Digestivamente: Mobile application for patients with irritable bowel syndrome / Digestivamente: Aplicación móvil para pacientes con Síndrome de Intestino Irritable.

Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder that represents a significant public health problem due to the impact it produces on quality of life. Recommended treatments include cognitive-behavioral therapy to address psychological factors that may exacerbate symptoms. The use of technology and particularly mobile applications has grown significantly in recent years. In Argentina, no applications have been developed for IBS. Digestivamente is a mobile application, based on cognitive-behavioral therapy developed in this country. It aims to register the psychological factors of patients with IBS, in the context of a psychotherapeutic treatment. This work describes the application and its functionalities. The use of the application is expected to allow greater adherence to treatment and an improvement in the symptoms of these patients.

El Síndrome de Intestino Irritable (SII) es un trastorno gastrointestinal funcional crónico que representa un problema en salud pública debido al impacto que produce en la calidad de vida. Los tratamientos recomendados incluyen a la terapia cognitivo-conductual para el abordaje de aquellos factores psicológicos que exacerban los síntomas. El uso de la tecnología y particularmente de aplicaciones móviles ha crecido de manera significativa durante los últimos años. En Argentina no se han desarrollado aplicaciones para SII. Digestivamente es una aplicación móvil, basada en la terapia cognitivo-conductual desarrollada en este país. Tiene por objetivo el registro de los factores psicológicos de los pacientes con SII en el contexto de un tratamiento psicoterapéutico. En el presente trabajo se describe la aplicación y sus funcionalidades. Se espera que la utilización de la aplicación permita mayor adherencia al tratamiento y una mejoría en la sintomatología de estos pacientes.

RGB-D-Based Framework to Acquire, Visualize and Measure the Human Body for Dietetic Treatments.

This research aims to improve dietetic-nutritional treatment using state-of-the-art RGB-D sensors and virtual reality (VR) technology. Recent studies show that adherence to treatment can be improved using multimedia technologies. However, there are few studies using 3D data and VR technologies for this purpose. On the other hand, obtaining 3D measurements of the human body and analyzing them over time (4D) in patients undergoing dietary treatment is a challenging field. The main contribution of the work is to provide a framework to study the effect of 4D body model visualization on adherence to obesity treatment. The system can obtain a complete 3D model of a body using low-cost technology, allowing future straightforward transference with sufficient accuracy and realistic visualization, enabling the analysis of the evolution (4D) of the shape during the treatment of obesity. The 3D body models will be used for studying the effect of visualization on adherence to obesity treatment using 2D and VR devices. Moreover, we will use the acquired 3D models to obtain measurements of the body. An analysis of the accuracy of the proposed methods for obtaining measurements with both synthetic and real objects has been carried out.

Spanish list of potentially inappropriate drugs in the elderly (ES-PIA project).

PURPOSE: In the last decades, different criteria have been developed for detecting inappropriate prescription in older patients. In Spain, translations and adaptations of international lists are available but it would be necessary a national list which could cope with the peculiarities of our health system, existing pharmaceutical market, and prescription habits. We propose in this project the creation of a Spanish potentially inappropriate drugs list which could be applicable in our clinical scenario. METHODS: We use a Delphi method involving 25 experts from different backgrounds (Clinical Pharmacology, Geriatrics, Rational Use of Drugs and Pharmacy, Primary Care and Pharmacoepidemiology, and Pharmacovigilance) that were asked to participate in two-round questionnaires. For analysis, current recommendations of Worth and Pigni were applied, and every statement was classified into one of three groups: strong, moderate, or low agreement. Statements with strong agreement were accepted to be part of the inadequate prescription list. Moderate agreement statements were selected to enter the second questionnaire, and statements with low agreement were further analyzed to determine if it was due to heterogeneity or due to dispersion in the answers. RESULTS: The first questionnaire consisted of 160 proposed sentences, of which 106 reached a high agreement, 32 a moderate agreement, and 22 a low agreement. All sentences proposed in the second questionnaire reached a strong agreement. The total accepted sentences were 138. CONCLUSIONS: We offer a list of inadequate prescription in older patients adapted to the Spanish pharmacopeia and according to the prescription habits in our environment.

Hypogean pseudoscorpions (Arachnida) from Jaén province (Andalusia, Spain), with descriptions of four new species and a new synonymy.

