Activity in Hospitalized Elderly Patients

Abstract

Loss of function during hospitalization in older adults can be attributed to a number of factors including age, previous disability, functional status prior to admission, cognition, habitual physical activity, seriousness of the medical condition, length of stay, whether the patient is admitted to a specialized unit for elders, social and psychological factors, as well as the development of new functional deficits during hospitalization. Few studies have examined the out of bed activity during hospitalization. PURPOSE: The purpose of this study will be to characterize ambulation of elder, non-surgical, hospitalized patients in relation to function during hospitalization and 1-month after. SUBJECTS: 38 hospitalized elders (27 women, 11 men; 77.7+/−6.7 years) who were ambulatory prior to hospitalization. METHODS: Activity was monitored as the percent time of inactivity and average number of steps completed during hospitalization. Number of steps was recorded with a Step Activity Monitor (SAM), an accelerometer worn on the ankle just above the lateral malleoli. Subjects wore the device throughout hospitalization except during special medical tests such as MRIs. Data is downloaded via a docking station and processed with special software (StepWatch, version 2.0). Subjects reported physical activity (Physical Activity Scale for Elders- PASE) prior to admission, and function (Functional Independence Measure-FIM) at admission, discharge, and 1-month follow-up (FU). RESULTS: The subjects were hospitalized 3.9 +/−2.3 days. They were inactive 95.3 +/−3.3 % of the day and walked 360.3 +/−336.6 steps/day. Low activity (< 15 steps/min) occurred 4.3 +/−3 % of the day. Medium activity occurred 0.4 +/−0.4% of the time, and high activity just 0.1 +/−0.2 % of the day. These subjects reported a score of 10.3 on the PASE, suggesting a low level of activity prior to hospitalization. Both admission and discharge FIM were significantly lower than 1-month FU (F= 12.74; p< 0.001) CONCLUSION: Elders who are ambulatory display almost complete inactivity and bedrest when hospitalized despite being hospitalized on a special floor for elders. Interventions to enhance activity during acute hospitalization for elders should be explored.