Do morbidity measures predict the decline of activities of daily living and instrumental activities of daily living amongst older inpatients? A systematic review

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Abstract
Objectives Older adults often suffer from multimorbidity, which results in hospitalizations. These are often associated with poor health outcomes such as functional dependence and mortality. The aim of this review was to summarize the current literature on the capacities of morbidity measures in predicting activities of daily living (ADL) and instrumental activities of daily living (IADL) among inpatients. Methods A systematic literature search was performed using four databases: Medline, Cochrane, Embase and Cinahl Central from inception to 6th March 2019. Keywords included comorbidity, multimorbidity, ADL and iADL, along with specific morbidity measures. Articles reporting on morbidity measures predicting ADL and IADL decline among inpatients aged 65 years or above were included. Results Out of 7334 unique articles, 12 articles were included reporting on 7826 inpatients (mean age 77.6 years, 52.7% females). Out of five morbidity measures, the Charlson Comorbidity Index was most often reported. Overall, morbidity measures were poorly associated with ADL and IADL decline among older inpatients. Conclusion Morbidity measures are poor predictors for ADL or IADL decline among older inpatients and follow up duration does not alter the performance of morbidity measures.

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