Hospitalized older adult: predictors of functional decline.

The sample was small, with 101 patients analysed, so the tests may not detect weaker associations. Functional capacity was reported by patients or caregivers, so it may under- or over-estimate true independence. The study did not include a physical performance measure, which could have given more accurate functional data. Some variables were not collected, including number of falls in the last year, mobility in hospital, socioeconomic status, and medications introduced during hospitalization. Functional capacity was not assessed at admission, so the effect of acute illness before hospitalization is unclear. Delirium was assessed at admission only in the morning, and during-hospitalization assessment occurred at a single moment. Only nine patients had delirium at admission and eight developed it during hospitalization, so delirium results are limited by small numbers. The study was done in internal medicine services at one university hospital, so results may not apply to other settings.

Supported by Centro Hospitalar e Universitário de Coimbra, Portugal. Supported by National Funds through Fundação para a Ciência e a Tecnologia within the CINTESIS R&D Unit.

Do not conclude that changing these predictors will prevent functional decline. This was an observational cohort, and the study did not test interventions.