Disablement Process Research Articles

Sensory Processing Difficulties Correlate With Disease Severity and Quality of Life Among Children With Migraine.

Introduction: Headaches are common among children and about 80% of children reporting them. Migraine and tension type headaches are the most common primary headaches in children and the prevalence of migraine is about 8%. Accompanying sensory symptoms are common before, during and after migraine attacks. They may be a part of a wider symptom constellation called sensory processing disorder or difficulties (SPD). This includes both hyper or hypo sensitivity to sensations. However, the literature regarding sensory processing symptoms of children and youth with headaches as well as its interaction with child's emotional aspects and quality of life is scarce.Materials and Methods: One hundred and thirty-four children between the ages of 8 and 12 participated in this study. Fifty-four children (22 boys and 32 girls) with episodic migraine were prospectively recruited from pediatric neurological clinics during the years 2014–2017. The control group included 80 healthy children. Both groups completed a health and demographic questionnaire, headache assessment including Ped-MIDAS, Short Sensory Profile, State-Trait Anxiety Inventory (STAI) for children, and the Pediatric Quality of Life Inventory.Results: Children with migraine showed significantly higher prevalence of sensory processing difficulties and lower quality of life compared to healthy controls. Among children with migraine, sensory processing difficulties significantly correlated with lower quality of life. Headache-related disability and sensory processing difficulties predicted quality of life.Conclusion: The possible relationship between migraine and sensory processing disorder or difficulties stresses the need to screen for sensory processing difficulties among children with migraine and when found—refer to their impacts on children's daily function and quality of life.

Sources of income following a rejected disability pension application: a sequence analysis study

Purpose: To identify different income trajectories after a rejected disability pension application and to analyze socio-demographic and disability process related determinants of these trajectories.Methods: Finnish residents aged 18–58 years with a first rejected disability pension application in 2010 (N = 3683) were followed for 48 months with register data. We performed a sequence analysis of six income sources (employment, unemployment benefit, sickness allowance, rehabilitation benefit, awarded disability pensions, other/unknown). Multinomial logistic regression was used in analyses.Results: Four clusters were identified, displaying unemployment, awarded disability pension, employment, or unknown source as the primary source of post-rejection income. Transitions between income sources were frequent, especially in the employment and unemployment clusters. Using the awarded pension cluster as the reference group, previous unemployment raised the odds of unemployment cluster membership the most. Similarly, previous employment raised the odds of employment cluster the most. A somatic rather than mental disorder and being under 50 years old raised the odds of being in the unemployment and employment clusters.Conclusions: After a rejected disability pension, main income paths include unemployment benefits, re-applied disability pension, and fragmented employment. Labor market and sickness history and age are associated with the probability of these paths.Implications for RehabilitationRejected disability pension applicants should be offered medical or vocational rehabilitation, to enable sustained labor market participation.Partial disability pension, supported by rehabilitation is one solution when a full-time labor market participation is not a realistic option.

Examining Psychosocial Mechanisms of Pain-Related Disability in Inflammatory Bowel Disease.

Disability in inflammatory bowel disease (IBD) is under-investigated. Models theorize that disability is the result of a disease and its related impairments, limitations, and restrictions. This disablement process can be affected by psychosocial factors. Pain, depression, catastrophizing, and social support are associated with IBD-disability outcomes, but no studies have examined these factors concurrently. This study examined the role of psychosocial factors in the process of IBD disablement within the context of pain. Depressive symptoms, pain catastrophizing, and perceived social support were proposed as mediators in the relationship between pain and pain-related disability in cross-sectional and longitudinal models. Cross-sectionally, the mediation effects of depressive symptoms and pain catastrophizing, but not perceived social support, were significant. Longitudinally, depression was a significant mediator. Depressive symptoms and pain catastrophizing have mechanistic roles in the relationship between IBD patients' pain and pain-related disability and should be targets for intervention.

