Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Oct;57(10):1757-66.
doi: 10.1111/j.1532-5415.2009.02455.x. Epub 2009 Aug 20.

Functional decline and recovery of activities of daily living in hospitalized, disabled older women: the Women's Health and Aging Study I

Cynthia M Boyd  1 , Michelle Ricks, Linda P Fried, Jack M Guralnik, Qian-Li Xue, Jin Xia, Karen Bandeen-Roche
Affiliations

Functional decline and recovery of activities of daily living in hospitalized, disabled older women: the Women's Health and Aging Study I

Cynthia M Boyd et al. J Am Geriatr Soc. 2009 Oct.

Abstract

Objectives: To determine, in disabled, older, community-dwelling women who were hospitalized, the rates and predictors of functional decline, the probability and time course of subsequent functional recovery, and predictors of functional recovery.

Design: Population-based observational cohort.

Setting: Woman's Health and Aging Study.

Participants: A subset of the 1,002 moderately to severely disabled community-dwelling older women who were hospitalized over 3 years (N=457).

Measurements: Functional decline and complete and partial recovery were defined using a 0 to 6 scale of dependencies in activities of daily living (ADLs) evaluated every 6 months over 3 years. Complete recovery was defined as returning to baseline function (function at visit immediately preceding hospitalization) after functional decline; partial recovery was defined as any improvement in the ADL scale after functional decline. Multiple logistic regression analysis was used to determine predictors of functional decline. Kaplan-Meier curves estimate the proportions recovering as a function of time since hospitalization. Discrete-time proportional hazards models regress the time-to-recovery hazards on the predictor variables.

Results: Thirty-three percent of hospitalized women experienced functional decline at the first visit after hospitalization. Frailty, longer length of stay, and higher education were associated with functional decline. Fifty percent fully recovered over the subsequent 30 months, with 33% recovering within 6 months and an additional 14% over the following 6 months. Younger women were more likely to recover (aged 80 to 70, hazard ratio=0.39, 95% confidence interval=0.24-0.64).

Conclusion: Although most recovery of function occurs by 6 months after the first visit after a hospitalization, a substantial proportion of disabled community-dwelling women recover over the following 2 years.

PubMed Disclaimer

Figures

Figure 1
Figure 1
a and b: Defining Study Time: WHAS I
Figure 1
Figure 1
a and b: Defining Study Time: WHAS I
Figure 2
Figure 2
Probability of Functional Decline in Conjunction with Hospitalization, by age
Figure 3
Figure 3
Full and Partial Recovery after Hospitalization: WHAS I Kaplan Meier (n=102)
Figure 4
Figure 4
Kaplan Meier Plot for full recovery by age categories
See this image and copyright information in PMC

References

    1. Gill TM, Allore HG, Holford TR, et al. Hospitalization, restricted activity, and the development of disability among older persons. Jama. 2004;292:2115–2124. - PubMed
    1. Boyd CM, Xue QL, Simpson CF, et al. Frailty, hospitalization, and progression of disability in a cohort of disabled older women. Am J Med. 2005;118:1225–1231. - PubMed
    1. Boyd CM, Xue QL, Guralnik JM, et al. Hospitalization and Development of Dependence in Activities of Daily Living in a Cohort of Disabled Older Women: The Women’s Health and Aging Study I. J Gerontol A Biol Sci Med Sci. 2005;60:888–893. - PubMed
    1. McCusker J, Kakuma R, Abrahamowicz M. Predictors of functional decline in hospitalized elderly patients: a systematic review. J Gerontol A Biol Sci Med Sci. 2002;57:M569–577. - PubMed
    1. Covinsky KE, Palmer RM, Fortinsky RH, et al. Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. J Am Geriatr Soc. 2003;51:451–458. - PubMed

Publication types