Changes in Activities of Daily Living, Nutrient Intake, and Systemic Inflammation in Elderly Adults Receiving Recuperative Care
Article first published online: 23 NOV 2012
© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 60, Issue 12, pages 2246–2253, December 2012
How to Cite
J Am Geriatr Soc 2012.
- Issue published online: 11 DEC 2012
- Article first published online: 23 NOV 2012
- Veterans Health Administration
- Health Services Research and Development
- Clinical Science Research and Development
- Katz Index of ADLs;
- physical function;
- calorie counts;
- nutrient intake
To determine the relationships between physical function, systemic inflammation, and nutrient intake in elderly adults who are deconditioned or recovering from medical illness.
Prospective observational study.
Recuperative care and rehabilitation setting of a Veterans Affairs hospital.
Older adults assessed to be in need of and likely to benefit from specialized inpatient care (N = 336, aged 78.9 ± 7.5, median length of stay 24 days).
Functional assessments and plasma analyses for albumins and inflammatory markers were performed at admission and discharge. Complete nutrient intake assessments were performed daily. Katz (independence in activities of daily living) and walking endurance (distance capability and summation of need for assistive device and human help) scores were based on direct observation and provider query. Data were analyzed using least-squares and logistic regression analyses.
Changes in physical function between admission and discharge were positively correlated with change in nutrient intake and inversely correlated with inflammation at admission and its change. Participants in the upper quartile of change for nutrient intake (particularly improved protein intake) were two to three times as likely to experience a clinically significant change in functional status during the hospitalization. Similarly, the odds of experiencing an improvement in physical function were two to four times as great for participants whose C-reactive protein levels declined as for those whose levels increased. These relationships remained significant after controlling for age, length of stay, and other baseline indicators of health status.
Protein intake and inflammation are significantly correlated with functional recovery for aging individuals undergoing recuperative care and rehabilitation. Future studies should investigate whether combined interventions that target these factors improve recovery during hospitalization for this population.