Upright time during hospitalization for older inpatients: A prospective cohort study

Olga Theou; D. Scott Kehler; Judith Godin; K. Mallery; Mark A. MacLean; Kenneth Rockwood

doi:10.1016/j.exger.2019.110681

Upright time during hospitalization for older inpatients: A prospective cohort study

Olga Theou, D. Scott Kehler, Judith Godin, K. Mallery, Mark A. MacLean, Kenneth Rockwood

Medicine

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

Abstract

Background: The purpose of this study was to examine: a) how long and how frequently older hospitalized patients spend upright; b) whether duration and frequency of upright time change by time of the day, the day of the week, and during hospitalization; and c) whether these relationships differ based on the mobility level of patients at admission. Methods: This prospective cohort study included 111 patients (82.2 ± 8 years old, 52% female) from the Emergency Department and a Geriatric Assessment Unit who were at least 60 years old and had an anticipated length of stay of at least three days. The main outcomes were accelerometer-measured total upright time and number of bouts of upright time during awake hours. Results: Patients were upright 15.9 times/day (interquartile range (IQR): 8.4–27.4) for a total of 54.2 min/day (IQR: 17.8–88.9) during awake hours. Time of day and day of week had little impact on the outcomes. Patients who walked independently at admission had 151.5 min (95% CI: 87.7–215.3) of upright time on hospital day 1 and experienced a decline of 4.5 min/day (−7.2 to −1.8). Those who needed personal mobility assistance or were bedridden had 29.5 min (−38.5–97.4) and 25 min (−48.3–100.3) of upright time on day 1, and demonstrated an increase of 3.6 (1.3–5.9) and 2.4 (0.05–4.5) min/day, respectively. Conclusion: Hospitalized older adults spend only 6% of their awake hours upright while in hospital. Patients who can walk independently are more active but experience a decline in their upright time during hospitalization.

Original language	English
Article number	110681
Journal	Experimental Gerontology
Volume	126
DOIs	https://doi.org/10.1016/j.exger.2019.110681
Publication status	Published - Oct 15 2019

Bibliographical note

Funding Information:
Kenneth Rockwood is President and Chief Science Officer of DGI Clinical, which in the last five years has contracts with pharma and device manufacturers (Baxter, Baxalta, Shire, Hollister, Nutricia, Roche, Otsuka) on individualized outcome measurement. In 2017 he attended an advisory board meeting with Lundbeck. Otherwise any personal fees are for invited guest lectures and academic symposia, received directly from event organizers, chiefly for presentations on frailty. He is Associate Director of the Canadian Consortium on Neurodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, and with additional funding from the Alzheimer Society of Canada and several other charities, as well as, in its first phase (2013–2018), from Pfizer Canada and Sanofi Canada. The rest of the authors have no conflicts of interest.

Funding Information:
This work was supported in part by a Nova Scotia Health Authority Research Fund grant, Dalhousie University Internal Medicine Research Fellowship, and Canadian Institutes of Health Research Banting Fellowship.

Publisher Copyright:
© 2019 Elsevier Inc.

ASJC Scopus Subject Areas

Biochemistry
Ageing
Molecular Biology
Genetics
Endocrinology
Cell Biology

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't

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10.1016/j.exger.2019.110681

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title = "Upright time during hospitalization for older inpatients: A prospective cohort study",

abstract = "Background: The purpose of this study was to examine: a) how long and how frequently older hospitalized patients spend upright; b) whether duration and frequency of upright time change by time of the day, the day of the week, and during hospitalization; and c) whether these relationships differ based on the mobility level of patients at admission. Methods: This prospective cohort study included 111 patients (82.2 ± 8 years old, 52% female) from the Emergency Department and a Geriatric Assessment Unit who were at least 60 years old and had an anticipated length of stay of at least three days. The main outcomes were accelerometer-measured total upright time and number of bouts of upright time during awake hours. Results: Patients were upright 15.9 times/day (interquartile range (IQR): 8.4–27.4) for a total of 54.2 min/day (IQR: 17.8–88.9) during awake hours. Time of day and day of week had little impact on the outcomes. Patients who walked independently at admission had 151.5 min (95% CI: 87.7–215.3) of upright time on hospital day 1 and experienced a decline of 4.5 min/day (−7.2 to −1.8). Those who needed personal mobility assistance or were bedridden had 29.5 min (−38.5–97.4) and 25 min (−48.3–100.3) of upright time on day 1, and demonstrated an increase of 3.6 (1.3–5.9) and 2.4 (0.05–4.5) min/day, respectively. Conclusion: Hospitalized older adults spend only 6% of their awake hours upright while in hospital. Patients who can walk independently are more active but experience a decline in their upright time during hospitalization.",

author = "Olga Theou and Kehler, {D. Scott} and Judith Godin and K. Mallery and MacLean, {Mark A.} and Kenneth Rockwood",

