Dalhousie University-Medicine, Halifax, Nova Scotia, Canada.
Age Ageing. 2017 Nov 1;46(6):920-925. doi: 10.1093/ageing/afw257.
to investigate how frailty and mobility impairment affect recovery of balance and mobility in acutely ill older patients.
secondary analysis of cohort study.
general and geriatric medicine inpatient units, QEII Health Sciences Centre, Dalhousie University, Canada.
four hundred and nine older adults (mean age = 81 ± 7 standard deviation, 64% women).
we constructed a frailty index based on a comprehensive geriatric assessment (FI-CGA), at baseline (2 weeks before admission; mean 0.31 ± 0.10), and on admission (mean 0.40 ± 0.10), and recorded Hierarchical Assessment of Balance and Mobility (HABAM) scores daily. Recovery was measured as the difference in HABAM scores between discharge and admission.
the odds of no or incomplete recovery increased by 1.06 (95% confidence interval: 1.01-1.11) for each 0.1 increment in the baseline FI-CGA. Recovery odds were similarly dependent on age, but independent of baseline HABAM scores. Recovery time was related to Day 1 HABAM scores, initial treatment response and change in the FI-CGA from baseline to admission (r = 0.35, P < 0.001). Recovery time was independent of age. Patients whose mobility improved within 48 h (n = 113; 28%) showed greater improvement and quicker recovery.
frailer patients are at a greater risk of incomplete or lengthier recovery from impaired mobility and balance. Tracking mobility and balance might help providers, patients and families understand the course of acute illness in older adults.
探讨衰弱和活动能力受损如何影响急性病老年患者平衡和活动能力的恢复。
队列研究的二次分析。
加拿大达尔豪斯大学 QEII 健康科学中心的普通和老年医学住院病房。
409 名老年患者（平均年龄 81 ± 7 标准差，64%为女性）。
我们根据全面老年评估构建了一个衰弱指数（FI-CGA），在基线（入院前 2 周；平均 0.31 ± 0.10）和入院时（平均 0.40 ± 0.10）进行评估，并每天记录分层平衡和活动能力评估（HABAM）评分。恢复程度以出院和入院时 HABAM 评分的差值衡量。
FI-CGA 基线每增加 0.1，无恢复或不完全恢复的可能性增加 1.06（95%置信区间：1.01-1.11）。恢复的可能性同样依赖于年龄，但与基线 HABAM 评分无关。恢复时间与第 1 天 HABAM 评分、初始治疗反应以及 FI-CGA 从基线到入院的变化有关（r = 0.35，P < 0.001）。恢复时间与年龄无关。48 小时内活动能力改善的患者（n = 113；28%）表现出更大的改善和更快的恢复。
更虚弱的患者在从活动能力和平衡受损中恢复方面，更有可能出现不完全恢复或恢复时间更长的情况。跟踪活动能力和平衡状况可能有助于提供者、患者和家属了解老年患者急性病的病程。
