In our longitudinal study, geriatric syndromes
such as decreased ADLs, urinary incontinence,
depression, hyponutrition and delirium steeply
increase after acute illness. However, it is
unclear what factors are involved in functional
decline in acute care hospitals. We investigated
632 elderly subjects admitted to Tokyo University
Hospital from 1995 to 1999. ADLs (Barthel
Index) were recorded on admission and before
discharge.

Cognitive function (HDSR), vitality
(Vitality Index), body mass index, number of
diseases, number of geriatric syndromes and
existence of emergency admission were
examined in relation to functional decline. In
patients with functional decline, lower score of
HDSR, Vitality Index and BMI were found. In
conclusion, to prevent functional decline, we
have to check cognitive, nutritional and
emotional function in elderly inpatients in
acute care hospitals.