The Proportion of Hospital-Associated Deconditioning Among Hospitalised Older Adults at Hospital Pakar Universiti Sains Malaysia
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Abstract
Background: Hospital-associated deconditioning (HAD), defined as the loss of independence in activities of daily living following acute hospitalisation, is observed among older adults. Multiple factors are associated with HAD, and knowing these factors allows us to identify high-risk patients and intervene both during and after hospitalisation to maintain patient functioning. This study aims to determine the proportion of HAD among elderly patients admitted to the general medical wards at Hospital Pakar Universiti Sains Malaysia and to identify associated factors.
Methods: A cross-sectional study involving 242 patients aged 60 years or older who were admitted to the hospital’s general medical wards was conducted. Demographic data were collected using a proforma. Functional status was assessed using the Katz Index at both admission and discharge. Simple and multiple logistic regression analyses were performed to identify factors associated with HAD.
Results: A total of 242 older adults (mean age 70.8 ± 7.3 years; 52.9% female) were included. Most were Malay (92.1%) and had hypertension (81.4%), hyperlipidaemia (57.4%) and diabetes mellitus (56.6%). The proportion of HAD was 17.8%. Factors significantly associated with HAD included hypoalbuminaemia (adjusted OR: 14.5; 95% CI: 2.15, 97.94; P = 0.006), malnutrition (adjusted OR: 9.5; 95% CI: 3.06, 29.31; P < 0.001) and delirium (adjusted OR: 9.9; 95% CI: 4.32, 22.89; P < 0.001).
Conclusion: HAD is prevalent among hospitalised elderly patients with malnutrition and is significantly associated with hypoalbuminaemia and delirium. Early interventions, including nutritional support, mobility programmes and delirium-prevention strategies, are essential for mitigating HAD and improving patient outcomes.
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