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Frailty And Its Association With Rehabilitation Outcomes: An Irish Prospective Cohort Study Of A Post-Acute Older Population
Nolan, Mary T
<p>The projected increase in the older population over the coming decades will place a greater demand on health-care services. Frailty is highly prevalent in the hospitalised older adult. There is a lack of research examining the impact of frailty on determinants of physical function, quality-of-life and falls self-efficacy.</p> <p><strong>Aims and Objectives:</strong></p> <p><strong></strong>The primary aim of this research was to evaluate the changes in physical function, quality-oflife and falls self-efficacy in frail older adults undergoing inpatient rehabilitation. A secondary aim was to examine the association between frailty and rehabilitation outcomes of physical function, quality-of-life, self-efficacy, time spent in therapy, length of stay and discharge destination.</p> <p><strong>Methods</strong>:</p> <p>A prospective cohort study design was employed using a sample of convenience. Forty-one subjects attending an inpatient post-acute rehabilitation unit were assessed on admission and at discharge. A range of physical determinants were used to assess function. They included the Clinical Frailty Scale (CFS), Grip-strength, Timed-Up-and-Go (TUG), ten meter walk test (10MWT), Elderly Mobility Scale (EMS), Tinetti Balance and Gait Assessment, Barthel ii Index (BI). The EuroQol-5D Visual Analogue Scale (EQ-5D-VAS) was used to assess quality-of-life and the Falls Efficacy Scale (FES) as a measure of falls self-efficacy.</p> <p><strong>Results</strong>:</p> <p>The mean (±SD) age of the sample was 80.3(±7.1) years and the majority were female. Statistically significant changes from admission to discharge were found in the CFS (p≤0.001), grip-strength (p≤0.001), TUG (p≤0.001), 10MWT (p≤0.001), Tinetti (p≤0.001), BI (p≤0.001), EQ-5D-VAS (p≤0.001) and FES (p≤0.001). Moderate positive correlations were found between admission CFS and TUG (r=0.438, p</p> <p><strong>Conclusions</strong>:</p> <p>Frailty on admission was shown to have a modest relationship with many physical determinants of function, time spent in therapy and length of stay. It is evident that frailty iii alone does not provide the clinician with a definitive clinical evaluation of an older person's potential outcome following rehabilitation.</p> <p><strong> Implication of Findings</strong>:</p> <p>This research provides the clinician with a better understanding of the relationship between frailty and specific functional outcomes of the older person. Policy makers are also more informed of the influence of frailty on health-service provision in the older adult undergoing post-acute rehabilitation.</p> <p>A thesis submitted in partial fulfilment of the requirements for the degree of MSc in Neurology and Gerontology to the Royal College of Surgeons in Ireland in 2014.</p>
Keyword(s): Frailty; Elderly; Rehabilitation Outcome; Medicine and Health Sciences; Physiotherapy; Rehabilitation and Therapy
Publication Date:
Type: Master thesis (taught)
Peer-Reviewed: No
Institution: Royal College of Surgeons in Ireland
Citation(s): Nolan MT. Frailty And Its Association With Rehabilitation Outcomes: An Irish Prospective Cohort Study Of A Post-Acute Older Population [MSc Thesis]. Dublin: Royal College of Surgeons in Ireland; 2014.
Supervisor(s): Dr Frances Horgan
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First Indexed: 2015-07-31 15:34:49 Last Updated: 2018-02-13 07:22:44