Four new hypogean species are described from the Jaén province (southern Spain): Chthonius (Ephippiochthonius) espa- nyoli sp. nov., C. (E.) giennensis sp. nov., C. (E.) villacarrillo sp. nov. and Neobisium (Ommatoblothrus) perezruizi sp. nov. New records are given for the species Chthonius (E.) cazorlensis, C. (E.) perezi, C. (E.) tetrachelatus, Neobisium (O.) perezi, Microcreagrella caeca caeca and Allochernes masi. Chthonius (E.) verai and C. (E.) minutus are removed from the list of the Andalusian fauna. A new synonymy is proposed: Neobisium (O.) gev Carabajal Márquez, García Carrillo & Rodríguez Fernández, 2011, is a junior subjective synonym of N. (O.) perezi Carabajal Márquez, García Carrillo & Rodríguez Fernández, 2011.

On hypogean Roncocreagris (Arachnida: Pseudoscorpiones: Neobisiidae) from Portugal, with descriptions of three new species.

Three new hypogean species of the Iberian genus Roncocreagris Mahnert, 1974 are described from mainland Portugal: R. borgesi sp. nov. and R. gepesi sp. nov. from caves in the Sicó massif, and R. occidentalis sp. nov. from caves in the Montejunto and Cesaredas karst plateau. This brings to nine the number of known hypogean species of the mostly Iberian genus Roncocreagris: five from Portugal and four from Spain. Ecological comments and new localities for some of the previously known species are also included.

Effect of Familial Longevity on Frailty and Sarcopenia: A Case-Control Study.

Familial longevity confers advantages in terms of health, functionality, and longevity. We sought to assess potential differences in frailty and sarcopenia in older adults according to a parental history of extraordinary longevity. A total of 176 community-dwelling subjects aged 65-80 years were recruited in this observational case-control study, pair-matched 1:1 for gender, age, and place of birth and residence: 88 centenarians' offspring (case group) and 88 non-centenarians' offspring (control group). The main variables were frailty and sarcopenia based on Fried's phenotype and the European Working Group on Sarcopenia in Older People (EWGSOP) definitions, respectively. Sociodemographics, comorbidities, clinical and functional variables, the presence of geriatric syndromes, and laboratory parameters were also collected. Related sample tests were applied, and conditional logistic regression was performed. Cases had a higher percentage of robust patients (31.8% vs. 15.9%), lower percentages of frailty (9.1% vs. 21.6%) and pre-frailty (59.1% vs. 62.5%) (p = 0.001), and lower levels of IL-6 (p = 0.044) than controls. The robust adjusted OR for cases was 3.00 (95% CI = 1.06-8.47, p = 0.038). No significant differences in muscle mass were found. Familial longevity was also associated with less obesity, insomnia, pain, and polypharmacy and a higher education level and total and low-density lipoprotein cholesterol. The results suggest an inherited genetic component in the frailty phenotype, while the sarcopenia association with familial longevity remains challenging.

[Suitability of the use of benzodiazepines prescribed by the pharmacist in the elderly. A doctor-pharmacist collaboration study]. / Adecuación de la utilización de benzodiazepinas en ancianos desde la oficina de farmacia. Un estudio de colaboración médico-farmacéutico.

AIMS: To improve the use of benzodiazepines (BZD) in the elderly by a pharmacist-physician collaboration, and to insure that BZD are effective, safe, and used as long as necessary. DESIGN: A single blind controlled study was conducted on 11 pharmacies in the Community of Valencia. SETTING: Eleven pharmacies in the Community of Valencia. PARTICIPANTS: Patients older than 65 years treated with BZD attending the participating pharmacies. INTERVENTIONS: Interviews and pharmaceutical care for a year. MAIN MEASUREMENT: detection of duplications, adverse drug reactions, drug interactions and measuring the effectiveness of the treatment. RESULTS: We studied 314 patients, randomised to control or intervention and who used 346 BZD. The majority (67%) of patients used BZD for more than 1 year. Only 5% patients with anxiety knew the duration of treatment should be one month. Long-acting BZD were used by 20% of the patients, 76% used medium-acting (39% lorazepam and 37% other BZD) and 4% short-acting BZD. A total of 132 drug interactions were detected and 278 adverse drug reactions: 32% memory loss, 21% drowsiness, 12% lack of coordination, 8.3% dizziness and confusion, 8,3% disorientation and 10% others. A total of 426 pharmacist interventions were performed, 30 accepted by the doctor and 78 were resolved at the end of the year of study. Eleven per cent of cases were considered satisfactory in the control group and 30% in the intervention group. CONCLUSION: The use of benzodiazepines in the Community of Valencia exceeds the recommendations of the Spanish Medicines Agency.

