Influencing Factors of Activity of Daily Living in Patients Admitted to the Acute Elderly Care Unit.
- Author:
Myung Sook PARK
1
;
Su Hyun CHUNG
;
Yae Won SEO
;
Eun Yung KIM
;
Hae Yung KIM
;
Hee Joo LEE
;
Eun Il KIM
;
Ki Dong YU
;
Cheol Ho KIM
;
Kwang Il KIM
Author Information
1. Geriatric Center, Seoul National University Bundang Hospital. kikim907@snubh.org
- Publication Type:Original Article
- Keywords:
Activity of daily living;
Cognition;
Depression;
Nutrition;
Elderly patient;
Comprehensive geriatric assessment
- MeSH:
Activities of Daily Living;
Aged*;
Cognition;
Depression;
Emergencies;
Geriatric Assessment;
Humans;
Inpatients;
Length of Stay;
Mortality;
Multivariate Analysis;
Prognosis;
Seoul
- From:Journal of the Korean Geriatrics Society
2007;11(2):60-66
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: The purpose of this study is to investigate the clinical significance of activity of daily living(ADL) and to identify the influencing factors on ADL in elderly patients admitted to the hospital-based acute geriatric care unit. METHODS: We studied a total of 279 patients aged 65 years and older who admitted to the Acute Elderly Care Unit at Seoul National University Bundang Hospital between May, 2004 and April, 2005. Comprehensive geriatric assessment including medical, psychosocial and functional evaluation was performed by the geriatric team. RESULTS: Most of the patients need ADL(62.7%) and IADL(68.8%) assistance. Dependent ADL patients were older (p<0.01), admitted via emergency room(p<0.01), demented(p<0.01), and associated with depression(p<0.01), malnutrition(p<0.01), and stroke(p<0.05) compared to independent ADL group. The length of stay was also significantly increased in dependent ADL group(p<0.01) and six-month mortality rate was higher in dependent ADL group(p<0.01). In correlation analysis, MMSE-KC score(r=0.708, p<0.01), nutritional state(r=0.581, p<0.01), the length of stay(r=-0.433, p<0.01), depression(r=-0.309, p<0.01), the numbers of chronic disease(r=-0.287, p<0.01), age (r=-0.236, p<0.01) showed significant association with ADL. In multivariate analysis, cognitive impairment(OR=5.80), emergent admission(OR=4.33), over the 75 years old age(OR=3.33), malnutrition(OR=2.86), and depression(OR=2.61) were identified as the independent influencing factors on ADL dependency. CONCLUSION: ADL dependency is common in elderly inpatient and significantly associated with poor prognosis. Identifying and controlling the influencing factor on ADL decline may improve the patients' functional status and clinical outcome.
