Determinants of trajectories of fatigability and mobility among older medical patients during and after hospitalization; an explorative study.
BMC Geriatr
; 22(1): 12, 2022 01 03.
Article
en En
| MEDLINE
| ID: mdl-34979955
ABSTRACT
BACKGROUND:
Fatigability is an important marker of functional decline in community dwelling older people, yet its relationship with functional decline after hospitalization is unclear. The objectives of this study were to identify trajectories of fatigability and mobility over time and to examine the association between demographic and clinical characteristics and these trajectories in medical patients aged 70 years and older admitted to a Dutch tertiary care teaching hospital.METHODS:
In this prospective cohort study with baseline (in-hospital), discharge, three-, and six-months post discharge follow-up measurements, fatigability was assessed by the physical subscale of the Pittsburgh Fatigability Scale (PFS). Mobility was assessed by the De Morton Mobility Index (DEMMI). Group-based trajectory modeling was used to identify joint trajectories of fatigability and mobility. Covariates included demographic (age, sex, living situation, education) and clinical characteristics (functional status, frailty status, depression, comorbidity, length of hospital stay).RESULTS:
Among 44 patients, three distinct fatigability trajectories and two mobility trajectories were identified over the course from hospital admission up to six months after discharge. Subsequently, three joint trajectories were identified, including low fatigability and high mobility (11%), improving fatigability and high mobility (52%), and high fatigability and low mobility (36%). Controlling for baseline functional status, patients with a lower comorbidity score (OR 0.27, 95%CI 0.10; 0.74) and higher frailty status (OR 1.36, 95%CI 1.07; 1.74) were more likely to be a member of the high fatigability and low mobility trajectories.CONCLUSIONS:
From hospital admission up to six months after discharge, three distinct trajectories of fatigability and mobility were identified among older medical patients. Our results should be interpreted with caution due to the small sample size, but may inspire other researchers to determine the value of fatigability assessment in identifying older medical patients at risk for developing mobility problems.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
11_ODS3_cobertura_universal
Problema de salud:
11_delivery_arrangements
Asunto principal:
Evaluación Geriátrica
/
Cuidados Posteriores
Tipo de estudio:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Humans
Idioma:
En
Revista:
BMC Geriatr
Asunto de la revista:
GERIATRIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Países Bajos