Hospitalisation-associated disability affects about one in four older inpatients

Design

Systematic review and meta-analysis of observational studies

Population

439,406 older adults across 46 studies and 15 regions

Primary outcome

Pooled prevalence of hospitalisation-associated disability

Effect

27% (95% CI 24% to 31%); prediction interval 7% to 48%

Older people often leave hospital less able to function than when they arrived, from the deconditioning, bed rest and interruptions of an admission rather than the acute illness alone. This meta-analysis of 46 studies and 439,406 older adults quantified how common this hospitalisation-associated disability is.

The pooled prevalence was 27% (95% CI 24% to 31%), with wide variation across studies (prediction interval 7% to 48%). It was more common in patients aged 75 to 89, those admitted with lower respiratory tract infection, and when measured against a pre-admission functional baseline.

The practical message is to treat loss of function as a core inpatient outcome, not an incidental one. Record a pre-admission functional baseline, identify high-risk patients early, and build in the countermeasures — mobilisation, avoiding unnecessary bed rest and catheters, nutrition and daily function goals — that prevent an admission from leaving a patient dependent.

• Meta-analysis of 46 studies and 439,406 older inpatients.
• Pooled prevalence of hospitalisation-associated disability was 27% (95% CI 24% to 31%).
• Higher in patients aged 75 to 89 and those with lower respiratory tract infection.
• Record a pre-admission functional baseline and identify high-risk patients on admission.
• Mobilise early and avoid unnecessary bed rest, catheters and deconditioning.

Why it matters

It frames the loss of independence during an admission as a measurable, partly preventable outcome rather than an inevitable part of ageing in hospital.

Don't overread it

This pooled observational prevalence varies widely by setting and method; it quantifies the problem rather than proving any one prevention strategy works.

The statistics, in plain English

A pooled prevalence of 27% with a wide prediction interval (7% to 48%) means the average is reliable but individual settings vary a lot, reflecting different patients and measurement methods rather than a single true rate.

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