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ABSTRACT: Background
Hospital-acquired disability (HAD) is common and often related to low physical activity while in the hospital.Objective
To examine whether wearable hospital activity trackers can be used to predict HAD.Design
A prospective observational study between January 2016 and March 2017.Setting
An academic medical center.Participants
Community-dwelling older adults, aged 60?years or older, enrolled within 24?hours of admission to general medicine (n = 46).Main measures
Primary outcome was HAD, defined as having one or more new activity of daily living deficits, decline of four or greater on the Late-Life Function and Disability Instrument (calculated between baseline and discharge), or discharge to a skilled nursing facility. Hospital activity (mean active time, mean sedentary time, and mean step counts per day) was measured using ankle-mounted accelerometers. The association of the literature-based threshold of 900 steps/day with HAD was also evaluated.Results
Mean age was 73.2?years (SD = 9.5?years), 48% were male, and 76% were white. Median length of stay was 4?days (interquartile range [IQR] =?2.0-6.0?days); 61% (n = 28) reported being able to walk without assistance of another person or walking aid at baseline. Median daily activity time and step counts were 1.1 h/d (IQR = 0.7-1.7 h/d) and 1455.7 steps/day (IQR = 908.5-2643 steps/day), respectively. Those with HAD (41%; n = 19) had lower activity time (0.8 vs 1.4 h/d; P = .04) and fewer step counts (1186 vs 1808 steps/day; P = .04), but no difference in sedentary time, compared to those without HAD. The 900 steps/day threshold had poor sensitivity (40%) and high specificity (85%) for detecting HAD.Conclusions
Low hospital physical activity, as measured by wearable accelerometers, is associated with HAD. Clinicians can utilize wearable technology data to refer patients to physical/occupational therapy services or other mobility interventions, like walking programs. J Am Geriatr Soc 68:261-265, 2020.
SUBMITTER: Pavon JM
PROVIDER: S-EPMC7002200 | biostudies-literature | 2020 Feb
REPOSITORIES: biostudies-literature
Pavon Juliessa M JM Sloane Richard J RJ Pieper Carl F CF Colón-Emeric Cathleen S CS Cohen Harvey J HJ Gallagher David D Hall Katherine S KS Morey Miriam C MC McCarty Midori M Hastings Susan N SN
Journal of the American Geriatrics Society 20191120 2
<h4>Background</h4>Hospital-acquired disability (HAD) is common and often related to low physical activity while in the hospital.<h4>Objective</h4>To examine whether wearable hospital activity trackers can be used to predict HAD.<h4>Design</h4>A prospective observational study between January 2016 and March 2017.<h4>Setting</h4>An academic medical center.<h4>Participants</h4>Community-dwelling older adults, aged 60 years or older, enrolled within 24 hours of admission to general medicine (n = 46 ...[more]