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J Gerontol A Biol Sci Med Sci. 2017 Jan 1;72(1):82-88. doi: 10.1093/gerona/glw040.

Effects of Mobility and Cognition on Hospitalization and Inpatient Days in Women in Late Life.

Author information

1
Department of Medicine and.
2
Division of Epidemiology & Community Health, University of Minnesota, Minneapolis.
3
Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota.
4
California Pacific Medical Center Research Institute, San Francisco.
5
NORC at the University of Chicago, Health Care Department, Bethesda, Maryland.
6
Department of Rheumatology, Park Nicollet Clinic, St. Louis Park, Minnesota.
7
Division of Health Policy & Management, University of Minnesota, Minneapolis.
8
Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minnesota.
9
Department of Epidemiology, University of Pittsburgh, Pennsylvania.
10
Department of Epidemiology and Biostatistics and.
11
Departments of Psychiatry, Neurology, and Epidemiology, University of California, San Francisco.
12
Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.

Abstract

Background:

This study examines effects of mobility and cognition on hospitalization and inpatient days among women late in life.

Methods:

Prospective study of 663 women (mean age 87.7 years) participating in the Study of Osteoporotic Fractures Year 20 examination (2006-2008) linked with their inpatient claims data. At Year 20, mobility ascertained by Short Physical Performance Battery categorized as poor, intermediate, or good. Cognitive status adjudicated based on neuropsychological tests and classified as normal, mild cognitive impairment, or dementia. Hospitalizations (n = 182) during 12 months following Year 20.

Results:

Reduced mobility and poorer cognition were each associated in a graded manner with higher inpatient health care utilization, even after accounting for each other and traditional prognostic indicators. For example, adjusted mean inpatient days per year were 0.94 (95% confidence interval [CI] 0.52-1.45) among women with good mobility increasing to 2.80 (95% CI 1.64-3.89) among women with poor mobility and 1.59 (95% CI 1.08-2.03) among women with normal cognition increasing to 2.53 (95% CI 1.55-3.40) among women with dementia. Women with poor mobility/dementia had a nearly sixfold increase in mean inpatient days per year (4.83, 95% CI 2.73-8.54) compared with women with good mobility/normal cognition (0.84, 95% CI 0.49-1.44).

Conclusions:

Among women late in life, mobility limitations and cognitive deficits were each independent predictors of higher inpatient health care utilization even after considering each other and conventional predictors. Additive effects of reduced mobility and poorer cognition may be important to consider in medical decision making and health care policy planning for the growing population of adults aged ≥85 years.

KEYWORDS:

Cognitive status; Elderly women; Hospitalization; Physical performance

PMID:
26961583
PMCID:
PMC5155657
DOI:
10.1093/gerona/glw040
[Indexed for MEDLINE]
Free PMC Article

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