1. Factors Associated with Step Numbers in Acutely Hospitalized Older Adults: The Hospital-Activities of Daily Living Study
- Author
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Daisy Kolk, Jesse J. Aarden, Janet L. MacNeil-Vroomen, Lucienne A. Reichardt, Rosanne van Seben, Marike van der Schaaf, Martin van der Esch, Jos W.R. Twisk, Jos A. Bosch, Bianca M. Buurman, Raoul H.H. Engelbert, Ingeborg Kuper, Annemarieke de Jonghe, Maike Leguit-Elberse, Ad Kamper, Nynke Posthuma, Nienke Brendel, Johan Wold, Epidemiology and Data Science, APH - Health Behaviors & Chronic Diseases, APH - Methodology, AMS - Rehabilitation & Development, AMS - Amsterdam Movement Sciences, Geriatrics, Rehabilitation medicine, Medical Psychology, AMS - Ageing & Vitality, APH - Aging & Later Life, APH - Mental Health, APH - Digital Health, APH - Quality of Care, Klinische Psychologie (Psychologie, FMG), Lectoraat Revalidatie in de Acute Zorg, Urban Vitality, and Lectoraat Interdisciplinaire Zorg voor Chronische Gewrichtsaandoeningen
- Subjects
medicine.medical_specialty ,Activities of daily living ,Aftercare ,postdischarge ,03 medical and health sciences ,0302 clinical medicine ,Older patients ,Interquartile range ,Activities of Daily Living ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,General Nursing ,older adults ,Aged ,Aged, 80 and over ,business.industry ,Health Policy ,post-acute care ,Mean age ,General Medicine ,physical performance ,Hospitals ,Patient Discharge ,Confidence interval ,Accelerometer ,Physical performance ,Emergency medicine ,Geriatrics and Gerontology ,business ,Psychosocial ,030217 neurology & neurosurgery ,Cohort study ,hospitalization - Abstract
ObjectivesTo determine the number of steps taken by older patients in hospital and 1 week after discharge; to identify factors associated with step numbers after discharge; and to examine the association between functional decline and step numbers after discharge.DesignProspective observational cohort study conducted in 2015–2017.Setting and ParticipantsOlder adults (≥70 years of age) acutely hospitalized for at least 48 hours at internal, cardiology, or geriatric wards in 6 Dutch hospitals.MethodsSteps were counted using the Fitbit Flex accelerometer during hospitalization and 1 week after discharge. Demographic, somatic, physical, and psychosocial factors were assessed during hospitalization. Functional decline was determined 1 month after discharge using the Katz activities of daily living index.ResultsThe analytic sample included 188 participants [mean age (standard deviation) 79.1 (6.7)]. One month postdischarge, 33 out of 174 participants (19%) experienced functional decline. The median number of steps was 656 [interquartile range (IQR), 250–1146] at the last day of hospitalization. This increased to 1750 (IQR 675–4114) steps 1 day postdischarge, and to 1997 (IQR 938–4098) steps 7 days postdischarge. Age [β = −57.93; 95% confidence interval (CI) −111.15 to −4.71], physical performance (β = 224.95; 95% CI 117.79–332.11), and steps in hospital (β = 0.76; 95% CI 0.46–1.06) were associated with steps postdischarge. There was a significant association between step numbers after discharge and functional decline 1 month after discharge (β = −1400; 95% CI –2380 to −420; P = .005).Conclusions and ImplicationsAmong acutely hospitalized older adults, step numbers double 1 day postdischarge, indicating that their capacity is underutilized during hospitalization. Physical performance and physical activity during hospitalization are key to increasing the number of steps postdischarge. The number of steps 1 week after discharge is a promising indicator of functional decline 1 month after discharge.
- Published
- 2021