[Incurable disease in Spain during the 19th century. The Hospital para Hombres Incurables Nuestra Señora del Carmen]. / Enfermedad incurable en la España del siglo XIX: el Hospital para Hombres Incurables Nuestra Señora del Carmen.

This paper examines the State's assumption of medical care for patients with "permanent needs" in 19th century Spain. These patients were the incurably ill, the chronically ill and the elderly. This process is contextualized within the liberal reforms of the Spanish healthcare system in the reign of Isabel 11 (1833-1868). The goal of these reforms was the creation and consolidation of a national health system that would gradually replace the religious health charities. Healthcare reform became necessary due to the increase in migration that started in the 1830's and intensified in the 1850's. Traditional care networks formed by the family, local community and religious charities were no longer available to those who had left their village or town. In addition, many religious charities were bankrupted by the seizure of their properties in a programme of confiscation. Similar healthcare reform processes were taking place in the United Kingdom, France and Germany, among other European countries, and involved significant changes in the lives of patients, who became strictly controlled and medicalised. My aim was to identify changes in the patients' experience of illness through a case study of the living conditions of inmates at the Nuestra Señora del Carmen Hospital for Incurable Men, based in Madrid from 1852 to 1949. This was one of the institutions devoted to caring for patients with "permanent needs" and was under the direct control of the General State Administration.

Vegetation Pattern Modulates Ground Arthropod Diversity in Semi-Arid Mediterranean Steppes.

The ecological functioning of dryland ecosystems is closely related to the spatial pattern of the vegetation, which is typically structured in patches. Ground arthropods mediate key soil functions and ecological processes, yet little is known about the influence of dryland vegetation pattern on their abundance and diversity. Here, we investigate how patch size and cover, and distance between patches relate to the abundance and diversity of meso-and microarthropods in semi-arid steppes. We found that species richness and abundance of ground arthropods exponentially increase with vegetation cover, patch size, and patch closeness. The communities under vegetation patches mainly respond to patch size, while the communities in the bare-soil interpatches are mostly controlled by the average distance between patches, independently of the concurrent changes in vegetation cover. Large patches seem to play a critical role as reserve and source of ground arthropod diversity. Our results suggest that decreasing vegetation cover and/or changes in vegetation pattern towards small and over-dispersed vegetation patches can fast lead to a significant loss of ground arthropods diversity in drylands.

Oxidative stress and exceptional human longevity: Systematic review.

OBJECTIVE: Oxidative stress (OS) has been previously linked to the aging process, as have some diseases and geriatric syndromes as frailty and sarcopenia. The aim of the present study was to perform a systematic review on oxidative stress activity and extreme longevity in humans. METHODS: We conducted a systematic literature review following the PRISMA guidelines. Observational studies assessing OS-biomarkers and/or antioxidants in long-lived individuals (97 years old or over) comparing them to those of one or more age groups, (at least one of which from comprising elderly subjects) were considered for inclusion. A narrative synthesis was planned. Quality of selected studies was assessed using the Newcastle-Ottawa quality assessment scale (NOS). RESULTS: After screening and eligibility phases, 12 articles were finally selected, with 646 long-lived participants and 1052 controls, 447 adults (20-60 years old) and 605 elderly individuals (over 60 years old). The average score on NOS scale of studies was 4,8 out of 9. Centenarians showed significantly less (p<0,05) oxidative damage to lipids in different samples, lower levels of oxidized proteins in plasma and lower superoxide anion levels in neutrophils than elderly groups. Centenarian presented significantly lower superoxide dismutase and higher glutathione reductase activities, higher levels of vitamins A and E, lower of coenzyme Q10, and lower susceptibility to lipid peroxidation than elderly controls. CONCLUSION: Based on studies of medium-low quality, available evidence suggests that long-lived individuals display less oxidative damage, particularly lower plasma lipid peroxidation biomarkers, than controls. More studies with better experimental designs are needed.

A new pseudoscorpion genus from western Georgia (Pseudoscorpiones: Neobisiidae: Cornuroncus n. gen.), with a key to all Neobisiinae genera.

