Clinical, methodological, and dynamic perspectives on recovery of acutely ill older adults

The number of frail older adults that require emergency care and hospital admissions is rising. Medical care is mainly focused on the acute medical condition, however after discharge older adults are at high risk of insufficient recovery. The objective of this thesis was to evaluate the recovery potential of acutely ill older adults that were admitted to the emergency department (ED) or hospital. The first part of this thesis evaluated which factors contribute to unplanned revisits to the ED from the perspectives of older adults, and evaluated the feasibility of a large cohort study investigating dynamic indicators of resilience in older adults that were admitted to the ED. In the second part of this thesis was investigated which variables of frailty are associated with physical activity levels after hospital discharge and which levels of physical activity are associated with recovery in the post-discharge recovery period. Finally, the association of time series of symptoms and physical activity with an individual’s ability to resist or recover from functional decline after acute hospital admission was investigated. This thesis shed light on the importance of careful monitoring recovery in older adults that were acutely admitted to the ED or hospital. Future interventions should focus on the treatment of post-acute health conditions and rehabilitation of physical functioning after discharge. In this thesis it is also recommended to include the assessment of frailty and continuous monitoring of symptoms and physical activity among acutely ill older adults during and after hospital admission.