Hospitalization Associated Disability

Loss of ability to complete 1 of the basic activities of daily living needed to live independently: bathing dressing rising from chair or a bed, using the toilet, eating, or walking across a room.

Individuals with HAD cannot live without assistance and require the help of caregivers or need a long term care facility.

At least 30% of patients older than 70 years hospitalized with an illness develop HAD that did not exist before the development of the acute illness.

Very elderly and frail patients have higher rates of HAD.

Declines in physical function, and inability to regain physical function after a hospital stay strongly predicts the risk of re-hospitalization and mortality in older patients.

Most hospitalized patients remain largely inactive during their stay.

In a study of hospitalized elderly patients in an academic institution, approximately 73% did not walk at all during a 3 hour period(Callen BL).

Hospitalized elderly patients frequently experience inactivity, malnutrition, and disease burden which collectively contributes to acceleration of sarcopenia.

Among elderly, lack of activity during hospitalization is independently associated with higher mortality, decline in functional status, increase in readmission rates, and greater rate of nursing home placement.

Nearly 50% of elderly patients are bed bound or have low mobility during their hospitalization, despite lack of a clear medical indication.

Approximately 50% of disability in the elderly develops in the setting of a hospitalization.

Age is the most potent risk factor.

Other significant risk factors for HAD include depression and cognitive dysfunction. What he

More than 50% of those 85 years or older leave the hospital with a major new activity of daily living disability.

Elderly me with low testosterone levels are particularly vulnerable to adverse events after hospitalization, given that this testosrerone deficiency is independently associated with sarcopenia, and health decline.

Less than 50% of older adults recover to their preillness function levels by 1 year, and rates of nursing home placement and mortality are high.

HAD results in a loss of independence portending along term care in a nursing facility, repeat hospitalizations and even death.

Hospital environmental processes that contribute to physical disability include prolonged bed rest, inadequate nutritional support, restrictive diets, excess use of monitors, urinary catheters, intravenous lines, and sedation medications.

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