A new genus and species of epigean pseudoscorpions belonging to the subfamily Neobisiinae Chamberlin, 1930, is described from western Georgia and its diagnostic characters are illustrated. Cornuroncus n. gen. resembles the genus Roncus L. Koch, 1873 in several characters but differs by having a short dorso-distal spine on tarsus IV, and the presence of a ventral tooth on one of the claws of tarsus IV. An identification key for all valid Neobisiinae genera is provided.

A daily multidisciplinary assessment of older adults undergoing elective colorectal cancer surgery is associated with reduced delirium and geriatric syndromes.

OBJECTIVES: Comprehensive geriatric assessment (CGA) has shown to benefit older patients undergoing urological and orthopedic surgery. However, this approach has been scarcely assessed in patients elected for colorectal surgery. MATERIALS AND METHODS: Retrospective cohort of patients aged ≥70 years admitted for elective colorectal cancer surgery to a single hospital between 2008 and 2012. Upon admission, patients were assigned to a usual care (UC) plan or a CGA-based care (GS) plan conducted by a multidisciplinary team, according to standard clinical criteria.Analyzed outcomes included the incidence of delirium and other geriatric syndromes during hospital stay, mortality, readmissions, andnumber of perioperative complications. RESULTS: The cohort included 310 patients, 203 assigned to the GS group and 107 to the UC group. Patients in the GS group had significantly lower Barthel and Lawton scores, higher prevalence of dementia and heart failure, and higher comorbidity burden. Fifty-four (17.5%) patientsexperienced delirium (23 [11.3%] and 31 [29.2%] in the GS and UC groups, respectively; p < .001), and 49 (15.8%) patient experienced other geriatric syndromes (21 [10.3%] and 28 [26.2%] in the GS and UC groups, respectively; p < .001). Serious complications were more frequent in the GS group: 154 (75.9%) vs 60 (56.1%) in the UC group; p < .001. No significant differences were observed between groups regarding readmissions, and in-hospital and post-discharge (1 year follow-up) mortality. CONCLUSIONS: Despite the poorer clinical condition of patients in the GS group, the CGA-based intervention resulted in a lower incidence of delirium and other geriatric syndromes compared with the UC group.

Influence of hospital adverse events and previous diagnoses on hospital care cost of patients with hip fracture.

Previous diagnoses of patients with hip fracture influence the hospitalization cost of these patients, either directly or by increasing the risk of in-hospital adverse events associated with increased costs. PURPOSE: To investigate how previous diagnoses influence the occurrence of in-hospital adverse events and how both factors impact on hospital costs. METHODS: This is a retrospective analysis of the hospital Minimum Basic Data Set. Patients aged 70 years or older admitted for hip fracture (HF) at a single University Hospital between January 2012 and December 2016. Both, previous diagnoses and adverse events, were defined according to the International Classification of Diseases (ICD-9/ICD-10). The anticipated cost of each admission was calculated based on diagnosis-related groups and using the "all patients refined" method (APR-DRG). The occurrence of adverse events during hospital stay was assessed by excluding all diagnoses present on admission. RESULTS: The record included 1571 patients with a mean (SD) age of 84 years. The most frequent previous diagnoses were diabetes (n = 432, 27.5%) and dementia (n = 251, 16.0%), and the most frequent adverse events were delirium (n = 238, 15.1%) and anemia (n = 188, 12.0%). The mean (SD) total acute care costs per patient were €8752.1 (1864.4). The presence of heart failure, COPD, and kidney disease at admission significantly increased the hospitalization cost. In-hospital adverse events of delirium, cardiac events, anemia, urinary tract infection, and digestive events significantly increased costs. The multivariate analyses identified kidney disease as a previous diagnosis significantly contributing to explain an increase in hospitalization costs, and delirium, cardiac disease, anemia, urinary infection, respiratory event, and respiratory infection as in-hospital adverse events significantly contributing to an increase of hospitalization costs. CONCLUSIONS: Although few baseline comorbidities have a direct impact on hospitalization costs, most previous diagnoses increase the risk of in-hospital adverse events, which ultimately influence the hospitalization cost.

New species of Pseudoscorpiones (Arachnida) from tree hollows in a Mediterranean oak forest in Spain.

