Variation in functional independence in hospitalized elderly related to social and health variables

Authors

  • Kozue Kawasaki Universidade Estadual de Campinas
  • Maria José D’Elboux Diogo Universidade Estadual de Campinas

DOI:

https://doi.org/10.11606/issn.2317-0190.v14i3a102826

Keywords:

Disability Evaluation, Hospitalization, Quality of Life, Activities of Daily Living, Aged

Abstract

The aging process, non-transmissible chronic diseases and hospitalizations can cause functional decline in the elderly. Objective: to identify the variation in functional capacity in elderly during hospitalization and correlate it with social and health variables. Method: The study was developed at a University Hospital in Campinas, SP, with 28 elderly inpatients of both sexes, admitted for clinical treatment, with a mean age of 68 years. The Functional Independence Measure (FIM) was used at the admission, during the hospitalization, at the discharge and one month after the discharge. The variation in FIM scores was calculated at different moments of evaluation, expressed by deltas and correlated with the variables: gender, previous hospitalization, presence of caregiver and use of medications. Results: There was a significant difference in the deltas of FIM between the discharge-home return periods (p=0.0010) and the admission-discharge periods (p<0.0001), in total FIM and its domains, showing decreased functional independence during hospitalization and recovery after the return home. The gender, previous hospitalization and presence of caregiver did not significantly influence the functional capacity of the elderly inpatients; however the increased number of prescribed medications between the admission and the discharge periods presented a moderate (r=0.5059) and a very significant correlation (p=0.0071) with functional decline in this period. Conclusion: There was a functional decrease in elderly inpatients during the hospitalization, being more significant among inpatients that had an increased number of prescribed medications during hospitalization.

Downloads

Download data is not yet available.

References

Ramos LRMP. Epidemiologia do envelhecimento. In: Freitas EV, Py L, Neri AL, Cançado FAX, Gorzoni ML, Rochas SM. Tratado de geriatria e gerontologia. Sao Paulo: Guanabara Koogan; 2002. p.72-8.

Veras R, Lourenço R, Martins CSF, Sanchez MA, Chaves PH. Novos paradigmas do modelo assistencial no setor saúde: conseqüência da explosao populacional dos idosos no Brasil. In: Veras RP. Terceira idade: gestao contemporânea em saúde. Rio de Janeiro: Relume Dumara; 2002. p.11-79.

Diogo MJD'E. Satisfaçao global com a vida e determinados domínios entre idosos com amputaçao de membros inferiores. Pan Am J Public Health. 2003;13(6):395-9.

Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW Studies of illness in the aged. The Index of ADL: A standardized measure of biological and psychosocial function. JAMA. 1963;185:914-9.

Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179-86.

Neri AL. Palavras-chave em gerontologia. Sao Paulo: Alínea; 2001.

Inouye SK, Wagner DR, Acampora D, Horwitz RI, Cooney LM Jr, Hurst LD, et al. A predictive index for functional decline in hospitalized elderly medical patients. J Gen Intern Med. 1993;8(12):645-52.

Sager MA, Rudberg MA, Jalaluddin M, Franke T, Inouye SK, Landefeld CS, et al. Hospital admission risk profile (HARP): identifying older patients at risk for functional decline following acute medical illness and hospitalization. J Am Geriatr Soc. 1996;44(3):251-7.

Mateev A, Gaspoz JM, Borst F, Waldvogel F, Weber D. Use of a short-form screening procedure to detect unrecognized functional disability in the hospitalized elderly. J Clin Epidemiol. 1998;51(4):309-14.

Sandoval P, Palma A, Sandoval F. Variación de la capacidad funcional en adultos mayores que requirieron de hospitalización. Bol Hosp S J Dios. 1998; 45:268-72.

Rodríguez JG, Rojas VD, Jaurrieta JJS. Deterioro funcional secundario a la hospitalización por enfermedad aguda en el anciano. Análisis de la incidencia y los factores de riesgo asociados. Rev Clin Española. 1999;199:418-23.

