Mobility Activity and Its Value as a Prognostic Indicator of Survival in Hospitalized Older Adults
Objectives To objectively assess total steps and minutes active in the first and last 24 hours of hospitalization and to examine associations with survival after discharge in hospitalized older adults. Design A prospective study. Setting A 20‐bed Acute Care for Elders (ACE) hospital unit. Participan...
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| Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 2013-04, Vol.61 (4), p.551-557 |
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| container_title | Journal of the American Geriatrics Society (JAGS) |
| container_volume | 61 |
| creator | Ostir, Glenn V. Berges, Ivonne M. Kuo, Yong-Fang Goodwin, James S. Fisher, Steven R. Guralnik, Jack M. |
| description | Objectives
To objectively assess total steps and minutes active in the first and last 24 hours of hospitalization and to examine associations with survival after discharge in hospitalized older adults.
Design
A prospective study.
Setting
A 20‐bed Acute Care for Elders (ACE) hospital unit.
Participants
Two hundred twenty‐four older adults admitted to an ACE hospital unit.
Measurements
An activity monitor was used to collect information on total steps and minutes of activity in the first and last 24 hours of hospitalization. The main outcome was 2‐year survival from hospital discharge date.
Results
Participants were active for approximately 80 minutes in the first 24 hours of hospitalization. Participants aged 65–84 were active approximately 28 minutes more in the last 24 hours of hospitalization, but activity levels were essentially unchanged for those aged 85 and older. The median step count for participants was low, with a median of 478 steps in the first 24 hours of hospitalization and 846 in the last 24 hours. Multivariate survival models showed that, in the first and last 24 hours of hospitalization, each 100‐step increase was associated with a 2% (hazard ratio (HR) = 0.98, 95% confidence interval (CI) = 0.96–1.00) and 3% (HR = 0.97, 95% CI = 0.94–0.99) lower risk of death over 2 years, respectively. A decline in steps from first to last 24 hours of hospitalization was associated with a more than four times greater risk of death (HR = 4.21, 95% CI = 1.65–10.77) 2 years after discharge.
Conclusion
Accelerometers could provide meaningful information about walking activity. The ability to apply objective information about the individual's functional status to improve the delivery of health care and health outcomes is important. |
| doi_str_mv | 10.1111/jgs.12170 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1352284063</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1327726325</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5550-3a13e7fe1aa6f905dc78b4a919e093794847f7de14fad810c2f03f2d69b680453</originalsourceid><addsrcrecordid>eNqN0U1vEzEQBmALgWgaOPAHkCWEBIdtPf5Y7x5DBWlQoUjl42h5bW_l4KxTezcl_Ho2JC0SEhK-2IdnZjx6EXoG5ATGc7q8zidAQZIHaAKC0UJwEA_RhBBCi6oEfoSOc14SApRU1WN0RJmgshYwQc2H2Pjg-y2emd5vdg_dWbzoM_6qw-CwzljjTyledzH33uBFZ73RfUw4tvhqSBu_0QH7Dp_HvPa9Dv6ns_gyWJfwzA6hz0_Qo1aH7J4e7in68u7t57Pz4uJyvjibXRRGCEEKpoE52TrQumxrIqyRVcN1DbUjNZM1r7hspXXAW20rIIa2hLXUlnVTVoQLNkWv9n3XKd4MLvdq5bNxIejOxSErGJemFScl-w9KpaQlo7uuL_6iyzikblxEAWd1BaVgMKrXe2VSzDm5Vq2TX-m0VUDULiM1ZqR-ZzTa54eOQ7Ny9l7ehTKClwegs9GhTbozPv9xktWcjr-botO9u_XBbf89Ub2fX92NLvYVPvfux32FTt9VKZkU6tvHuaKcQkk4V2_YL5Z3tFk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1439816531</pqid></control><display><type>article</type><title>Mobility Activity and Its Value as a Prognostic Indicator of Survival in Hospitalized Older Adults</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Ostir, Glenn V. ; Berges, Ivonne M. ; Kuo, Yong-Fang ; Goodwin, James S. ; Fisher, Steven R. ; Guralnik, Jack M.</creator><creatorcontrib>Ostir, Glenn V. ; Berges, Ivonne M. ; Kuo, Yong-Fang ; Goodwin, James S. ; Fisher, Steven R. ; Guralnik, Jack M.</creatorcontrib><description>Objectives
To objectively assess total steps and minutes active in the first and last 24 hours of hospitalization and to examine associations with survival after discharge in hospitalized older adults.
