Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Campus, 3rd & 4th Floor South Wing Block D, Westminster Bridge Road, London SE1 7EH, UK.
Department of Ageing and Health, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, 9th Floor North Wing, Westminster Bridge Road, London SE1 7EH, UK.
Age Ageing. 2024 Nov 1;53(11). doi: 10.1093/ageing/afae241.
Hospital-associated deconditioning is a broad term, which refers non-specifically to declines in any function of the body secondary to hospitalisation. Older people, particularly those living with frailty, are known to be at greatest risk. It has historically been most commonly used as a term to describe declines in muscle mass and function (i.e. acute sarcopenia). However, declines in physical function do not occur in isolation, and it is recognised that cognitive deconditioning (defined by delayed mental processing as part of a spectrum with fulminant delirium at one end) is commonly encountered by patients in hospital. Whilst the term 'deconditioning' is descriptive, it perhaps leads to under-emphasis on the inherent organ dysfunction that is associated, and also implies some ease of reversibility. Whilst deconditioning may be reversible with early intervention strategies, the long-term effects can be devastating. In this article, we summarise the most recent research on this topic including new promising interventions and describe our recommendations for implementation of tools such as the Frailty Care Bundle.
医院相关的去适应状态是一个广义的术语，它通常指的是由于住院而导致身体任何功能下降的情况。老年人，特别是那些患有衰弱症的老年人，是风险最高的人群。历史上，它最常被用作描述肌肉质量和功能下降的术语（即急性肌肉减少症）。然而，身体功能的下降并不是孤立发生的，人们认识到认知去适应状态（定义为精神处理延迟，作为一端为暴发性谵妄的频谱的一部分）在医院中经常发生在患者身上。虽然“去适应状态”是描述性的，但它可能导致对相关的固有器官功能障碍的重视不足，并且还暗示了一些易于逆转的可能性。虽然早期干预策略可能使去适应状态可逆，但长期影响可能是毁灭性的。在本文中，我们总结了关于这个主题的最新研究，包括新的有前途的干预措施，并描述了我们对实施脆弱性护理包等工具的建议。
