Daytime Physical Activity and Sleep in Hospitalized Older Adults: Association with Demographic Characteristics and Disease Severity

Beveridge, Claire; Knutson, Kristen L.; Spampinato, L; Flores, Andrea; Meltzer, David O.; Cauter, Eve Van; Arora, Vineet M.

doi:10.1111/jgs.13520

“…The strengths of this study are its large sample size, its broad inclusion criteria, the use of accelerometers to assess PA and the large number of PA hours recorded. Regarding sample size, this study is the largest when compared to other studies in Europe (12,13,(16)(17)(18)41), the USA (20,21,32) and Australia (14,19). Regarding inclusion criteria, and contrary to previous studies (12,32,47,48), we included patients with cognitive impairment/confusion as they are at increased risk of post-hospitalization functional decline (28,39).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Further, the data collected can be analyzed with algorithms that classify locomotion and nonlocomotion periods in everyday life (15). Still, there is a paucity of studies assessing PA levels by accelerometry in hospitalized older patients (12)(13)(14)(16)(17)(18)(19)(20)(21)(22). In a previous paper, Lim et al reported that the PA levels of 38 hospitalized older patients were very low and that most PA was sustained over short periods (12).…”

Section: Introductionmentioning

confidence: 99%

Accelerometry Assessed Physical Activity of Older Adults Hospitalized with Acute Medical Illness - an Observational Study

Tasheva

¹

,

Kraege

²

,

Vollenweider

³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: In a hospital setting and among older patients, inactivity and bedrest are associated with a wide range of negative outcomes such as functional decline, increased risk of falls, longer hospitalization and institutionalization. Our aim was to assess the distribution, determinants and predictors of physical activity (PA) levels using wrist-worn accelerometers in older patients hospitalized with acute medical illness.Methods: Observational study conducted from February to November 2018 at an acute internal medicine unit in the University hospital of Lausanne, Switzerland. We enrolled 177 patients aged ≥65 years, able to walk prior to admission. PA during acute hospital stay was continuously recorded via a 3D wrist accelerometer. Clinical data was collected from medical records or by interview. Autonomy level prior to inclusion was assessed using Barthel Index score. PA levels were defined as <30 mg for inactivity, 30-99 mg for light and ≥100 for moderate PA. Physically active patients were defined as 1) being in the highest quartile of time spent in light and moderate PA or 2) spending ≥20 minutes/day in moderate PA.Results: Median [interquartile range - IQR] age was 83 [74-87] years and 60% of participants were male. The median [IQR] time spent inactive and in light PA was 613 [518-663] and 63 [30-97] minutes/day, respectively. PA peaked between 8 and 10 am, at 12 am and at 6 pm. Less than 10% of patients were considered physically active according to definition 2. For both definitions, active patients had a lower prevalence of walking aids and a lower dependency level according to Barthel Index score. For definition 1, use of medical equipment was associated with a 70% reduction in the likelihood of being active: odds ratio (OR) 0.30 [0.10-0.92] p=0.034; for definition 2, use of walking aids was associated with a 75% reduction in the likelihood of being active: OR=0.24 [0.06-0.89], p=0.032.Conclusion: Older hospitalized patients are physically active only 10% of daily time and concentrate their PA around eating periods. Whether a Barthel Index below 95 prior to admission may be used to identify patients at risk of inactivity during hospital stay remains to be proven.

show abstract

“…The APR-DRGs is reported to be able to estimate the global impairment of older Barriers to Promoting Mobility adults (Pilotto et al, 2011). Patients with increased severity of illness may have greater comorbidities and may be more likely to have poor health outcomes (Beveridge et al, 2015).…”