Design
A prospective study.
Setting
A 20‐bed Acute Care for Elders (ACE) hospital unit.
Participants
Two hundred twenty‐four older adults admitted to an ACE hospital unit.
Measurements
An activity monitor was used to collect information on total steps and minutes of activity in the first and last 24 hours of hospitalization. The main outcome was 2‐year survival from hospital discharge date.
Results
Participants were active for approximately 80 minutes in the first 24 hours of hospitalization. Participants aged 65–84 were active approximately 28 minutes more in the last 24 hours of hospitalization, but activity levels were essentially unchanged for those aged 85 and older. The median step count for participants was low, with a median of 478 steps in the first 24 hours of hospitalization and 846 in the last 24 hours. Multivariate survival models showed that, in the first and last 24 hours of hospitalization, each 100‐step increase was associated with a 2% (hazard ratio (HR) = 0.98, 95% confidence interval (CI) = 0.96–1.00) and 3% (HR = 0.97, 95% CI = 0.94–0.99) lower risk of death over 2 years, respectively. A decline in steps from first to last 24 hours of hospitalization was associated with a more than four times greater risk of death (HR = 4.21, 95% CI = 1.65–10.77) 2 years after discharge.
Conclusion
Accelerometers could provide meaningful information about walking activity. The ability to apply objective information about the individual's functional status to improve the delivery of health care and health outcomes is important.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/jgs.12170</identifier><identifier>PMID: 23527951</identifier><identifier>CODEN: JAGSAF</identifier><language>eng</language><publisher>Hoboken, NJ: Blackwell Publishing Ltd</publisher><subject>Activities of Daily Living ; Aged ; Aged, 80 and over ; aging ; Biological and medical sciences ; Female ; General aspects ; Geriatric Assessment - methods ; Health Status Indicators ; Hospitalization ; Humans ; Male ; Medical prognosis ; Medical sciences ; Miscellaneous ; Mobility ; Motor Activity - physiology ; Older people ; Patient Discharge - statistics & numerical data ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Quality of Life ; Severity of Illness Index ; Survival analysis ; Walking - physiology</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2013-04, Vol.61 (4), p.551-557</ispartof><rights>2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society</rights><rights>2014 INIST-CNRS</rights><rights>2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.</rights><rights>2013 American Geriatrics Society and Wiley Periodicals, Inc</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5550-3a13e7fe1aa6f905dc78b4a919e093794847f7de14fad810c2f03f2d69b680453</citedby><cites>FETCH-LOGICAL-c5550-3a13e7fe1aa6f905dc78b4a919e093794847f7de14fad810c2f03f2d69b680453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgs.12170$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgs.12170$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27928,27929,45578,45579</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27394226$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23527951$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ostir, Glenn V.</creatorcontrib><creatorcontrib>Berges, Ivonne M.</creatorcontrib><creatorcontrib>Kuo, Yong-Fang</creatorcontrib><creatorcontrib>Goodwin, James S.</creatorcontrib><creatorcontrib>Fisher, Steven R.</creatorcontrib><creatorcontrib>Guralnik, Jack M.</creatorcontrib><title>Mobility Activity and Its Value as a Prognostic Indicator of Survival in Hospitalized Older Adults</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>Objectives
To objectively assess total steps and minutes active in the first and last 24 hours of hospitalization and to examine associations with survival after discharge in hospitalized older adults.
