisure activities was measured by the Activity Card Sort. In-hospital factors included cognitive status (telephone version of the Mini-Mental State Examination, Color Trails Test), functional cognition screening (medication sorting task from the alternative Executive Function Performance Test), emotional status (Hospital Anxiety and Depression scale), functional decline during hospitalization (modified Barthel index), length of hospital stay, the severity of the acute illness, symptoms severity and comorbidities. Results Functional cognition outperformed the neuropsychological measures in predicting participation declines in a sample of relatively high-functioning older adults. According to a hierarchical multiple linear regression analysis, the overall model explained 28.4% of the variance in participation after one month and 19.5% after three months. Age and gender explained 18.6% of the variance after one month and 13.5% after three months. The medication sorting task explained an additional 5.5% of the variance of participation after one month and 5.1% after three months, beyond age and gender. Length of stay and the Color Trails Test were not significant contributors to the change in participation. Conclusions By incorporating functional cognition into acute settings, healthcare professionals would be able to better detect older adults with mild executive dysfunctions who are at risk for participation declines. Early identification of executive dysfunctions can improve continuity of care and planning of tailored post-discharge rehabilitation services, especially for high-functioning older adults, a mostly overlooked population in acute settings. The results support the use of functional cognition screening measure of medication management ability in acute settings.

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ADL recovery trajectory after discharge and its predictors among baseline-independent older inpatients

Cited by 16 publications

References 27 publications

Detecting functional disabilities in elderly persons with cardiovascular diseases using the self-reporting method

Detecting functional disabilities in elderly persons with cardiovascular diseases using the self-reporting method

Value shift in response to aging: A longitudinal study based on healthy aging

The contribution of functional cognition screening during acute illness hospitalization of older adults in predicting participation in daily life after discharge

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