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J Am Geriatr Soc. 2019 Feb;67(2):261-268. doi: 10.1111/jgs.15631. Epub 2018 Nov 19.

Effect of Hospitalizations on Physical Activity Patterns in Mobility-Limited Older Adults.

Author information

1
Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland.
2
Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland.
3
Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.
4
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina.
5
Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
6
Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida.
7
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida.
8
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
9
Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, California.
10
Department of Medicine, School of Medicine, Stanford University, Stanford, California.
11
Population and Public Health, Pennington Biomedical Research Center, Baton Rouge, Louisiana.
12
Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
13
Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida.

Abstract

OBJECTIVES:

To evaluate the effect of hospitalizations on patterns of sedentary and physical activity time in mobility-limited older adults randomized to structured physical activity or health education.

DESIGN:

Secondary analysis of investigator-blinded, parallel-group, randomized trial conducted at 8 U.S. centers between February 2010 and December 2013.

PARTICIPANTS:

Sedentary men and women aged 70 to 89 at baseline who wore a hip-fitted accelerometer 7 consecutive days at baseline and 6, 12, and 24 months after randomization (N=1,341).

MEASUREMENTS:

Participants were randomized to a physical activity (PA; n = 669) intervention that included aerobic, resistance, and flexibility training or to a health education (HE; n = 672) intervention that consisted of workshops on older adult health and light upper-extremity stretching. Accelerometer patterns were characterized as bouts of sedentary (<100 counts/min; ≥1, ≥10, ≥30, ≥60 minute lengths) and activity (≥100 counts/min; ≥1, ≥2, ≥5, ≥10 minute lengths) time. Each participant was categorized as having 0, 1 to 3, or 4 or more cumulative hospital days before each accelerometer assessment.

RESULTS:

Hospitalization increased sedentary time similarly in both intervention groups (8 min/d for 1-3 cumulative hospital days and 16 min/d for ≥4 cumulative hospital days). Hospitalization was also associated with less physical activity time across all bouts of less than 10 minutes (≥1: -7 min/d for 1-3 cumulative hospital days, -16 min/d for ≥4 cumulative hospital days; ≥2: -5 min/d for 1-3 cumulative hospital days, -11 min/d for ≥4 cumulative hospital days; ≥5: -3 min/d for 1-3 cumulative hospital days, -4 min/d for ≥4 cumulative hospital days). There was no evidence of recovery to prehospitalization levels (time effect p >.41). PA participants had less sedentary time in bouts of less than 30 minutes than HE participants (-8 to -10 min/d) and more total activity (+3 to +6 min/d), although hospital-related changes were similar between the intervention groups (interaction effect p >.26).

CONCLUSION:

Participating in a PA intervention before hospitalization had expected benefits, but participants remained susceptible to hospitalization's detrimental effects on their daily activity levels. There was no evidence of better activity recovery after hospitalization. J Am Geriatr Soc 67:261-268, 2019.

KEYWORDS:

accelerometer; clinical trial; exercise; hospital; sedentary behavior

PMID:
30452084
DOI:
10.1111/jgs.15631

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