Section: Other Measuresmentioning

confidence: 99%

Barriers to Promoting Mobility in Hospitalized Older Adults

Dermody¹,

Kovach²

2018

Research in Gerontological Nursing

View full text Add to dashboard Cite

Hospitalized older adults who do not receive sufficient mobility are more likely to sustain negative health outcomes, including higher rates of mortality and institutionalization. Accordingly, the purpose of the current secondary data analysis was to examine the nurse-promoted mobility of hospitalized older adults and the association between nurses' barriers and nurse-promoted mobility. In addition, the relationship among patient severity of illness, proxy levels for function, and nurse-promoted mobility was examined. The final study sample included 61 nurses working in medical units caring for a total of 77 older adults. Findings suggest nurse knowledge gaps and attitude barriers could potentially influence the type and frequency of mobility they promote in older patients. A relationship was found between older patients with impaired mobility using assistive devices for mobility at home, and those at high risk for falls and nurses promoting more sedentary activity (e.g., chair sitting, walking in the room). Interestingly, nurses promoted significantly more sedentary mobility for patients with physical therapy orders. [Res Gerontol Nurs. 2018; 11(1):17-27.].

show abstract

“…The strengths of this study are its large sample size, its broad inclusion criteria, the use of accelerometers to assess PA and the large number of PA hours recorded. Regarding sample size, this study is the largest when compared to other studies in Europe (12,13,(16)(17)(18)41), the USA (20,21,32) and Australia (14,19).…”

Section: Strengths and Limitationsmentioning

confidence: 95%

Accelerometry Assessed Physical Activity of Older Adults Hospitalized with Acute Medical Illness - an Observational Study

Tasheva

¹

,

Kraege

²

,

Vollenweider

³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: In a hospital setting and among older patients, inactivity and bedrest are associated with a wide range of negative outcomes such as functional decline, increased risk of falls, longer hospitalization and institutionalization. Our aim was to assess the distribution, determinants and predictors of physical activity (PA) levels using wrist-worn accelerometers in older patients hospitalized with acute medical illness.Methods: Observational study conducted from February to November 2018 at an acute internal medicine unit in the University hospital of Lausanne, Switzerland. We enrolled 177 patients aged ≥65 years, able to walk prior to admission. PA during acute hospital stay was continuously recorded via a 3D wrist accelerometer. Clinical data was collected from medical records or by interview. Autonomy level prior to inclusion was assessed using Barthel Index score. PA levels were defined as <30 mg for inactivity, 30-99 mg for light and ≥100 for moderate PA. Physically active patients were defined as 1) being in the highest quartile of time spent in light and moderate PA or 2) spending ≥20 minutes/day in moderate PA.Results: Median [interquartile range - IQR] age was 83 [74-87] years and 60% of participants were male. The median [IQR] time spent inactive and in light PA was 613 [518-663] and 63 [30-97] minutes/day, respectively. PA peaked between 8 and 10 am, at 12 am and at 6 pm. Less than 10% of patients were considered physically active according to definition 2. For both definitions, active patients had a lower prevalence of walking aids and a lower dependency level according to Barthel Index score. For definition 1, use of medical equipment was associated with a 70% reduction in the likelihood of being active: odds ratio (OR) 0.30 [0.10-0.92] p=0.034; for definition 2, use of walking aids was associated with a 75% reduction in the likelihood of being active: OR=0.24 [0.06-0.89], p=0.032.Conclusion: Older hospitalized patients are physically active only 10% of daily time and concentrate their PA around eating periods. Whether a Barthel Index below 95 prior to admission may be used to identify patients at risk of inactivity during hospital stay remains to be proven.

show abstract

Daytime Physical Activity and Sleep in Hospitalized Older Adults: Association with Demographic Characteristics and Disease Severity

Cited by 43 publications

References 54 publications

Accelerometry Assessed Physical Activity of Older Adults Hospitalized with Acute Medical Illness - an Observational Study

Accelerometry Assessed Physical Activity of Older Adults Hospitalized with Acute Medical Illness - an Observational Study

Barriers to Promoting Mobility in Hospitalized Older Adults

Accelerometry Assessed Physical Activity of Older Adults Hospitalized with Acute Medical Illness - an Observational Study

Contact Info

Product

Resources

About