TY - JOUR
T1 - Factors Associated with Step Numbers in Acutely Hospitalized Older Adults: The Hospital-Activities of Daily Living Study
AU - Kolk, Daisy
AU - Aarden, Jesse J.
AU - MacNeil-Vroomen, Janet L.
AU - Reichardt, Lucienne A.
AU - van Seben, Rosanne
AU - van der Schaaf, Marike
AU - van der Esch, Martin
AU - Twisk, Jos W.R.
AU - Bosch, Jos A.
AU - Buurman, Bianca M.
AU - Engelbert, Raoul H.H.
AU - Hospital-ADL study group
N1 - Funding Information:
This study is funded by the Netherlands Organisation for Health Research and Development (NWO-ZonMw), grant number 16156071 .
Funding Information:
This study is funded by the Netherlands Organisation for Health Research and Development (NWO-ZonMw), grant number 16156071.
Publisher Copyright:
© 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine
PY - 2021/2
Y1 - 2021/2
N2 - OBJECTIVES: To 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.DESIGN: Prospective observational cohort study conducted in 2015-2017.SETTING AND PARTICIPANTS: Older adults (≥70 years of age) acutely hospitalized for at least 48 hours at internal, cardiology, or geriatric wards in 6 Dutch hospitals.METHODS: Steps 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.RESULTS: The 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 IMPLICATIONS: Among 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.
AB - OBJECTIVES: To 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.DESIGN: Prospective observational cohort study conducted in 2015-2017.SETTING AND PARTICIPANTS: Older adults (≥70 years of age) acutely hospitalized for at least 48 hours at internal, cardiology, or geriatric wards in 6 Dutch hospitals.METHODS: Steps 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.RESULTS: The 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 IMPLICATIONS: Among 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.
KW - accelerometer
KW - hospitalization
KW - older adults
KW - physical performance
KW - post-acute care
KW - postdischarge
UR - http://www.scopus.com/inward/record.url?scp=85088363758&partnerID=8YFLogxK
U2 - 10.1016/j.jamda.2020.06.027
DO - 10.1016/j.jamda.2020.06.027
M3 - Article
C2 - 32713773
SN - 1525-8610
VL - 22
SP - 425
EP - 432
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 2
ER -