Transitions in Functional Status and Frailty Among Post-Hospitalized COVID-19 Oldest-Old Adults: An 18-Month Follow-Up Study

Sep 30, 2026

Upload by jay

This study analyzes physical function and frailty transitions in older adults at 1, 12, and 18 months after hospital discharge for COVID-19, focusing on risk factors linked to distinct change patterns. An observational, longitudinal unicentric design included participants aged 80+ admitted to a Spanish tertiary hospital who survived COVID-19. Functional outcomes were assessed using the Barthel Index and Functional Ambulation Category, while frailty was measured with the FRAIL scale. Among 233 individuals, worse baseline frailty and longer length of stay predicted frailty worsening, while older age, longer stay, and worse baseline physical function and FRAIL scores predicted 18-month impairments.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages15

Reading Time38 min

AccessFree to download

Abstract

Introduction

Article Transitions in Functional Status and Frailty Among Post-Hospitalized COVID-19 Oldest-Old Adults: An 18-Month Follow-Up Study Rafael Saavedra-Palacios 1,†, Alejandro Álvarez-Bustos 2,†, Lucía Furones-Fernández 3, Ángel Chen-Chim 4, María Teresa Boimorto-Medina 5, Rebeca Martiño-Córdoba 6, Pedro Gil-Gregorio 6, Walter Sepúlveda-Loyola 7,8, * and Isabel Rodríguez-Sánchez 6,9, * Academic Editor: TakaeEbihara Received: 11 November 2025 Revised: 18 December 2025 Accepted: 25 December 2025 Published: 27 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Geriatrics Department, Hospital del Río, Av. 24 de Mayo, Cuenca 010150, Ecuador 2 Department of Health, Universidad Villanueva, 28034 Madrid, Spain; [a.alvarezbu@gmail.com](a.alvarezbu@gmail.com) [3](3 Geriatrics Department)[ Geriatrics Department](3 Geriatrics Department), [Hospital Universitario Infanta Elena](Hospital Universitario Infanta Elena), [Av](Av). De los Reyes Católicos, 21, Valdemoro, 28342 Madrid, Spain 4 Geriatrics Department, Hôpitaux Robert Schuman, 9 Rue Edward Steichen, Neudorf-Weimershof, 2540 Luxembourg, Luxembourg 5 Geriatrics Department, Hospital General de Villalba, Carretera M-608, Km 41, Collado Villalba, 28400 Madrid, Spain 6 Geriatrics Medicine Department, Hospital Universitario Clínico San Carlos, C/Profesor Martín Lagos s/n, 28040 Madrid, Spain 7 Faculty of Health and Social Sciences, Universidad de Las Américas, Santiago de Chile 8370040, Chile 8 Center for Research in Biological and Chemical Sciences, Universidad de Las Américas, Santiago de Chile 8370040, Chile 9 Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Fundación para la Investigación Biomédica (IdISCC), 28040 Madrid, Spain * [Correspondence: wsepulveda@udla.cl](Correspondence: wsepulveda@udla.cl) (W.S.-L.); [isabelrs89@gmail.com](isabelrs89@gmail.com) (I.R.-S.); Tel.: +34-913303000 (I.R.-S.)† These authors contributed equally to this work. Abstract Objectives: This study seeks to analyze physical function and frailty transitions in older adults at 1, 12, and 18 months after hospital discharge for coronavirus disease (COVID-19). Furthermore, we examined risk factors associated with patterns of changes. Methods: This is an observational, longitudinal, unicentric study. Participants aged ≥80 years who were admitted to a Spanish tertiary hospital and survived COVID-19 were included. Functional status was evaluated at baseline and after 1, 12, and 18 months of discharge using the Barthel Index (BI) and Functional Ambulation Category (FAC), and frailty was assessed using the FRAIL scale. Clinical, sociodemographic, and functional parameters were evaluated ascovariates. Results: Two hundred and thirty-three individuals (mean age 86.2 ± 4.0 years, 48.9% men) were included. Patterns of changes were classified into three categories as follows: no changes (i.e., same score at baseline and follow-up), improvement (i.e., better results at follow-up), and worsening (i.e., detriments at follow-up). Worse frailty status at baseline [relative risk ratio (RRR) = 1.39] and longer length of stay (RRR = 1.03) were associated with higher risk of frailty impairment (worsening pattern). Older age (RRR = 1.11), longer length of stay (RRR = 1.03), and worse baseline physical function (RRR = 1.01) and FRAIL scores (RRR = 1.37) were associated with impairments in physical status at 18 months. Conclusions: Three distinct patterns of changes in functionality and frailty were observed among older adults discharged after COVID-19. Age, length of stay, and worse frailty and functional status at baseline emerged as significant risk factors for worsening in the examined conditions. Keywords: SARS-CoV-2; functional decline; physical decline; Barthel index; length of stay 1. Introduction

FAQs

What time points were used to assess functional status and frailty after discharge?

Functional status and frailty were evaluated at 1, 12, and 18 months after hospital discharge.

How were functional status and frailty measured in this study?

Functional status used the Barthel Index (BI) and Functional Ambulation Category (FAC), and frailty was assessed with the FRAIL scale.

What baseline factors predicted frailty worsening?

Worse frailty status at baseline and longer length of stay were associated with a higher risk of frailty impairment, identified as the worsening pattern.

Sep 30, 2026

Upload by jay