Pseudoscorpions inhabiting mature Quercus pyrenaica Willd. trees have been surveyed using hollow emergence traps and window traps in Salamanca, Spain. Three new species are described: Neobisium (N.) hispanicum Zaragoza Hernández-Corral, n. sp., Rhacochelifer gaeli Zaragoza Hernández-Corral, n. sp. and Rhacochelifer nonidezi Zaragoza Hernández-Corral, n. sp. The genera Amblyolpium Simon, 1898 and Beierochelifer Mahnert, 1977 and the species Amblyolpium dollfusi Simon, 1898 and Beierochelifer peloponnesiacus (Beier, 1929) are new records for the Iberian Peninsula. Beierochelifer peloponnesiacus jonicus (Beier, 1932) is shown to be a junior subjective synonym of B. peloponnesiacus n. syn. New regional records of five other species belonging to the families Cheliferidae, Chernetidae and Withiidae are given. Keys are given for the species of the genera Pseudorhacochelifer Beier, 1976 and Rhacochelifer Beier, 1932 with elongated keels on posterolateral corners of carapace and anterior tergites in males, and for the Rhacochelifer species of the Iberian Peninsula. Complementary data to the description of the female syntypes from Caravaca (Murcia, mainland Spain) and males from the Canary Islands of Rhacochelifer pinicola (Nonídez, 1917) are given. Brief redescriptions of the female of Neobisium (N.) maroccanum Beier, 1930 and the male of Rhacochelifer euboicus Mahnert, 1977 are provided. The previous record of R. disjunctus from Slovakia is shown to be an error for R. euboicus. New data on the distribution and habitats of species of Cheliferidae, Chernetidae and Withiidae are given.

A new Antillobisium species (Arachnida: Pseudoscorpiones: Bochicidae) from Cuba, with biogeographical and ecological remarks on the genus.

A new troglobitic species of the genus Antillobisium is described from Sancti Spiritus province, Cuba. Antillobisium tomasi n. sp. is the third known species of the genus and is well characterized by its large size and extremely slender appendages. Biogeographical and ecological considerations on the genus are given.

Estimate of the Costs Caused by Adverse Effects in Hospitalised Patients Due to Hip Fracture: Design of the Study and Preliminary Results.

INTRODUCTION: Hip fracture is a health problem that presents high morbidity and mortality, negatively influencing the patient's quality of life and generating high costs. Structured analysis of quality indicators can facilitate decision-making, cost minimization, and improvement of the quality of care. METHODS: We studied 1571 patients aged 70 years and over with the diagnosis of hip fracture at Hospital Universitario de la Ribera in the period between 1 January 2012 and 31 December 2016. Demographic, clinical, functional, and quality indicator variables were studied. An indirect analysis of the costs associated with adverse events arising during hospital admission was made. A tool based on the "Minimum Basic Data Set (CMBD)" was designed to monitor the influence of patient risk factors on the incidence of adverse effects (AE) and their associated costs. RESULTS: The average age of the patients analysed was 84.15 years (SD 6.28), with a length of stay of 8.01 days (SD 3.32), a mean preoperative stay of 43.04 h (SD 30.81), and a mortality rate of 4.2%. Likewise, the percentage of patients with AE was 41.44%, and 11.01% of patients changed their cost as a consequence of these AEs suffered during hospital admission. The average cost of patients was €8752 (SD: 1,864) and the average cost increase in patients with adverse events was €2321 (SD: 3,164). CONCLUSIONS: Through the analysis of the main clinical characteristics and the indirect estimation of the complexity of the patients, a simple calculation of the average cost of the attention and its adverse events can be designed in patients who are admitted due to hip fracture. Additionally, this tool can fit the welfare quality indicators by severity and cost.

Revision of the Ephippiochthonius complex in the Iberian Peninsula, Balearic Islands and Macaronesia, with proposed changes to the status of the Chthonius subgenera (Pseudoscorpiones, Chthoniidae).