Mitochondrial Dysfunction and Multiple Sclerosis.

In recent years, several studies have examined the potential associations between mitochondrial dysfunction and neurodegenerative diseases such as multiple sclerosis (MS), Parkinson’s disease and Alzheimer’s disease. In MS, neurological disability results from inflammation, demyelination, and ultimately, axonal damage within the central nervous system. The sustained inflammatory phase of the disease leads to ion channel changes and chronic oxidative stress. Several independent investigations have demonstrated mitochondrial respiratory chain deficiency in MS, as well as abnormalities in mitochondrial transport. These processes create an energy imbalance and contribute to a parallel process of progressive neurodegeneration and irreversible disability. The potential roles of mitochondria in neurodegeneration are reviewed. An overview of mitochondrial diseases that may overlap with MS are also discussed, as well as possible therapeutic targets for the treatment of MS and other neurodegenerative conditions.

Vitamin K Status and Mobility Limitation and Disability in Older Adults: The Health, Aging, and Body Composition Study.

Vitamin K has been implicated in chronic diseases associated with increased risk for mobility disability, such as osteoarthritis and cardiovascular disease. However, the association between vitamin K status and mobility disability is unknown. Therefore, we examined the association between vitamin K status and incident mobility disability in the Health, Aging, and Body Composition Study. Plasma phylloquinone (vitamin K1) was categorized as <0.5, 0.5-<1.0 and ≥1.0 nmol/L (n = 1,323, 48% male). Plasma ucMGP, which increases when vitamin K status is low, was measured in 716 participants and categorized into tertiles. Mobility limitation and disability, defined as two consecutive semiannual reports of having any or a lot of difficulty walking a one-fourth mile or climbing 10 steps without resting, were assessed over a median 6-10 years of follow-up. Multivariate Cox proportional hazard models were used to evaluate the association between vitamin K status and incident mobility limitation and disability. Participants with plasma phylloquinone less than 0.5 nmol/L were more likely to develop mobility limitation and disability compared to those with at least 1.0 nmol/L (adjusted HR (95% CI) mobility limitation: 1.27 (1.05-1.53); disability: 1.34 (1.01-1.76)). After further adjustment for knee pain, the associations were partially attenuated (HR (95% CI) mobility limitation: 1.20 (0.99-1.45); disability: 1.26 (0.96-1.67)). Plasma ucMGP was not associated with incident mobility limitation, but was nonlinearly associated with incident mobility disability (HR (95% CI), compared to tertile 1: tertile 2 = 1.64 (1.19-2.27), tertile 3 = 1.17 (0.83-1.66), fully adjusted). Our results suggest vitamin K may be involved in the disablement process in older age. Future studies are needed to confirm our findings and clarify the underlying mechanism.

Determinants of disability pension applications and awarded disability pensions in Finland, 2009 and 2014.

Aims: Examining the non-medical determinants of applying for and being awarded disability pension is important for assessing the functionality of the disability pension system. We examined how demographic and socioeconomic factors as well as factors related to the disability process associate with the probability of applying for disability pension and the probability of applicants being awarded pension in 2009 and 2014. Methods: 70% random samples of Finnish non-retired residents aged 18-64 in 2009 (n = 2,076,881) and in 2014 (n = 2,097,790) were analysed with logistic regression analysis. The application rates were 0.9% in 2009 and 0.7% in 2014, and the rates of awarded pensions were 80.6% in 2009 and 72.2% in 2014. Results: Being an upper-level non-manual employee and having more employment during the preceding four calendar years decreased the odds of applying for disability pension but increased the odds of being awarded one. Older age increased the odds of both applying for and being awarded pension. Compared to applications based on mental disorders, those applying due to neoplasms and diseases of the circulatory system had increased odds of being awarded pension whereas those applying due to musculoskeletal diseases or injuries had decreased odds. Only minor temporal changes were found in the determinants of applying for or being awarded disability pension. Conclusions: With a greater probability of disability pension applications but also a lower probability of being awarded pension, the occupational disability process involves a comprehensive disadvantage for lower socioeconomic status groups.