note = "Funding Information: Kenneth Rockwood is President and Chief Science Officer of DGI Clinical, which in the last five years has contracts with pharma and device manufacturers (Baxter, Baxalta, Shire, Hollister, Nutricia, Roche, Otsuka) on individualized outcome measurement. In 2017 he attended an advisory board meeting with Lundbeck. Otherwise any personal fees are for invited guest lectures and academic symposia, received directly from event organizers, chiefly for presentations on frailty. He is Associate Director of the Canadian Consortium on Neurodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, and with additional funding from the Alzheimer Society of Canada and several other charities, as well as, in its first phase (2013–2018), from Pfizer Canada and Sanofi Canada. The rest of the authors have no conflicts of interest. Funding Information: This work was supported in part by a Nova Scotia Health Authority Research Fund grant, Dalhousie University Internal Medicine Research Fellowship, and Canadian Institutes of Health Research Banting Fellowship. Publisher Copyright: {\textcopyright} 2019 Elsevier Inc.",

year = "2019",

month = oct,

day = "15",

doi = "10.1016/j.exger.2019.110681",

language = "English",

volume = "126",

journal = "Experimental Gerontology",

issn = "0531-5565",

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T1 - Upright time during hospitalization for older inpatients

T2 - A prospective cohort study

AU - Theou, Olga

AU - Kehler, D. Scott

AU - Godin, Judith

AU - Mallery, K.

AU - MacLean, Mark A.

AU - Rockwood, Kenneth

N1 - Funding Information: Kenneth Rockwood is President and Chief Science Officer of DGI Clinical, which in the last five years has contracts with pharma and device manufacturers (Baxter, Baxalta, Shire, Hollister, Nutricia, Roche, Otsuka) on individualized outcome measurement. In 2017 he attended an advisory board meeting with Lundbeck. Otherwise any personal fees are for invited guest lectures and academic symposia, received directly from event organizers, chiefly for presentations on frailty. He is Associate Director of the Canadian Consortium on Neurodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, and with additional funding from the Alzheimer Society of Canada and several other charities, as well as, in its first phase (2013–2018), from Pfizer Canada and Sanofi Canada. The rest of the authors have no conflicts of interest. Funding Information: This work was supported in part by a Nova Scotia Health Authority Research Fund grant, Dalhousie University Internal Medicine Research Fellowship, and Canadian Institutes of Health Research Banting Fellowship. Publisher Copyright: © 2019 Elsevier Inc.

PY - 2019/10/15

Y1 - 2019/10/15

N2 - Background: The purpose of this study was to examine: a) how long and how frequently older hospitalized patients spend upright; b) whether duration and frequency of upright time change by time of the day, the day of the week, and during hospitalization; and c) whether these relationships differ based on the mobility level of patients at admission. Methods: This prospective cohort study included 111 patients (82.2 ± 8 years old, 52% female) from the Emergency Department and a Geriatric Assessment Unit who were at least 60 years old and had an anticipated length of stay of at least three days. The main outcomes were accelerometer-measured total upright time and number of bouts of upright time during awake hours. Results: Patients were upright 15.9 times/day (interquartile range (IQR): 8.4–27.4) for a total of 54.2 min/day (IQR: 17.8–88.9) during awake hours. Time of day and day of week had little impact on the outcomes. Patients who walked independently at admission had 151.5 min (95% CI: 87.7–215.3) of upright time on hospital day 1 and experienced a decline of 4.5 min/day (−7.2 to −1.8). Those who needed personal mobility assistance or were bedridden had 29.5 min (−38.5–97.4) and 25 min (−48.3–100.3) of upright time on day 1, and demonstrated an increase of 3.6 (1.3–5.9) and 2.4 (0.05–4.5) min/day, respectively. Conclusion: Hospitalized older adults spend only 6% of their awake hours upright while in hospital. Patients who can walk independently are more active but experience a decline in their upright time during hospitalization.

AB - Background: The purpose of this study was to examine: a) how long and how frequently older hospitalized patients spend upright; b) whether duration and frequency of upright time change by time of the day, the day of the week, and during hospitalization; and c) whether these relationships differ based on the mobility level of patients at admission. Methods: This prospective cohort study included 111 patients (82.2 ± 8 years old, 52% female) from the Emergency Department and a Geriatric Assessment Unit who were at least 60 years old and had an anticipated length of stay of at least three days. The main outcomes were accelerometer-measured total upright time and number of bouts of upright time during awake hours. Results: Patients were upright 15.9 times/day (interquartile range (IQR): 8.4–27.4) for a total of 54.2 min/day (IQR: 17.8–88.9) during awake hours. Time of day and day of week had little impact on the outcomes. Patients who walked independently at admission had 151.5 min (95% CI: 87.7–215.3) of upright time on hospital day 1 and experienced a decline of 4.5 min/day (−7.2 to −1.8). Those who needed personal mobility assistance or were bedridden had 29.5 min (−38.5–97.4) and 25 min (−48.3–100.3) of upright time on day 1, and demonstrated an increase of 3.6 (1.3–5.9) and 2.4 (0.05–4.5) min/day, respectively. Conclusion: Hospitalized older adults spend only 6% of their awake hours upright while in hospital. Patients who can walk independently are more active but experience a decline in their upright time during hospitalization.

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Upright time during hospitalization for older inpatients: A prospective cohort study

Abstract

Bibliographical note

ASJC Scopus Subject Areas

PubMed: MeSH publication types

Access to Document

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