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Changes in Activities of Daily Living, Nutrient Intake, and Systemic Inflammation in Elderly Adults Receiving Recuperative Care

Authors

  • Richard A. Dennis PhD,

    1. Geriatric Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
    2. Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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  • Larry E. Johnson MD, PhD,

    1. Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
    2. Geriatrics and Extended Care Service, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
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  • Paula K. Roberson PhD,

    1. Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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  • Muhannad Heif MD,

    1. Division of Gastroenterology and Hepatology, University of Colorado Hospital, Aurora, Colorado
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  • Melinda M. Bopp BS,

    1. Geriatric Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
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  • Kimberly K. Garner MD,

    1. Geriatric Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
    2. Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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  • Kalpana P. Padala MD, MS,

    1. Geriatric Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
    2. Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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  • Prasad R. Padala MD, MS,

    1. Geriatric Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
    2. Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
    3. Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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  • Patricia M. Dubbert PhD,

    1. Geriatric Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
    2. Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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  • Dennis H. Sullivan MD

    Corresponding author
    1. Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
    • Geriatric Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
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Address correspondence to Dennis H. Sullivan, Geriatric Research, Education and Clinical Center, Building 170, 3J/NLR, Central Arkansas Veterans Healthcare System, 4300 W 7th Street, Little Rock, AR 72205. E-mail: SullivanDennisH@uams.edu

Abstract

Objectives

To determine the relationships between physical function, systemic inflammation, and nutrient intake in elderly adults who are deconditioned or recovering from medical illness.

Design

Prospective observational study.

Setting

Recuperative care and rehabilitation setting of a Veterans Affairs hospital.

Participants

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).

Measurements

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.

Results

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.

Conclusion

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.

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