Assessment of physical functioning in the clinical care of the patient with advanced kidney disease.

Maintenance of independent living is the top health priority among patients with advanced chronic kidney disease (CKD). Mobility limitation is often the first sign of functional limitation leading to loss of independence. Regular assessments of physical capacity can help provide kidney health providers identify patients at risk of frailty and other adverse health-related outcomes that contribute to the loss of functional independence. These physical capacities can be measured with commonly used self-reported measures of physical function or by objective physical performance testing. The current review describes commonly used assessments of self-reported physical function and physical performance. First, we describe the disablement process and how these assessments can be performed with commonly used quality of life instruments measuring self-reported physical function or objective physical performance tests. Second, we identify the determinants and correlates of self-reported physical function and physical performance and their contribution to the frailty phenotype. Third, we describe the association of physical capacities with clinical outcomes. We conclude with on possible approach to identifying and intervening on persons with CKD at high risk of functional decline.

Loneliness as a Predictor of Work Disability Onset Among Nondisabled, Working Older Adults in 14 Countries.

Objective: The objective of this study is to examine the relationship between loneliness and work disability and whether depression mediates the hypothesized relationship. Method: We draw on data from the 2013 and 2015 waves of the Survey of Health, Aging, and Retirement in Europe. We limited the sample to adults between the ages of 50 and 65 who were working and without work limitations in 2013, which consisted of 10,154 adults from 14 countries. We apply multivariate logistic regression and a binary mediation analysis with logistic regression to examine predictors of the onset of work disability in 2015. Results: Loneliness was predictive of future work disability onset when adjusting for other factors in the disablement process. Depression partly mediated the longitudinal relationship between loneliness and work disability. Discussion: The results indicate that addressing loneliness could mitigate the risk of depression and, in turn, work disability onset.

Measuring Activity Limitations Within the National Health and Aging Trends Study (NHATS).

To better understand the disablement process among older adults, improved measures of activity limitations are needed. Traditional population-level measures lack the ability to distinguish precise gradations of activity limitation and are unable to detect degrees of differences over a wide range of ability levels. Therefore, we used contemporary measurement methods to improve upon current methodologies for characterizing activity limitations within the National Health and Aging Trends Study (NHATS) . We used the NHATS Round 1 cohort to assess the feasibility of constructing an Activity Limitations scale using Rasch item response theory methods. Factor analysis was used to develop the scale from a set of existing items in the NHATS Mobility, Self-Care, and Household Activity domains. Psychometric properties of the scale were evaluated and the scale was used to examine change in activity limitations among the sample from 2011 to 2015. Results supported an 18-item scale (N = 7,609). Rasch infit and outfit statistics were within acceptable range for all items (Cronbach's alpha = 0.95; sample score reliability = 0.83). From 2011 to 2015, 5.88% older adults demonstrated increase in function, 15% showed decrease in function, and 78% of the sample showed no change (did not exceed ± MDC90). Findings demonstrate that a unidimensional, interval scale of activity limitations can be constructed using traditional survey measures nested within the NHATS. Results revealed concerns regarding ceiling effects within the current self-report items of activity limitations suggesting future work is needed to expand the range of ability currently represented in the NHATS Activity Limitation items.

