Physical capacity, cognitive status, and social support at hospital admission predict where frail older adults will be discharged—home, rehabilitation, or long-term care. Early assessment of these factors enables hospitals to coordinate appropriate post-acute care, reducing readmission rates and optimizing outcomes during a critical vulnerability window.
Key Points
- Admission assessments predict discharge destination with clinical utility
- Physical and cognitive function integration improves prediction accuracy
- Social support status determines likelihood of home discharge
Longevity Analysis
Hospitalization represents a cascade point where frail older adults either recover functional capacity or experience irreversible decline. The ability to predict discharge destination at admission—based on observable physical, cognitive, and social markers—allows clinicians to intervene during the acute phase when neuroplasticity and recovery potential remain highest. Rather than passively observing where patients end up, early identification enables targeted rehabilitation, family coordination, and realistic goal-setting that can preserve independence and reduce the trajectory toward institutional care. This is ultimately about distinguishing between reversible deconditioning and genuine functional loss during a window when both still respond to intervention.
Original published by SAGE Research on Aging, by Manon K. van Leeuwen, Marieke S. van Dam, Frederique A. de Croock, Inge J. Perquin, Thea P. M. Vliet Vlieland, Maaike G. J. Gademan, Frederiek van den Bos1Department of Physical Therapy, LUMC, University Medical Center Leiden, Leiden, The Netherlands2Department of Internal Medicine, Section of Gerontology & Geriatrics, LUMC, University Medical Center Leiden, Leiden, The Netherlands3Department of Orthopaedics, Rehabilitation and Physical Therapy, LUMC, University Medical Center Leiden, Leiden, The Netherlands4Department of Clinical Epidemiology, LUMC, University Medical Center Leiden, Leiden, The Netherlands.