Christine Loyd1, T Mark Beasley2, Rebecca S Miltner3, Diane Clark4, Barbara King5, Cynthia J Brown1,6. 1. Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama. 2. Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama. 3. School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama. 4. Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama. 5. School of Nursing, University of Wisconsin-Madison, University of Wisconsin Hospital and Clinics, Madison, Wisconsin. 6. Geriatric Research, Education, and Clinical Care Center, Birmingham/Atlanta Veterans Affairs, Birmingham, Alabama.
Abstract
OBJECTIVES: To identify trajectories of recovery of community mobility in acutely ill older adults using the University of Alabama at Birmingham Life-Space Assessment (LSA). DESIGN: Prospective observation cohort study. SETTING: Central Alabama, Birmingham Veterans Affairs Medical Center. PARTICIPANTS: Community-dwelling adults aged 65 and older hospitalized for nonsurgical medical reasons (N=173). MEASUREMENTS: We determined LSA scores for the month before and monthly for 6 months after hospitalization (composite scores ranging from 0-120, with 120 reflecting completely unrestricted mobility). RESULTS: In the month after hospitalization, 92 (53%) participants had a clinically significant decrease in life-space mobility, while 42 (24%) were unchanged, and 39 (23%) had an increase from the month preceding hospitalization. Of participants with a life-space decrease, the majority recovered their prehospitalization mobility status during 6 months of follow-up, whereas 34% did not recover. Participants whose life-space decreased were hospitalized significantly longer (P=.01) and, on average, had higher prehospital life-space scores (P=.01) than those who maintained or increased their life-space. CONCLUSION: A clinically significant loss of community mobility was common after hospitalization, but most participants recovered to prehospitalization mobility within 6 months of discharge. Research examining in-hospital and posthospitalization interventions to achieve faster recovery of community mobility is needed.
OBJECTIVES: To identify trajectories of recovery of community mobility in acutely ill older adults using the University of Alabama at Birmingham Life-Space Assessment (LSA). DESIGN: Prospective observation cohort study. SETTING: Central Alabama, Birmingham Veterans Affairs Medical Center. PARTICIPANTS: Community-dwelling adults aged 65 and older hospitalized for nonsurgical medical reasons (N=173). MEASUREMENTS: We determined LSA scores for the month before and monthly for 6 months after hospitalization (composite scores ranging from 0-120, with 120 reflecting completely unrestricted mobility). RESULTS: In the month after hospitalization, 92 (53%) participants had a clinically significant decrease in life-space mobility, while 42 (24%) were unchanged, and 39 (23%) had an increase from the month preceding hospitalization. Of participants with a life-space decrease, the majority recovered their prehospitalization mobility status during 6 months of follow-up, whereas 34% did not recover. Participants whose life-space decreased were hospitalized significantly longer (P=.01) and, on average, had higher prehospital life-space scores (P=.01) than those who maintained or increased their life-space. CONCLUSION: A clinically significant loss of community mobility was common after hospitalization, but most participants recovered to prehospitalization mobility within 6 months of discharge. Research examining in-hospital and posthospitalization interventions to achieve faster recovery of community mobility is needed.
Authors: S K Inouye; S T Bogardus; P A Charpentier; L Leo-Summers; D Acampora; T R Holford; L M Cooney Journal: N Engl J Med Date: 1999-03-04 Impact factor: 91.245
Authors: Cynthia J Brown; Richard E Kennedy; Alexander X Lo; Courtney P Williams; Patricia Sawyer Journal: Am J Med Date: 2016-06-08 Impact factor: 4.965
Authors: Melisa L Wong; Ying Shi; Alexander K Smith; Christine Miaskowski; W John Boscardin; Harvey Jay Cohen; Vivian Lam; Melissa Mazor; Lia Metzger; Carolyn J Presley; Grant R Williams; Kah Poh Loh; Carling J Ursem; Terence W Friedlander; Collin M Blakely; Matthew A Gubens; Gregory Allen; Dianne Shumay; Louise C Walter Journal: J Am Geriatr Soc Date: 2021-10-05 Impact factor: 5.562
Authors: Kumar Dharmarajan; Ling Han; Evelyne A Gahbauer; Linda S Leo-Summers; Thomas M Gill Journal: J Am Geriatr Soc Date: 2020-02-21 Impact factor: 5.562
Authors: Michael A Liu; Clark DuMontier; Anays Murillo; Tammy T Hshieh; Jonathan F Bean; Robert J Soiffer; Richard M Stone; Gregory A Abel; Jane A Driver Journal: Blood Date: 2019-06-05 Impact factor: 25.476
Authors: Thomas M Gill; Ling Han; Evelyne A Gahbauer; Linda Leo-Summers; Terrence E Murphy; Lauren E Ferrante Journal: Crit Care Med Date: 2021-06-01 Impact factor: 9.296
Authors: Benoit Smeuninx; Yasir S Elhassan; Konstantinos N Manolopoulos; Elizabeth Sapey; Alison B Rushton; Sophie J Edwards; Paul T Morgan; Andrew Philp; Matthew S Brook; Nima Gharahdaghi; Kenneth Smith; Philip J Atherton; Leigh Breen Journal: J Cachexia Sarcopenia Muscle Date: 2020-12-21 Impact factor: 12.910
Authors: Thomas M Gill; Ling Han; Evelyne A Gahbauer; Linda Leo-Summers; Terrence E Murphy; Robert D Becher Journal: Ann Surg Date: 2021-05-01 Impact factor: 13.787