Relationship quality and functional limitations among older adults with cardiovascular disease in the United States of America

AbstractSubstantial research shows that cardiovascular disease is a major cause of disability in the United States of America (USA) and worldwide. Despite the well-documented significance of intimate partnerships for cardiovascular health and disease management, how relationship quality contributes to the functional health of older adults diagnosed with cardiovascular disease is much less understood than mental health and mortality risk. Informed by the disablement process model and the lifecourse perspective, this study examines the association between relationship quality and functional limitations among partnered older adults aged 50 years and older diagnosed with cardiovascular disease in the USA. Data are from the Health and Retirement Study, 2006–2012 (N = 1,355). Multi-level linear regression analyses show that baseline negative relationship quality is significantly associated with increased functional limitations over the two- and four-year follow-ups. Additionally, the link between negative relationship quality and functional limitations is stronger among older adults with lower household income over a two-year span, compared to their higher-income counterparts, suggesting that these older adults are doubly disadvantaged by higher relationship strains and limited economic resources. Our findings demonstrate the significance of relationship quality for the functional health of older adults with cardiovascular disease and shed light on the importance of marriage/partnerships as an important social context for a critical stage in the disablement process (i.e. functional limitations).

PENGARUH PENDIDIKAN KESEHATAN DENGAN METODE DEMONSTRASI TERHADAP KEMANDIRIAN PERAWATAN DIRI PADA PASIEN KUSTA CACAT TINGKAT II DI RUMAH SAKIT SUMBERGLAGAH MOJOKERTO

Lack of self-care independence is a phenomenon that appears on an outpatient at the sumberglagah hospital, Mojokerto. Most of the patients have less independence in self-care efforts in leprosy, causing a faster rate of patients to the disability process. The data explained that the demonstration method can improve self-care independence. This research was aimed to analyze the influence of health education with demonstration method in self care independent for disability 2nd grade of leprosy. Design used in this research was quasy experimental pre post test designed. The sampling technique used was purposive sampling. Samples were taken from those suitable with inclusion criteria, with total samples were 16 people. The independent variable was intervention of health education with demonstration method and the dependent variable was self care independence on leprosy measured by questioner and observation instrument of independence. Data were analyzed by Wilcoxon signed rank test and Mann Whitney test significance a &lt; 0,05. Result showed that treatment group has significance level p=0.016 and control group has significance level p=0.102 and the result of Mann whitney test showed p 0.001. This study describes the demonstration method can improve the level of self-care independence of disabled leprosy patients in 2nd grade. Demonstration method can help leprosy patients in terms of habit and routine care for themselves independently, to prevent further disability. This method can also be offered at the hospital sumberglagah to keep providing health education demonstration method in outpatient leprosy patients. It can also be a solution to decrease amount of disabled leprosy patients in Indonesia.

Late life disability and experienced wellbeing: Are economic resources a buffer?

BackgroundDisablement has been linked to compromised wellbeing in later life, but whether material resources buffer these negative effects is unclear. ObjectiveDrawing upon conceptual models of stress and coping, we analyze experienced wellbeing data from time diary interviews with adults ages 60 and older. We expect that experienced wellbeing will be influenced by each stage of the disablement process and that higher income and wealth will buffer the negative effects of disability on experienced wellbeing. Because income is a better reflection of one's liquid resources while assets reflect lifetime accumulation, we expect income to be a more substantial buffer than assets. MethodsWe use the Disability and Use of Time Supplement to the Panel Study of Income Dynamics (N = 1607). We consider several measures of the disablement process (activity limitations, impairment severity, duration of limiting condition) and history of work limitation and evaluate both pre-tax income and net worth quartiles. We estimate a series of multi-level regression models that account for clustering of individuals within couples. We calculate the marginal effects of disability on wellbeing at different quartiles of economic resources. ResultsWe find that impairment severity is associated with worse experienced wellbeing before and after adjusting for covariates, and income buffers these negative effects for those in the middle-income quartiles. ConclusionsFuture research should further explore the mechanisms through which income buffers the negative effects of impairment severity and specify the accommodations that enable economically disadvantaged and advantaged older adults alike to withstand physical declines while maintaining wellbeing.

The Association of Psychological Well-Being with Disablement Processes in a National Sample.

