Ambulatory activity of older adults hospitalized with acute medical illness

Abstract

Objectives: To describe the amount and patterns of ambulatory activity in hospitalized older adults over consecutive hospital days.

Design: Observational cohort study.

Setting: University teaching hospital Acute Care for Elderly (ACE) unit.

Participants: Adults aged 65 and older (N = 239) who wore a step activity monitor during their hospital stay.

Measurements: Total number of steps per 24-hour day. Mean daily steps were calculated based on number of days the step activity monitor was worn.

Results: Mean age was 76.6 ± 7.6; 55.1% of participants were female. Patients took a mean number of 739.7 (interquartile range 89-1,014) steps per day during their hospital stay. Patients with shorter stays tended to ambulate more on the first complete day of hospitalization and had a markedly greater increase in mobility on the second day than patients with longer lengths of stay. There were no significant differences in mean daily steps according to illness severity or reason for admission.

Conclusion: Objective information on patient mobility can be collected for hospitalized older persons. Findings may increase understanding of the level of ambulation required to maintain functional status and promote recovery from acute illness.

Figure 1

Total daily steps as a function of length of stay. Patients were stratified according to number of complete 24-hour (midnight to midnight) days spent in the hospital, including 1, 2, 3, 4, and 5 or more days. 47 patients spent at least five 24-hour days, 34 at least six 24-hour days, and 28 at least seven 24-hour days. Activity monitoring began at midnight on the day of admission and ended at midnight of the day before discharge. Total length of stay therefore is always 2 days longer than the number of 24-hour days accumulated (e.g., 3 complete 24-hour days corresponds to a 5-calendar-day length of stay; 1 complete 24-hour day corresponds to a 3-day length of stay.