Impact of Hospitalization on Patients Ability to Perform Basic Activities of Daily Living


  • Myles W. O'Brien Dalhousie University
  • Kayla Mallery Dalhousie University
  • Kenneth Rockwood Dalhousie University
  • Olga Theou Dalhousie University



clinical frailty score, functional trajectory, acute hospital stay, patient care, tertiary hospital care


Functional independence is dictated by the ability to perform basic activities of daily living (ADLs). Although hospitalization is associated with impairments in function, we know less about patients’ functional trajectory following hospitalization. We examined patients’ ability to do basic ADLs across pre-admission, admission, and follow-up (discharge or two-weeks post-admission) and determined which factors predicted changes in ADLs at follow-up. A secondary analysis of a small prospective cohort study of older patients (n=83, 50 females, 81 ± 8 years) from the Emergency Department and a Geriatric Unit were included. ADL scores (dressing, walking, bathing, eating, in and out of bed, and using the toilet) and frailty level (via the Clinical Frailty Scale) were measured. Comparing follow-up to pre-admission, patients reported worse ADL scores for dressing (36% of patients), walking (31%), bathing (34%), eating (25%), in and out of bed (37%), and using the toilet (35%). Most patients (59%) had more difficulty with 1+ ADL at follow-up versus pre-admission, with one-fourth of patients having greater difficulty with 3+ ADLs. Older age and higher frailty level were associated with (all, p < .04) worse functional scores for eating, getting in and out of bed, and using the toilet (frailty only) at follow-up versus pre-admission. Here, most inpatients experienced worse difficulty performing multiple basic ADLs after hospital admission, potentially predisposing them for re-hospitalization and functional dependence. Older and frailer patients generally were less likely to recover to pre-admission levels. Hospitalization challenges patients’ ability to perform ADLs in the short-term, post-discharge. Strategies to improve patients’ functional trajectory are needed.


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How to Cite

O’Brien MW, Mallery K, Rockwood K, Theou O. Impact of Hospitalization on Patients Ability to Perform Basic Activities of Daily Living. Can Geriatr J [Internet]. 2023 Dec. 1 [cited 2024 Feb. 25];26(4):524-9. Available from:



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