Centre of Expertise Urban Vitality

The course of geriatric syndromes in acutely hospitalized older adults

the Hospital-ADL study.


Objectives<br/>To establish the prevalence and course of geriatric syndromes from hospital admission up to 3 months postdischarge and to determine the probability to retain geriatric syndromes over the period from discharge until 3 months postdischarge, once they are present at admission.<br/><br/>Design<br/>Prospective multicenter cohort study conducted between October 2015 and June 2017.<br/><br/>Setting and participants<br/>Acutely hospitalized patients aged 70 years and older recruited from internal, cardiology, and geriatric wards of 6 Dutch hospitals.<br/><br/>Measures<br/>Cognitive impairment, depressive symptoms, apathy, pain, malnutrition, incontinence, dizziness, fatigue, mobility impairment, functional impairment, fall risk, and fear of falling were assessed at admission, discharge, and 1, 2, and 3 months postdischarge. Generalized estimating equations analysis were performed to analyze the course of syndromes and to determine the probability to retain syndromes.<br/><br/>Results<br/>A total of 401 participants [mean age (standard deviation) 79.7 (6.7)] were included. At admission, a median of 5 geriatric syndromes were present. Most prevalent were fatigue (77.2%), functional impairment (62.3%), apathy (57.5%), mobility impairment (54.6%), and fear of falling (40.6%). At 3 months postdischarge, an average of 3 syndromes were present, of which mobility impairment (52.7%), fatigue (48.1%), and functional impairment (42.5%) were most prevalent. Tracking analysis showed that geriatric syndromes that were present at admission were likely to be retained. The following 6 geriatric syndromes were most likely to stay present postdischarge: mobility impairment, incontinence, cognitive impairment, depressive symptoms, functional impairment, and fear of falling.<br/><br/>Implications<br/>Acutely hospitalized older adults exhibit a broad spectrum of highly prevalent geriatric syndromes. Moreover, patients are likely to retain symptoms that are present at admission postdischarge. Our study underscores the need to address a wide range of syndromes at admission, the importance of communication on syndromes to the next care provider, and the need for adequate follow-up care and syndrome management postdischarge.<br/><br/>

Reference van Seben, R., Reichardt, L. A., Aarden, J. J., van der Schaaf, M., van der Esch, M., Engelbert, R. H. H., Twisk, J. W. R., Bosch, J. A., & Buurman, B. M. (2019). The course of geriatric syndromes in acutely hospitalized older adults: the Hospital-ADL study. Journal of the American Medical Directors Association, 20(2), 152-158. https://doi.org/10.1016/j.jamda.2018.08.003
Published by  Kenniscentrum Gezondheid 1 February 2019

Publication date

Feb 2019


Rosanne van Seben
Lucienne A Reichardt
Jos W R Twisk
Jos A Bosch
Bianca M. Buurman


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