Inouye SK, Bogardus ST, Baker DI, Leo-Summers L, Cooney LM. The Hospital Elder Life Program: a model of care to prevent cognitive and functional decline in older hospitalized patients. Hospital Elder Life Program. J Am Geriatr Soc. 2000;48(12):1697-706.

Brown CJ, Friedkin RJ, Inouye SK. Prevalence and outcomes of low mobility in hospitalized older patients. J Am Geriatr Soc. 2004;52(8):1263-70.

Riberto M, Miyazaki MH, Jorge Filho D, Sakamoto H, Battistella LR. Reprodutibilidade da versao brasileira da Medida de Independência Funcional. Acta Fisiatr. 2001;8(1):45-52. Doi: https://doi.org/10.5935/0104-7795.20010002

Kawasaki K, Cruz KCT, Diogo MJD'E. A utilizaçao da Medida de Independência Funcional (MIF) em idosos. Med Reabil. 2004;23(3):57-60.

Polit DF, Hungler BP. Fundamentos de pesquisa em enfermagem. 3 ed. Porto Alegre: Artes Médicas; 1995.

Conover WJ. Practical nonparametric statistics. Nova Iorque: John Wiley & Sons; 1971.

Ajzen I, Fishbein M. Understanding attitudes and predicting social behavior. New Jersey: Prentice-Hall; 1980.

Covinsky KE, Palmer RM, Fortinsky RH, Counsell SR, Stewart AL, Kresevic D, et al. Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. J Am Geriatr Soc. 2003;51(4):451-8.

Gamarra-Samaniego P. Consecuencias de la hospitalización en el anciano. Bol Soc Med Interna. 2001;14:90-8.

Heruti RJ, Lusky A, Barell V, Ohry A, Adunsky A. Cognitive status at admission: does it affect the rehabilitation outcome of elderly patients with hip fracture? Arch Phys Med Rehabil. 1999;80(4):432-6.

Ergeletzis D, Kevorkian CG, Rintala D. Rehabilitation of the older stroke patient: functional outcome and comparison with younger patients. Am J Phys Med Rehabil. 2002;81(12):881-9.

Carlson JE, Zocchi KA, Bettencourt DM, Gambrel ML, Freeman JL, Zhang D, et al. Measuring frailty in the hospitalized elderly: concept of functional homeostasis. Am J Phys Med Rehabil. 1998;77(3):252-7.

Sager MA, Franke T, Inouye SK, Landefeld CS, Morgan TM, Rudberg MA, et al. Functional outcomes of acute medical illness and hospitalization in older persons. Arch Intern Med. 1996;156(6):645-52.

Hachisuka K, Tsutsui Y, Furusawa K, Ogata H. Gender differences in disability and lifestyle among community-dwelling elderly stroke patients in Kitakyushu, Japan. Arch Phys Med Rehabil. 1998;79(8):998-1002.

Baltes MM, Silverberg S. A dinâmica dependência-autonomia no curso de vida. In: Neri AL. Psicologia do envelhecimento. Sao Paulo: Papirus; 1995. p.73-100.

Carlson JE, Zocchi KA, Bettencourt DM, Gambrel ML, Freeman JL, et al. Measuring frailty in the hospitalized elderly: concept of functional homeostasis. Am J Phys Med Rehabil. 1998;77(3):252-7.

Braga TBT. Prevalência de prescriçao de medicamentos para pacientes internados em um hospital escola: idosos e nao idosos [tese]. Campinas: Universidade Estadual de Campinas; 1997.

Campbell SE, Seymour DG, Primrose WR; ACMEPLUS Project. A systematic literature review of factors affecting outcome in older medical patients admitted to hospital. Age Ageing. 2004;33(2):110-5.

Published

2007-09-09

Issue

Section

Original Article

How to Cite

1.
Kawasaki K, Diogo MJD. Variation in functional independence in hospitalized elderly related to social and health variables. Acta Fisiátr. [Internet]. 2007 Sep. 9 [cited 2024 May 19];14(3):164-9. Available from: https://www.revistas.usp.br/actafisiatrica/article/view/102826