Porto Guilherme, Gil Saulo, Ferriolli Eduardo, Gualano Bruno, Roschel Hamilton
Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Applied Physiology and Nutrition Research Group - School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil; Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil; Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil; UNISA Research Center, Universidade Santo Amaro, Post-Graduation in Health Sciences, São Paulo, Brazil.
Braz J Phys Ther. 2025 Aug 9;29(6):101254. doi: 10.1016/j.bjpt.2025.101254.
Physical disability significantly impacts health outcomes and is linked to higher mortality in older adults. However, research on its association with hospitalization rates remains limited.
To assess whether physical disability is a predictive measure of hospitalization (yes/no) in older individuals. Additionally, we tested whether physical disability predicts the frequency of hospitalizations (≤ 3 or >3).
This is a cross-sectional analysis of a dataset from the National Health and Nutrition Examination Survey (NHANES). We analyzed data from 2009-2018 from participants older than 65 years. Hospitalization status was determined using the Hospital Utilization and Access to Care questionnaire. Physical disability was assessed (yes/no) with the 4-item physical functioning questionnaire during an in-home interview to assess the participant's level of physical disability. The questionnaire asked about difficulty in walking from room to room (on the same level), standing up from an armless chair, eating, and dressing. Multivariable logistic regression model adjusted for age, sex, race/ethnicity, number of medications, number of comorbidities, and poverty index was used.
A total of 4346 participants met our inclusion criteria. The adjusted logistic regression model revealed that older adults with physical disability have greater odds to be hospitalized than those without physical disability (adjusted odds ratio [OR]: 2.13; 95% confidence interval [CI]: 1.74, 2.62). Secondary analysis also showed that older people with physical disability have greater odds to have 4 or more hospitalizations in one year in comparison with older adults who do not show physical disability (adjusted OR: 5.81; 95% CI: 2.40, 14.05).
The results reveal that physical disability is strongly associated with higher odds of hospitalization among older individuals. These data reinforce the importance of health policies and programs to prevent physical disability in this population.
身体残疾对健康结果有显著影响，并且与老年人较高的死亡率相关。然而，关于其与住院率关联的研究仍然有限。
评估身体残疾是否是老年人住院（是/否）的预测指标。此外，我们还测试了身体残疾是否能预测住院频率（≤3次或>3次）。
这是一项对来自美国国家健康与营养检查调查（NHANES）数据集的横断面分析。我们分析了2009年至2018年65岁以上参与者的数据。使用医院利用和医疗服务获取问卷确定住院状态。在家庭访谈中，通过4项身体功能问卷评估身体残疾情况（是/否），以评估参与者的身体残疾程度。该问卷询问了在同一楼层从一个房间走到另一个房间、从无扶手椅子上站起来、进食和穿衣方面的困难。使用了对年龄、性别、种族/族裔、药物数量、合并症数量和贫困指数进行调整的多变量逻辑回归模型。
共有4346名参与者符合我们的纳入标准。调整后的逻辑回归模型显示，身体残疾的老年人比无身体残疾的老年人住院几率更高（调整后的优势比[OR]：2.13；95%置信区间[CI]：1.74，2.62）。二次分析还表明，与无身体残疾的老年人相比，身体残疾的老年人在一年内有4次或更多次住院的几率更高（调整后的OR：5.81；95%CI：2.40，14.05）。
结果表明，身体残疾与老年人较高的住院几率密切相关。这些数据强化了健康政策和项目对预防该人群身体残疾的重要性。