A taxonomic revision of the subgenus Chthonius (Ephippiochthonius) in the Iberian Peninsula, Balearic Islands and    Macaronesia is presented. New and previously insufficiently studied characteristics are shown to be taxonomically useful, such as the chelal lyrifissures patterns, chaetotaxy and condylar complex. Three taxa previously treated as subgenera of Chthonius are here raised to generic rank: Ephippiochthonius n. stat., Globochthonius n. stat., and Hesperochthonius n. stat. Two new genera are described: Cantabrochthonius n. gen. and Occidenchthonius n. gen. Thirty-five new species are described: Ephippiochthonius aini n. sp., E. andalucia n. sp., E. aurouxi n. sp., E. benimaquia n. sp., E. caceresi n. sp., E. castellonensis n. sp., E. comasi n. sp., E. fadriquei n. sp., E. galcerani n. sp., E. gonzalezi n. sp., E. henderickxi n. sp., E. ibiza n. sp., E. masoae n. sp., E. portugalensis n. sp., E. riberai n. sp., E. serengei n. sp., E. sevai n. sp., E. tarraconensis n. sp., E. vicenae n. sp., E. zaballosi n. sp., Occidenchthonius anae n. sp., O. beieri n. sp., O. ebo n. sp., O. felgueraorum n. sp., O. gardinii n. sp., O. hoerwegi n. sp., O. lencinai n. sp., O. mahnerti n. sp., O. mateui n. sp., O. montagudi n. sp., O. murcia n. sp., O. oromii n. sp., O. ortunoi n. sp., O. riopar n. sp. and O. serranoi n. sp. A neotype is designated for Ephippiochthonius catalonicus (Beier, 1939), n. comb. As result of the changes in generic rank, 45 new combinations for species are proposed.

[Oxidative stress and longevity; a case-control study]. / El estrés oxidativo como predictor de longevidad; estudio de casos y controles.

INTRODUCTION: Human longevity is a complex issue influenced by genetic and environmental factors. Oxidative stress (OE) could play an important role in this process. Succesful aging could be related with the organism ability facing OE. In the present study we compared malondialdehyde (MDA) and oxidized proteins (OP) plasma levels, in elderly people older than 97 years and 70-80 years old, to better understand the effects of OE on human longevity. MATERIAL AND METHODS: Population-based case control study. We considered as cases patients who were born and live on la Ribera county in Valencia (Spain) older than 97 years old and who accepted to participate in the study. Controls were from the same poblational base, chosen randomly, and 70-80 years old. We made a descriptive analysis of sociodemographic, clinic and functional variables; an odds ratio (OR) estimation of being centenarian by OP and MDA quartiles; and a tendency analysis by Mantel-Haenszel test. RESULTS: Twenty eight cases and 31 controls were included. Functional state and robust percentage were worse in cases. MDA (1,44±0,45 vs 1,84±0,59, p=0,005), and OP (64,29±15,73 vs. 76,52±13,44, p=0,002) levels, were significantly lower in cases. The OR of being centenarian in lower/higher quartile were 3,8 for MDA and 5,7 for OP, with a Mantel-Haenszel signification of 0,029 and 0,044 respectively. CONCLUSIONS: In our study OE level were lower in centenarians than in younger elderly, and the lower the OE grade, the higher were the likelihood of being centenarian.

Severity of cognitive impairment as a prognostic factor for mortality and functional recovery of geriatric patients with hip fracture.

AIM: To identify how the severity of dementia influences functional recovery and mortality in elderly patients hospitalized for hip fracture. METHODS: An observational retrospective study of 1258 patients aged older than 69 years and diagnosed with hip fracture who received care within an orthogeriatrics unit from 2004 to 2008 was carried out. During a 12-month follow-up period, functional recovery and mortality outcomes were measured. RESULTS: Dementia was present in 383 (28.1%) patients: it was mild in 183 (48%), moderate in 102 (26.5%) and severe in 98 (25.5%). Compared with patients with preserved cognitive status, patients with dementia had the following statistically significant differences (means [standard deviation] or percentage): older age (preserved, 82.29 years [6.5 years]; mild, 83.63 years [6.1 years]; moderate, 83.47 years [5.9 years]; severe, 84.46 years [6.1 years]; P < 0.001); lower Barthel Index (89.7 [21.6], 72.7 [24.6], 58.9 [28.6], 38.0 [28.1]; P < 0.001); delirium (11.7%, 25.6%, 37.6%, 44.7%; P < 0.001); less ambulation at 6 months postdischarge (83.9%, 72.8%, 56.9%, 41.7%; P < 0.001); and higher mortality at discharge (4%, 5.7%, 8.2%, 10.6%; P < 0.001) and 12 months after discharge (21.2%, 32.3%, 46.3%, 53.5%; P < 0.001). Patients with severe dementia had lower probability of functional recovery at discharge (OR 0.272, 95% CI 0.140-0.526, P < 0.001) and 6 months after discharge (OR 0.439, 95% CI 0.197-0.979, P = 0.04), as well as a greater probability of dying (HR 1.640, 95% CI 1.020-2.635, P = 0.04). CONCLUSIONS: We observed higher 12-month mortality and less functional recovery with increasing severity of dementia.