The Course of Geriatric Syndromes in Acutely Hospitalized Older Adults: The Hospital-ADL Study.
J Am Med Dir Assoc. 2018 Sep 27;:
Authors: van Seben R, Reichardt LA, Aarden JJ, van der Schaaf M, van der Esch M, Engelbert RHH, Twisk JWR, Bosch JA, Buurman BM, Hospital-ADL Study Group
OBJECTIVES: To establish the prevalence and course of geriatric syndromes from hospital admission up to 3 months postdischarge and to determine the probability to retain geriatric syndromes over the period from discharge until 3 months postdischarge, once they are present at admission.
DESIGN: Prospective multicenter cohort study conducted between October 2015 and June 2017.
SETTING AND PARTICIPANTS: Acutely hospitalized patients aged 70 years and older recruited from internal, cardiology, and geriatric wards of 6 Dutch hospitals.
MEASURES: Cognitive impairment, depressive symptoms, apathy, pain, malnutrition, incontinence, dizziness, fatigue, mobility impairment, functional impairment, fall risk, and fear of falling were assessed at admission, discharge, and 1, 2, and 3 months postdischarge. Generalized estimating equations analysis were performed to analyze the course of syndromes and to determine the probability to retain syndromes.
RESULTS: A total of 401 participants [mean age (standard deviation) 79.7 (6.7)] were included. At admission, a median of 5 geriatric syndromes were present. Most prevalent were fatigue (77.2%), functional impairment (62.3%), apathy (57.5%), mobility impairment (54.6%), and fear of falling (40.6%). At 3 months postdischarge, an average of 3 syndromes were present, of which mobility impairment (52.7%), fatigue (48.1%), and functional impairment (42.5%) were most prevalent. Tracking analysis showed that geriatric syndromes that were present at admission were likely to be retained. The following 6 geriatric syndromes were most likely to stay present postdischarge: mobility impairment, incontinence, cognitive impairment, depressive symptoms, functional impairment, and fear of falling.
IMPLICATIONS: Acutely hospitalized older adults exhibit a broad spectrum of highly prevalent geriatric syndromes. Moreover, patients are likely to retain symptoms that are present at admission postdischarge. Our study underscores the need to address a wide range of syndromes at admission, the importance of communication on syndromes to the next care provider, and the need for adequate follow-up care and syndrome management postdischarge.
PMID: 30270027 [PubMed - as supplied by publisher]