Deconditioning and functional decline after illness
Why older inpatients lose function, the causes to exclude before calling it deconditioning, measuring ADLs and frailty, preventing hospital-associated disability, CGA and the Australian rehabilitation and aged care pathways.
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Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Deconditioning is loss of strength, aerobic capacity and balance from inactivity during illness. Functional decline is the result: new dependence in walking, transfers, toileting, dressing or self-care.
- It's the commonest complication of hospital for older people. About a third of medical inpatients aged 70 or more go home worse than before the illness, and many never recover.
- Deconditioning is a diagnosis of exclusion. Look for delirium, fracture, cord compression, stroke and metabolic causes first.
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Sources
- Delirium Clinical Care StandardAU/NZAustralian Commission on Safety and Quality in Health Care, 2021
- Comprehensive geriatric assessment for older adults admitted to hospital (Ellis G et al. Cochrane Database Syst Rev 2017;9:CD006211)Cochrane, 2017
- Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age (Covinsky KE et al. J Am Geriatr Soc 2003;51:451-8)Journal of the American Geriatrics Society, 2003
- Effect of 10 days of bed rest on skeletal muscle in healthy older adults (Kortebein P et al. JAMA 2007;297:1772-4)JAMA, 2007
- The underrecognized epidemic of low mobility during hospitalization of older adults (Brown CJ et al. J Am Geriatr Soc 2009;57:1660-5)Journal of the American Geriatrics Society, 2009
- Effect of exercise intervention on functional decline in very elderly patients during acute hospitalization: a randomized clinical trial (Martinez-Velilla N et al. JAMA Intern Med 2019;179:28-36)JAMA Internal Medicine, 2019
- A global clinical measure of fitness and frailty in elderly people (Rockwood K et al. CMAJ 2005;173:489-95)Canadian Medical Association Journal, 2005
- Transition Care ProgrammeAU/NZAustralian Government Department of Health, Disability and Ageing
- Support at Home programAU/NZAustralian Government Department of Health, Disability and Ageing, 2025
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy