Post-discharge light physical activity indicates recovery in acutely hospitalized older adults – the Hospital-ADL study

BMC Geriatrics

Research

Janet L. MacNeil Vroomen¹  Daisy Kolk²  Michel Terbraak³  Bianca M. Buurman⁴  Marike van der Schaaf⁵  Jos W. R. Twisk⁶ 

[1] Amsterdam UMC, Location University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands;Amsterdam UMC, Location University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands;Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, Netherlands;Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands;Amsterdam UMC, Location University of Amsterdam, Cardiology, Meibergdreef 9, Amsterdam, Netherlands;Amsterdam Cardiovascular Sciences, Atherosclerosis & Ischemic Syndromes, Amsterdam, Netherlands;Department of Physical Therapy, Amsterdam University of Applied Sciences, Tafelbergweg 51, 1105 BD, Amsterdam, Netherlands;Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands;Amsterdam UMC, Location University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands;Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands;Amsterdam UMC, Location University of Amsterdam, Rehabilitation, Meibergdreef 9, Amsterdam, Netherlands;Amsterdam Movement Sciences, Ageing and Vitality, Amsterdam, Netherlands;Epidemiology and Biostatistics, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, Netherlands;

关键词: Accelerometer;    Physical performance;    Rehabilitation;    Post-acute care;    Older patients;    Frailty;   

DOI  :  10.1186/s12877-023-04031-9

 received in 2022-10-14, accepted in 2023-05-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPhysical activity (PA) levels might be a simple overall physical function indicator of recovery in acutely hospitalized older adults; however it is unknown which amount and level of PA is associated with recovery. Our objective was to evaluate the amount and level of post discharge PA and its optimum cut-off values associated with recovery among acutely hospitalized older adults and stratified for frailty.MethodsWe performed a prospective observational cohort study including acutely hospitalized older adults (≥ 70 years). Frailty was assessed using Fried’s criteria. PA was assessed using Fitbit up to one week post discharge and quantified in steps and minutes light, moderate or higher intensity. The primary outcome was recovery at 3-months post discharge. ROC-curve analyses were used to determine cut-off values and area under the curve (AUC), and logistic regression analyses to calculate odds ratios (ORs).ResultsThe analytic sample included 174 participants with a mean (standard deviation) age of 79.2 (6.7) years of whom 84/174 (48%) were frail. At 3-months, 109/174 participants (63%) had recovered of whom 48 were frail. In all participants, determined cut-off values were 1369 steps/day (OR: 2.7, 95% confidence interval [CI]: 1.3–5.9, AUC 0.7) and 76 min/day of light intensity PA (OR: 3.9, 95% CI: 1.8–8.5, AUC 0.73). In frail participants, cut-off values were 1043 steps/day (OR: 5.0, 95% CI: 1.7–14.8, AUC 0.72) and 72 min/day of light intensity PA (OR: 7.2, 95% CI: 2.2–23.1, AUC 0,74). Determined cut-off values were not significantly associated with recovery in non-frail participants.ConclusionsPost-discharge PA cut-offs indicate the odds of recovery in older adults, especially in frail individuals, however are not equipped for use as a diagnostic test in daily practice. This is a first step in providing a direction for setting rehabilitation goals in older adults after hospitalization.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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