{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:33:17Z","timestamp":1790184797909,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2011,6,7]],"date-time":"2011-06-07T00:00:00Z","timestamp":1307404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:p>\n                    <jats:bold>BACKGROUND:<\/jats:bold>\n                    Many older adults who are independent prior to hospitalization develop a new disability by hospital discharge. Early risk stratification for new\u2010onset disability may improve care. Thus, this study's objective was to develop and validate a clinical index to determine, at admission, risk for new\u2010onset disability among older, hospitalized adults at discharge.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>DESIGN:<\/jats:bold>\n                    Data analyses derived from two prospective studies.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>SETTING:<\/jats:bold>\n                    Two teaching hospitals in Ohio.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>PARTICIPANTS:<\/jats:bold>\n                    Eight hundred eighty\u2010five patients aged 70 years and older were discharged from a general medical service at a tertiary care hospital (mean age 78, 59% female) and 753 patients discharged from a separate community teaching hospital (mean age 79, 63% female). All participants reported being independent in five activities of daily living (ADLs: bathing, dressing, transferring, toileting, and eating) 2 weeks before admission.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>MEASUREMENTS:<\/jats:bold>\n                    New\u2010onset disability, defined as a new need for personal assistance in one or more ADLs at discharge in participants who were independent 2 weeks before hospital admission.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    Seven independent risk factors known on admission were identified and weighted using logistic regression: age (80\u201389, 1 point; \u226590, 2 points); dependence in three or more instrumental ADLs at baseline (2 points); impaired mobility at baseline (unable to run, 1 point; unable to climb stairs, 2 points); dependence in ADLs at admission (2\u20133 ADLs, 1 point; 4\u20135 ADLs, 3 points); acute stroke or metastatic cancer (2 points); severe cognitive impairment (1 point); and albumin less than 3.0\u2003g\/dL (2 points). New\u2010onset disability occurred in 6%, 13%, 18%, 34%, 35%, 45%, 50%, and 87% of participants with 0, 1, 2, 3, 4, 5, 6, and 7 or more points, respectively, in the derivation cohort (area under the receiver operating characteristic curve (AUC)=0.784), and in 8%, 10%, 27%, 38%, 44%, 45%, 58%, and 83%, respectively, in the validation cohort (AUC=0.784). The risk score also predicted (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;.001) disability severity, nursing home placement, and long\u2010term survival.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CONCLUSION:<\/jats:bold>\n                    This clinical index determines risk for new\u2010onset disability in hospitalized older adults and may inform clinical care.\n                  <\/jats:p>","DOI":"10.1111\/j.1532-5415.2011.03409.x","type":"journal-article","created":{"date-parts":[[2011,6,7]],"date-time":"2011-06-07T12:23:21Z","timestamp":1307449401000},"page":"1206-1216","source":"Crossref","is-referenced-by-count":68,"title":["A Clinical Index to Stratify Hospitalized Older Adults According to Risk for New\u2010Onset Disability"],"prefix":"10.1111","volume":"59","author":[{"given":"Kala M.","family":"Mehta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Pierluissi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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