Physical, Cognitive and Social Characteristics of Frail Older Adults Associated With Their Discharge Destination Following Hospitalization

Early identification of discharge destination is an important aspect of hospital care for frail older adults. This retrospective cohort study examined whether physical, cognitive and social functioning assessments at admission are associated with discharge destination. Data from 114 community-dwelling patients aged ≥65 years, acutely admitted to a geriatric ward, were analyzed. Frailty was defined at admission by impaired Katz-Activities of Daily Living (ADL) or increased fall risk. Initial screening included Katz-ADL, fall risk and the Malnutrition Universal Screening Tool (MUST). Additional assessments comprised handgrip strength, Timed-Up-and-Go (TUG), Six-item Cognitive Impairment Test (6-CIT) and living situation. Multivariable logistic regression, adjusted for age and sex, showed that worse Katz-ADL scores (OR 1.45, 95% CI 1.18-1.78), lower handgrip strength (OR 2.28, 95% CI 1.02-5.10) and slower TUG performance (OR 11.19, 95% CI 3.40-36.89) were significantly associated with non-home discharge. Cognitive status and living situation were not. These findings indicate that these functional assessments are associated with discharge destination in frail older adults.