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

Exp Gerontol. 2019 Oct 15:126:110681. doi: 10.1016/j.exger.2019.110681. Epub 2019 Aug 2.

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.

Keywords: Accelerometers; Aging; Hospital; Upright time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accelerometry
  • Aged
  • Aged, 80 and over
  • Bed Rest / statistics & numerical data*
  • Female
  • Geriatric Assessment / methods
  • Health Services for the Aged
  • Hospitalization / statistics & numerical data*
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Mobility Limitation
  • Nova Scotia
  • Patient Positioning / methods*
  • Prospective Studies
  • Sitting Position*
  • Time Factors
  • Walking