Design
A prospective study.
Setting
A 20‐bed Acute Care for Elders (ACE) hospital unit.
Participants
Two hundred twenty‐four older adults admitted to an ACE hospital unit.
Measurements
An activity monitor was used to collect information on total steps and minutes of activity in the first and last 24 hours of hospitalization. The main outcome was 2‐year survival from hospital discharge date.
Results
Participants were active for approximately 80 minutes in the first 24 hours of hospitalization. Participants aged 65–84 were active approximately 28 minutes more in the last 24 hours of hospitalization, but activity levels were essentially unchanged for those aged 85 and older. The median step count for participants was low, with a median of 478 steps in the first 24 hours of hospitalization and 846 in the last 24 hours. Multivariate survival models showed that, in the first and last 24 hours of hospitalization, each 100‐step increase was associated with a 2% (hazard ratio (HR) = 0.98, 95% confidence interval (CI) = 0.96–1.00) and 3% (HR = 0.97, 95% CI = 0.94–0.99) lower risk of death over 2 years, respectively. A decline in steps from first to last 24 hours of hospitalization was associated with a more than four times greater risk of death (HR = 4.21, 95% CI = 1.65–10.77) 2 years after discharge.
Conclusion
Accelerometers could provide meaningful information about walking activity. The ability to apply objective information about the individual's functional status to improve the delivery of health care and health outcomes is important.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>aging</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>General aspects</subject><subject>Geriatric Assessment - methods</subject><subject>Health Status Indicators</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Mobility</subject><subject>Motor Activity - physiology</subject><subject>Older people</subject><subject>Patient Discharge - statistics & numerical data</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Quality of Life</subject><subject>Severity of Illness Index</subject><subject>Survival analysis</subject><subject>Walking - physiology</subject><issn>0002-8614</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0U1vEzEQBmALgWgaOPAHkCWEBIdtPf5Y7x5DBWlQoUjl42h5bW_l4KxTezcl_Ho2JC0SEhK-2IdnZjx6EXoG5ATGc7q8zidAQZIHaAKC0UJwEA_RhBBCi6oEfoSOc14SApRU1WN0RJmgshYwQc2H2Pjg-y2emd5vdg_dWbzoM_6qw-CwzljjTyledzH33uBFZ73RfUw4tvhqSBu_0QH7Dp_HvPa9Dv6ns_gyWJfwzA6hz0_Qo1aH7J4e7in68u7t57Pz4uJyvjibXRRGCEEKpoE52TrQumxrIqyRVcN1DbUjNZM1r7hspXXAW20rIIa2hLXUlnVTVoQLNkWv9n3XKd4MLvdq5bNxIejOxSErGJemFScl-w9KpaQlo7uuL_6iyzikblxEAWd1BaVgMKrXe2VSzDm5Vq2TX-m0VUDULiM1ZqR-ZzTa54eOQ7Ny9l7ehTKClwegs9GhTbozPv9xktWcjr-botO9u_XBbf89Ub2fX92NLvYVPvfux32FTt9VKZkU6tvHuaKcQkk4V2_YL5Z3tFk</recordid><startdate>201304</startdate><enddate>201304</enddate><creator>Ostir, Glenn V.</creator><creator>Berges, Ivonne M.</creator><creator>Kuo, Yong-Fang</creator><creator>Goodwin, James S.</creator><creator>Fisher, Steven R.</creator><creator>Guralnik, Jack M.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7T2</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201304</creationdate><title>Mobility Activity and Its Value as a Prognostic Indicator of Survival in Hospitalized Older Adults</title><author>Ostir, Glenn V. ; Berges, Ivonne M. ; Kuo, Yong-Fang ; Goodwin, James S. ; Fisher, Steven R. ; Guralnik, Jack M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5550-3a13e7fe1aa6f905dc78b4a919e093794847f7de14fad810c2f03f2d69b680453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>aging</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>General aspects</topic><topic>Geriatric Assessment - methods</topic><topic>Health Status Indicators</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Mobility</topic><topic>Motor Activity - physiology</topic><topic>Older people</topic><topic>Patient Discharge - statistics & numerical data</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Quality of Life</topic><topic>Severity of Illness Index</topic><topic>Survival analysis</topic><topic>Walking - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ostir, Glenn V.