Functional changes during hospitalization in older patients admitted to an acute care ward: results from the CRIME study

Background. Impact of hospital stay on changes in physical performance has rarely been evaluated. In this study, we examined functional changes during hospital stay by assessing both physical performance and activities of daily living. Additionally, we investigated characteristics of older patients associated with meaningful in-hospital improvement in physical performance. Methods. Data are from the CRiteria to assess appropriate Medication use among Elderly complex patients project. This was a multicentre, observational study of 1123 older patients, consecutively admitted to geriatric and internal medicine acute care wards of seven Italian hospitals. We analyzed data from 639 participants with a Mini Mental State Examination score ≥18/30. Physical performance was assessed by walking speed and grip strength, and functional status by activities of daily living at hospital admission and at discharge. Meaningful improvement was defined as ≥1 standard deviation of in-hospital change of the examined measurement. Multivariate logistic regression models predicting meaningful improvement included age, gender, type of admission, and physical performance at admission. Results. The mean age of the study participants was 79 years, 52% were female. Overall, mean walking speed and grip strength performance improved during hospital stay (walking speed improvement: 0.04±0.20 m/s, p