Objectives were to explore subgroups of individuals with differential disability trajectories and evaluate the protective effects of psychological well-being (i.e. hedonic and eudaimonic) in the presence of multiple disease conditions (or multimorbidity) and sociodemographic disadvantages. Data come from the prospective longitudinal cohort study the Midlife Development in the United States (n=3,904). Three waves of data spanning a 20-year period were used to identify subgroups with different disability trajectories. Subgroup membership was then modelled as a function of psychological well-being assessed at wave 1 of the study using multinomial logistic regression. Three unique groups were identified: a normative group with initially low and slowly increasing levels of disability; a group with high levels of disability that was stable over time; and a group with moderate initial levels of disability that increased over time. Hedonic well-being at wave 1 was associated with membership in the risk groups relative to the normative group. Individuals may follow one of three disability pathways mostly as a function of multimorbidity. However, hedonic well-being was associated with having an advantageous disability trajectory regardless of multimorbidity status. Cultivating psychological well-being may improve disability outcomes in aging individuals.

Yoga is for every (able) body: A content analysis of disability themes within mainstream yoga media

Yoga is increasingly being recommended as a health self-management strategy for people with a range of disabilities. Mainstream yoga media have been criticized for limited representation of racial/ethnic, gender, age, and body size diversity within their publications; however, it is not known how these media outlets include visual representations of or textual information relevant for people with disabilities (PWDs). The purpose of this research was to understand if and how mainstream yoga media visually represent and include information for PWDs. We conducted a content analysis of the “Yogapedia” section of each Yoga Journal magazine published in 2015 and 2016 (n = 17). Two independent coders rated all of the images and text in these sections. Data were analyzed using a thematic approach informed by a prominent theoretical model of disablement. Results suggest that images contained no representation of disability. In contrast, magazine text included an abundance of references to disability; however, these mentions predominately aligned with constructs found early in the disablement process and strongly focused on physical and mobility limitations. These findings expand upon previous research examining the underrepresentation of marginalized groups within yoga media and illuminate a paucity of relevant information for individuals with disabilities who are interested in and may benefit from yoga practice.

Defiant Memory as Disability Justice: An Interview with Patty Berne of Sins Invalid

Defiant Memory as Disability Justice: An Interview with Patty Berne of Sins Invalid Alison Kopit (bio) Alison Kopit, a cultural worker, interviews Patty Berne, a renowned activist and artistic director of the Bay Area–based performance project Sins Invalid, about her involvement with the group. They focus on a 2015 visual art exhibition and performance called Disability Liberated as a robust example of defiant memory practices. The interview explores Berne’s arts-based resistance work grounded in disability justice, focusing on the process and production of Disability Liberated, which coincided with the release of the book Disability Incarcerated and a corresponding conference that revolved around the incarceration of disabled people.1 The Disability Liberated project exhibited defiant memory practices and recognized state and interpersonal violence against disabled people of color. Featuring the art and stories of several formerly and currently incarcerated artists, Disability Liberated sought to amplify the voices and struggle of incarcerated disabled people and to visibilize stories that had been structurally silenced. Berne begins by introducing herself and contextualizing her work within the landscape of resistance. Berne: I’m a cofounder of Sins Invalid, along with Leroy Moore. My title is the executive and artistic director of Sins Invalid. I locate myself within a long history of resistance, both as a Haitian Japanese woman and as someone who’s participated in justice movements for over thirty years. Kopit: Do you want to tell readers who might be less familiar with disability justice a bit about it and how it departs from other forms of activism? Berne: [Sins Invalid has produced] a lot of text that describes, in robust and beautiful ways, what disability justice is, but at its core, it’s about recognizing and respecting the ways that our bodies live in the world and not complying with cis-hetero-capitalist expectations of how we move and love and work. That generates the principles of recognizing wholeness, of interdependence, of sustainability, and of anticapitalism. What’s ironic is that these ideas are [End Page 415] understood as revolutionary, but really, it’s the truth of our embodied lives. What is revolutionary is the practice of disability justice. In every organization, there would be collective access and we wouldn’t be ashamed of what we need. We would share responsibilities for meeting people’s needs and we’d keep a conscious balance of autonomy and community. Collective liberation necessarily means cross-disability solidarity. Kopit: I’m interested in some of the various ways that Sins Invalid uses disability justice as a framework in resistance work. Would you speak a little to that? Berne: I think even having an organization led by disabled people of color, built by disabled people of color, and for the benefit of disabled people of color is an act of defiance. To have a space where it’s a given that we are beautiful, that we are important, that we are amazing and sexy and powerful, that we can make history and help create a future of justice is defiant. Kopit: I’m curious about your experience working with other activist and art spaces with this approach. What kinds of responses do you receive? Berne: People have been really receptive because of the way that we can model it. We can start with one community at a time. That’s how movements happen. If people are going to be transformed by this practice, it’s going to take time. Disability justice is not just a theoretical ideal; it’s about how we treat each other and how we see each other in community. Kopit: I think you’re hitting on a difficult balance between this immediacy to do things now, because we don’t have infinite time, and also this patience and grace you have to have in going community by community. Berne: There’s a tension there, certainly, but I think that the process we use to reach each other is as important as the numbers. We’ve seen so many people with disabilities sacrificed. Disabled people of color shared the brunt of [Hurricane] Katrina’s violence. Folks who were in nursing homes and were shot with morphine, which was basically euthanasia.2...

