Department of medicine, internal medicine, Lausanne university hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
BMC Geriatr. 2020 Oct 2;20(1):382. doi: 10.1186/s12877-020-01763-w.
In a hospital setting and among older patients, inactivity and bedrest are associated with a wide range of negative outcomes such as functional decline, increased risk of falls, longer hospitalization and institutionalization. Our aim was to assess the distribution, determinants and predictors of physical activity (PA) levels using wrist-worn accelerometers in older patients hospitalized with acute medical illness.
Observational study conducted from February to November 2018 at an acute internal medicine unit in the University hospital of Lausanne, Switzerland. We enrolled 177 patients aged ≥65 years, able to walk prior to admission. PA during acute hospital stay was continuously recorded via a 3D wrist accelerometer. Clinical data was collected from medical records or by interview. Autonomy level prior to inclusion was assessed using Barthel Index score. PA levels were defined as < 30 mg for inactivity, 30-99 mg for light and ≥ 100 for moderate PA. Physically active patients were defined as 1) being in the highest quartile of time spent in light and moderate PA or 2) spending ≥20 min/day in moderate PA.
Median [interquartile range - IQR] age was 83 [74-87] years and 60% of participants were male. The median [IQR] time spent inactive and in light PA was 613 [518-663] and 63 [30-97] minutes/day, respectively. PA peaked between 8 and 10 am, at 12 am and at 6 pm. Less than 10% of patients were considered physically active according to definition 2. For both definitions, active patients had a lower prevalence of walking aids and a lower dependency level according to Barthel Index score. For definition 1, use of medical equipment was associated with a 70% reduction in the likelihood of being active: odds ratio (OR) 0.30 [0.10-0.92] p = 0.034; for definition 2, use of walking aids was associated with a 75% reduction in the likelihood of being active: OR = 0.24 [0.06-0.89], p = 0.032.
Older hospitalized patients are physically active only 10% of daily time and concentrate their PA around eating periods. Whether a Barthel Index below 95 prior to admission may be used to identify patients at risk of inactivity during hospital stay remains to be proven.
在医院环境中，对于老年人而言，缺乏活动和卧床休息与多种负面后果相关，如功能下降、跌倒风险增加、住院时间延长和住院机构化。我们的目的是使用腕部佩戴的加速度计评估急性内科疾病住院的老年患者的身体活动（PA）水平的分布、决定因素和预测因素。
这是一项于 2018 年 2 月至 11 月在瑞士洛桑大学附属医院的急性内科病房进行的观察性研究。我们纳入了 177 名年龄≥65 岁、入院前能够行走的患者。通过 3D 腕部加速度计连续记录急性住院期间的 PA。临床数据从病历或访谈中收集。纳入前的自理能力水平使用巴氏指数评分进行评估。PA 水平定义为<30mg 为不活动，30-99mg 为轻度，≥100mg 为中度 PA。体力活动患者定义为 1）处于轻、中度 PA 时间最高四分位数或 2）每天至少进行 20 分钟中度 PA。
中位（四分位距-IQR）年龄为 83 [74-87] 岁，60%的参与者为男性。中位（IQR）不活动和轻度 PA 时间分别为 613 [518-663] 和 63 [30-97] 分钟/天。PA 峰值出现在上午 8 点至 10 点、12 点和下午 6 点。根据定义 2，只有不到 10%的患者被认为是体力活动者。对于这两个定义，活动患者的助行器使用率较低，根据巴氏指数评分的依赖程度较低。对于定义 1，使用医疗设备与活动可能性降低 70%相关：比值比（OR）0.30 [0.10-0.92]，p=0.034；对于定义 2，使用助行器与活动可能性降低 75%相关：OR=0.24 [0.06-0.89]，p=0.032。
老年住院患者每天只有 10%的时间进行身体活动，并且将他们的 PA 集中在进食时间。入院前巴氏指数评分<95 是否可用于识别住院期间活动减少的风险患者，仍有待证实。
