Minor injuries can lead to functional decline in older adults

A substantial proportion of older adults who sustain minor injuries face persistent decline in their physical and/or cognitive functioning, with predictors including the use of a walking device, less than five outings per week, frailty, and older age, according to a study.

The analysis included 2,516 older adults (mean age 76.2 years, 65.3 percent women, 9 percent frail, 40.0 percent prefrail) screened in the emergency department (ED) setting and completed at least one follow-up.

Most of the injuries reported were due to falls (65.5 percent), while others were due to motor vehicle accidents (18.6 percent).

Following a minor injury, 1,746 (69.4 percent) of the participants remained functional in their daily life at 3 months, and most of them (n=1,641) remained stable at 6 months.

Functional decline (loss ≥2/28 Older American Resources Scale [OARS] points) was observed in 277 (11.0 percent) participants at 3 months and in 275 (10.9 percent) at 6 months, totalling 408 (16.2 percent) participants who experienced a functional decline over 6 months following a minor injury.

The 6-month cumulative incidence of functional decline was 17.0 percent (95 percent confidence interval, 12.5–23.0). Functional decline was significantly associated with the following baseline variables: occasional use of walking devices, having less than five outings/week, frailty, and older age.

The findings underscore a need for additional studies to assess whether ED-based risk stratification tools can pinpoint patients who should or should not be discharged home and those in whom ED-based initiated interventions can prevent postinjury functional decline.