• Oliver L Hatheway, Arnold Mitnitski, and Kenneth Rockwood.
• Dalhousie University-Medicine, Halifax, Nova Scotia, Canada.
• Age Ageing. 2017 Nov 1; 46 (6): 920-925.

Objectivesto investigate how frailty and mobility impairment affect recovery of balance and mobility in acutely ill older patients.Designsecondary analysis of cohort study.Settinggeneral and geriatric medicine inpatient units, QEII Health Sciences Centre, Dalhousie University, Canada.Subjectsfour hundred and nine older adults (mean age = 81 ± 7 standard deviation, 64% women).Methodswe constructed a frailty index based on a comprehensive geriatric assessment (FI-CGA), at baseline (2 weeks before admission; mean 0.31 ± 0.10), and on admission (mean 0.40 ± 0.10), and recorded Hierarchical Assessment of Balance and Mobility (HABAM) scores daily. Recovery was measured as the difference in HABAM scores between discharge and admission.Resultsthe odds of no or incomplete recovery increased by 1.06 (95% confidence interval: 1.01-1.11) for each 0.1 increment in the baseline FI-CGA. Recovery odds were similarly dependent on age, but independent of baseline HABAM scores. Recovery time was related to Day 1 HABAM scores, initial treatment response and change in the FI-CGA from baseline to admission (r = 0.35, P < 0.001). Recovery time was independent of age. Patients whose mobility improved within 48 h (n = 113; 28%) showed greater improvement and quicker recovery.Conclusionsfrailer patients are at a greater risk of incomplete or lengthier recovery from impaired mobility and balance. Tracking mobility and balance might help providers, patients and families understand the course of acute illness in older adults.© The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

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