</creatorcontrib><creatorcontrib>Berges, Ivonne M.</creatorcontrib><creatorcontrib>Kuo, Yong-Fang</creatorcontrib><creatorcontrib>Goodwin, James S.</creatorcontrib><creatorcontrib>Fisher, Steven R.</creatorcontrib><creatorcontrib>Guralnik, Jack M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ostir, Glenn V.</au><au>Berges, Ivonne M.</au><au>Kuo, Yong-Fang</au><au>Goodwin, James S.</au><au>Fisher, Steven R.</au><au>Guralnik, Jack M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mobility Activity and Its Value as a Prognostic Indicator of Survival in Hospitalized Older Adults</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2013-04</date><risdate>2013</risdate><volume>61</volume><issue>4</issue><spage>551</spage><epage>557</epage><pages>551-557</pages><issn>0002-8614</issn><eissn>1532-5415</eissn><coden>JAGSAF</coden><abstract>Objectives
To objectively assess total steps and minutes active in the first and last 24 hours of hospitalization and to examine associations with survival after discharge in hospitalized older adults.
Design
A prospective study.
Setting
A 20‐bed Acute Care for Elders (ACE) hospital unit.
Participants
Two hundred twenty‐four older adults admitted to an ACE hospital unit.
Measurements
An activity monitor was used to collect information on total steps and minutes of activity in the first and last 24 hours of hospitalization. The main outcome was 2‐year survival from hospital discharge date.
Results
Participants were active for approximately 80 minutes in the first 24 hours of hospitalization. Participants aged 65–84 were active approximately 28 minutes more in the last 24 hours of hospitalization, but activity levels were essentially unchanged for those aged 85 and older. The median step count for participants was low, with a median of 478 steps in the first 24 hours of hospitalization and 846 in the last 24 hours. Multivariate survival models showed that, in the first and last 24 hours of hospitalization, each 100‐step increase was associated with a 2% (hazard ratio (HR) = 0.98, 95% confidence interval (CI) = 0.96–1.00) and 3% (HR = 0.97, 95% CI = 0.94–0.99) lower risk of death over 2 years, respectively. A decline in steps from first to last 24 hours of hospitalization was associated with a more than four times greater risk of death (HR = 4.21, 95% CI = 1.65–10.77) 2 years after discharge.
Conclusion
Accelerometers could provide meaningful information about walking activity. The ability to apply objective information about the individual's functional status to improve the delivery of health care and health outcomes is important.</abstract><cop>Hoboken, NJ</cop><pub>Blackwell Publishing Ltd</pub><pmid>23527951</pmid><doi>10.1111/jgs.12170</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of the American Geriatrics Society (JAGS), 2013-04, Vol.61 (4), p.551-557 |
| issn | 0002-8614 1532-5415 |
| language | eng |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Activities of Daily Living Aged Aged, 80 and over aging Biological and medical sciences Female General aspects Geriatric Assessment - methods Health Status Indicators Hospitalization Humans Male Medical prognosis Medical sciences Miscellaneous Mobility Motor Activity - physiology Older people Patient Discharge - statistics & numerical data Predictive Value of Tests Prognosis Prospective Studies Public health. Hygiene Public health. Hygiene-occupational medicine Quality of Life Severity of Illness Index Survival analysis Walking - physiology |
| title | Mobility Activity and Its Value as a Prognostic Indicator of Survival in Hospitalized Older Adults |
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