1.     To describe changes of physical function for geriatric patients before and after admission.

2.     To understand correlated factors and outcomes of poorer physical function for hospitalized geriatric patients.Setting:

A geriatric unit of a medical center in Taipei city, Taiwan.Participants:

Patients admitted to an acute geriatric unit from December 2004 to June 2005.Measurement:
The finding reported is a part of comprehensive geriatric assessment at admission for patients. Measurements used in this report including Instrumental Activity of Daily Living (IADL), Barthel Index (BI), Mini-Nutritional Assessment (MNA), and Geriatric Depression Scale (GDS). Health consequences, such as readmission, emergency visits, were also collected by telephone follow-up in 90 days after discharge.
Results:

Eighty-nine participants were enrolled with a mean age of 78 years. The participants’ physical function, which measured by BI and IADL were significantly declined after admission to hospital (paired t = 7.35, 4.30, p < 0.01, respectively). Participants with advanced age (r = -0.22, p < 0.01), took more medication (r = -0.16, p < 0.01), had more chronic conditions (r = -0.29, p < 0.01), depression (r = -0.15, p < 0.01), and poorer nutritional condition (r = -0.71, p < 0.01), had poorer physical function at admission. Participants with poorer physical function at admission also had longer length of stay (r = -0.37, p < 0.01), higher probability of rehospitalization, emergency visits, been institutionalized and death in 90 days after discharge (t = -14.28, -11.62, -28.09, -26.26, p < 0.01, respectively). In conclusion, physical functioning and related assessments on admission are necessary to identify patients at risk for adverse health consequences after discharge. By providing needed care from physical function declination, enhancing the nutritional status, controlling depression and chronic conditions may improve health outcomes for the geriatric patients.

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