INVESTIGATION TYPES AND CAUSES OF BOCCE ATHLETES ACCORDING TO THE VIEWS OF THE UNIVERSITY

The aim of this study is to investigate the types and causes of disability in bocce sports according to the opinions of bocce athletes studying at university. The study was designed in general screening method. A total of 133 students (62 male and 71 female) from different universities participated voluntarily. As a data collection tool, bocce athletes' questionnaire form was used to investigate the types and causes of disability. Frequency and percentage values are calculated. Also, according to demographic characteristics of the athletes, the chi-square test was performed to determine if the disability processes showed a significant difference and the significance value was accepted as (p <.05). Male bocce athletes are mostly injured due to insufficient warming; half of the women were injured due to insufficient warming. When the data were examined, 60% (n = 28) of the athletes who received their opinions within the scope of the study and who stated that they had been injured previously stated that they were injured due to insufficient warming. 17.4% (n = 8) of the athletes stated that the physical structure was inconvenient, 13% (n = 6) had lack of concentration, and 8.7% (n = 4) suffered from disability due to motivation disorder. It was determined by the participants that the main factor of the risk of injury was inadequate heating and physical structure. Bocce athletes experienced hand injuries in the hand-wrist region. Therefore, in relation to bocce sport, both the training areas and the competition conditions should be rearranged and the factors causing physical disability should be prevented. In addition, it can be said that the correct warming methods will be effective for the athletes.

Classification of Functioning, Disability, and Health: ICF-CY Self Care (SCADI Dataset) Using Predictive Analytics

The International Classification of Functioning, Disability, and Health for Children and Youth (ICF-CY) is a scaffold for designating and systematizing data on functioning and disability. It offers a standard semantic and a theoretical foundation for the demarcation and extent of wellbeing and infirmity. The multidimensional layout of ICF-CY comprehends a plethora of information with about 1400 categories making it difficult to analyze. Our research proposes a predictive model that classify self-care problems on Self-Care Activities Dataset based on the ICF-CY. The data used in this study resides 206 attributes of 70 children with motor and physical disability. Our study implements, compare and analyze Random Forest, Support vector machine, Naive Bayes, Hoeffding tree, and Lazy locally weighted learning using two-tailed T-test at 95% confidence interval. Boruta algorithm involved in the study minimizes the data dimensionality to advocate the minimal-optimal set of predictors. Random forest gave the best classification accuracy of 84.75%; root mean squared error of 0.18 and receiver operating characteristic of 0.99. Predictive analytics can simplify the usage of ICF-CY by automating the classification process of disability, functioning, and health.

