Physical Performance Impairments and Limitations Among Hospitalized Frail Older Adults.

Background And Purpose: Early rehabilitation is important for frail older adults due to reduced reserve capacity and physical fitness. To facilitate individualized rehabilitation programs, we need tools to make it possible to assess physical fitness in relation to frailty, instead of chronological age. The purpose of this study was, in a Swedish context, to describe measures of physical fitness in hospitalized frail older adults in relation to their degree of frailty.

Methods: This was a cross-sectional study. A total of 408 frail older adults, mean age 86.6 years (75-99 years), in need of emergency medical inpatient care, were included in the NÄL-Uddevalla (NU) hospital group in Sweden. During the hospital stay, physical fitness was assessed using 4 different tests: hand-grip strength, the Timed Up and Go Test, 5-time sit-to-stand test, and 6-minute walk test. In the analyses, the physical fitness outcomes were related to the degree of frailty using the FRail Elderly Support ResearcH group screening instrument and previously used cutoffs or age-related reference values for older adults.

Results And Discussion: This study showed that most hospitalized frail older adults perform far lower than previously described age-related reference values relating to physical fitness. An increased degree of frailty contributes to reduced physical fitness in tests assessing strength and endurance.

Conclusions: A frail-related screening instrument may be useful in the evaluation of physical fitness in hospitalized frail older adults and may facilitate the development of realistic, individualized rehabilitation programs beneficial to an early start on the emergency medical ward.