Impact of hospitalizations on physical function among older adults: A 13-year longitudinal study

OBJECTIVES: To examine the impact of hospitalizations on objectively assessed physical function among older adults and to determine whether age, sex, and social environment moderate this association. STUDY DESIGN: A longitudinal observational study using data from 13 waves (2011-2023) of the U.S. National Health and Aging Trends Study. The analytic sample included 72,705 observations from 18,439 adults aged 65 years or more. Fixed-effects regression models were used to estimate within-person changes in physical function associated with hospitalizations, adjusting for time-varying sociodemographic and health-related covariates. MAIN OUTCOME MEASURES: Physical function was measured using the Short Physical Performance Battery, an objective assessment of balance, gait speed, and lower-body strength. Hospitalizations were self-reported annually. RESULTS: Each additional hospitalization was associated with a 0.26-point decrease in Short Physical Performance Battery score (95% CI -0.29 to -0.23) in the fully adjusted model. Age significantly moderated this relationship, with greater declines in score observed among the oldest participants. In contrast, sex did not significantly modify the effect of hospitalization on physical function. CONCLUSIONS: Hospitalizations exert a cumulative and detrimental effect on the physical function of older adults. These findings highlight the need for preventive strategies to reduce hospital admissions and for comprehensive post-hospital rehabilitation programs aimed at maintaining or restoring functional independence, particularly among the oldest age groups, who are the most vulnerable to declines following hospitalization.