Indigenous Persons with Disabilities and the Convention on the Rights of Persons with Disabilities

This article analyses how disability human rights protections and processes under the United Nations Convention on the Rights of Persons with Disabilities (crpd) have responded to the heightened vulnerability created when disability intersects with indigeneity. It considers the evolution of international human rights law instruments for indigenous persons with disabilities. It further examines the drafting history of the crpd related to indigenous-specific content and examines the crpd Committee’s engagement with the human rights protections and violations of indigenous persons with disabilities. It demonstrates that the crpd Committee has advanced these rights by acknowledging the rights of indigenous persons in the general course of its work, but has fallen short of adequately recognising the special vulnerabilities that are created when disability and indigeneity intersect. This evaluation is illustrated by expounding on the crpd Committee’s recommendation in Noble v Australia, a communication brought by an indigenous person with a ‘mental and intellectual disability’ whose indigenous status was not engaged.

Measuring Occupational Performance in Vulnerable Older Adults: Self-Reported or Performance-Based?

Abstract Date Presented 4/20/2018 A discord between the Canadian Occupational Performance Measure and the Assessment of Motor and Process Skills suggests that a discrepancy exists between older adults’ subjective perception and occupational therapists’ objective evaluation of occupational performance early in the disablement process. Primary Author and Speaker: Chiung-ju Liu Additional Authors and Speakers: Hilary Harris, Alyssa Davis, Louella Schoenfeld, Taylor Romero

Reversibility of nosocomial disability in hospitalized elderly patients through an individualized multicomponent exercise program: a randomized controlled trial

Introduction: Acute hospital admissions are sentinel events that play an important role in the disabling process of older adults, determining short and long term disability, nursing home placement or mortality. Despite the resolution of the reason that caused the hospital admission, the patient can be discharged with a major new disability that was not present before the onset of the acute illness, and older adults who are frail are particularly vulnerable to this nosocomial disability. Methods: This study was a a randomized clinical trial conducted in the Department of Geriatric. Hospitalized patients who met the inclusion criteria were randomly assigned within the first 48 h of admission. Participants assigned to the usual care group received habitual hospital care, which included physical rehabilitation when needed. The intervention consisted of a multicomponent exercise training programme composed of supervised progressive resistance exercise training, balance-training, and walking for 5–7 consecutive days. During the training period, patients trained in 20 min sessions twice a day morning and evening. The primary outcome measure was the change in functional and cognitive status during the study period. The secondary outcome measure were, the Spanish version of the Quality of life EuroQol Scale, Delirium, mortality, use of health resources and falls Results: A total of 157 patients in the intervention group and 153 patients in the usual care group finally entried the study. The analysis of the primary end point in the intention-to-treat population showed that the intervention improved function Barthel, SPPB, gait speed and cognition MMSE, Yesavage, as well as quality of life, with the same mean days of stay in the hospital. This results remained partially across the three months of follow up, but we did´n find differences in use of health resources or survival. Discussion: This trial demonstrates that a multicomponent, individualized and progressive exercise programme provides effective therapy for improving function and cognition of older adults hospitalized for medical pathology, not only preventing usual nosocomial disability, but also revesing disability and frailty at least at shorterm. The study couldn´t find differences in the use of health resources because of the limitations of the follow of a very complex population with high degrees of disability. Conclusion: A multicomponent exercise programme can prevent hospital associated disability and cognitive decline, and at least partially reverse frailty in older adults admitted to a hospital Lessons learned: A change of the current system of hospitalization of older adults with medical conditions may be justified. While the current system does not promote the execution of a scheduled exercise routine during the hospitalization period, if we can modify the current guidelines, it is likely that patients will present lower levels of functional and cognitive impairment after the hospitalization period, experience a better quality of life. Suggestions for future research: It´s necessary to replicate these results in multicentric studies and assess the ability of the program during longer periods of time.