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February 1, 1993Annals of Internal Medicine

Hazards of Hospitalization of the Elderly

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Key result

Hospitalization and bed rest in older persons can lead to irreversible functional decline, which may be avoided by modifying the hospital environment to facilitate ambulation and socialization.

Population

Older persons undergoing hospitalization

Design

Review

Authors

MCMorton C. CreditorUniversity of Kansas Medical Center

Discussion

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Implication

May warrant minimizing bed rest in older inpatients; leaves open optimal environmental modifications pending prospective trials.

Key Points

  • To identify the mechanisms underlying avoidable functional decline in hospitalized older adults and propose preventive environmental and clinical strategies.
  • Narrative review examining baseline physiological changes of aging and the secondary physiological impacts of acute hospitalization and immobilization.
  • Analysis of hospital environmental hazards and interdisciplinary care models influencing patient independence.
  • Enforced bed rest superimposes acute plasma volume reduction, accelerated bone loss, decreased pulmonary ventilation, and sensory deprivation onto normal age-related declines in muscle strength and aerobic capacity.
  • Hospital-induced functional deterioration and dependency cascades are preventable by minimizing bed rest, removing high bed rails, facilitating early ambulation, and implementing interdisciplinary care.

Structured PICO

P
Population
Older persons undergoing hospitalization

Highlights the risks of functional decline associated with hospitalization in the elderly and advocates for environmental and care modifications to prevent dependency.

Cite This Study

Morton C. Creditor (1993) conducted a review in Hospitalization-associated functional decline. Hospitalization and bed rest in older persons can lead to irreversible functional decline, which may be avoided by modifying the hospital environment to facilitate ambulation and socialization.

synapsesocial.com/papers/6a093560194fdbcdaed25d2ehttps://doi.org/10.7326/0003-4819-118-3-199302010-00011

Topics

Heart failure hospitalization
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Also Consider

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  1. 1Community Residence One Year After Hip Fracture1988 · 5 citations
  2. 2The Natural History of Functional Morbidity in Hospitalized Older Patients1990 · 493 citations
  3. 3Vertebral Bone Loss: An Unheeded Side Effect of Therapeutic Bed Rest1983 · 359 citations
  4. 4Activity of respiratory muscles in upright and recumbent humans1981 · 212 citations
  5. 5Physiology and Complications of Bed Rest1988 · 362 citations