Determinants of instrumented sedentary and physical activity behavior in geriatric rehabilitation inpatients: RESORT,Experimental Gerontology

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Determinants of instrumented sedentary and physical activity behavior in geriatric rehabilitation inpatients: RESORT
Experimental Gerontology ( IF 3.9 ) Pub Date : 2021-08-21 , DOI: 10.1016/j.exger.2021.111524
Anna Galina Maria Rojer ₁ , Britt C M Denneman ₁ , Puck Brouwer ₁ , Keenan A Ramsey ₁ , Marijke C Trappenburg ₂ , Carel G M Meskers ₃ , Mirjam Pijnappels ₁ , Rose Goonan ₄ , Celia Marston ₄ , Jacqueline E Kay ₄ , W Kwang Lim ₄ , Alisa Turbić ₄ , Louis Island ₄ , Esmee M Reijnierse ₅ , Andrea B Maier ₆

Affiliation

Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Movement Sciences, the Netherlands.
Department of Internal Medicine, Amstelland Hospital, Laan van de Helende Meesters 8, 1186 AM Amstelveen, the Netherlands; Department of Internal Medicine, Amsterdam UMC, VU University Medical Center, de Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, de Boelelaan 1118, 1081 HV Amsterdam, the Netherlands.
Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, 300 Grattan Street, Parkville, 3050, Victoria, Australia.
Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, 300 Grattan Street, Parkville, 3050, Victoria, Australia; Department of Rehabilitation Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam Movement Sciences, de Boelelaan 1118, 1081 HV Amsterdam, the Netherlands.
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Movement Sciences, the Netherlands; Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, 300 Grattan Street, Parkville, 3050, Victoria, Australia; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore.

Background

Physical inactivity in hospitalized older adults is highly prevalent and associated with detrimental health outcomes. Understanding its determinants is important for prognosis and tailoring interventions in geriatric rehabilitation inpatients.

Methods

Within the REStORing health of acutely unwell adulTs (RESORT) observational, longitudinal cohort, geriatric rehabilitation inpatients wore an inertial sensor (ActivPAL4) for one week to objectively assess instrumented sedentary behavior (i-SB) and physical activity (i-PA). Determinants were grouped in five geriatric domains: morbidity, cognition/psychology, physical performance, functional performance, and nutritional status. Their association with i-SB (mean sitting, lying, non-upright time) and i-PA (mean number of steps, sit-to-stand transitions and upright time) quintiles were examined using multivariate ordinal logistic regression analyses with Bonferroni correction (p < 0.006).

Results

A total of 145 inpatients were included (mean age 83.0, SD 7.7 years; 55.9% females). More comorbidities were associated with a lower daily number of steps (OR:0.91, 95%CI: 0.86–0.96) and lower upright time (OR:0.93, 95%CI: 0.88–0.98). Depressive symptoms (higher Hospital Anxiety and Depression Scale score) were associated with higher non-upright time (OR: 1.12, 95%CI: 1.03–1.21) and lower upright time (OR: 0.89, 95%CI: 0.83–0.96). Better physical performance (higher Functional Ambulation Classification, gait speed, and Short Physical Performance Battery score) was associated with lower i-SB measures (OR range: 0.07–0.78, p < 0.0005) and higher i-PA measures (OR range: 1.35–19.50, p < 0.0005). Higher functional performance (Katz index of Activities of Daily Living score) was associated with lower i-SB measures (OR range: 0.61–0.69, p ≤ 0.003) and higher i-PA measures (OR range: 1.60–3.64, p < 0.0005). Being malnourished was associated with lower i-PA measures (OR range: 0.29–0.32, p ≤ 0.004).

Conclusions

Worse morbidity, depressive symptoms, worse physical and functional performance, and worse nutritional status were associated with higher i-SB and lower i-PA. These determinants should be taken into account while designing and promoting multidisciplinary physical activity interventions.

中文翻译：

老年康复住院患者仪表化久坐和身体活动行为的决定因素：RESORT

背景

住院老年人缺乏身体活动非常普遍，并且与有害的健康结果相关。了解其决定因素对于老年康复住院患者的预后和定制干预措施非常重要。

方法

在急性不适成人恢复健康 (RESORT) 观察性纵向队列研究中，老年康复住院患者佩戴惯性传感器 (ActivPAL4) 一周，以客观评估仪表化久坐行为 (i-SB) 和身体活动 (i-PA)。决定因素分为五个老年领域：发病率、认知/心理、身体表现、功能表现和营养状况。他们与 i-SB（平均坐姿、躺卧、非直立时间）和 i-PA（平均步数、坐到站转换和直立时间）五分位数的关联使用带有 Bonferroni 校正的多变量序数逻辑回归分析进行了检查。p < 0.006)。

结果

共纳入 145 名住院患者（平均年龄 83.0 岁，标准差 7.7 岁；55.9% 为女性）。更多的合并症与较低的每日步数（OR：0.91，95%CI：0.86-0.96）和较低的直立时间（OR：0.93，95%CI：0.88-0.98）相关。抑郁症状（较高的医院焦虑和抑郁量表评分）与较高的非直立时间（OR：1.12，95%CI：1.03-1.21）和较低的直立时间（OR：0.89，95%CI：0.83-0.96）相关。更好的身体表现（更高的功能性行走分类、步态速度和短期身体表现电池评分）与更低的 i-SB 测量值（OR 范围：0.07-0.78 ，p < 0.0005）和更高的 i-PA 测量值（OR 范围：1.35）相关–19.50, p < 0.0005)。较高的功能表现（Katz 日常生活活动评分）与较低的 i-SB 测量值（OR 范围：0.61-0.69，p ≤ 0.003）和较高的 i-PA 测量值（OR 范围：1.60-3.64，p < 0.0005 ）相关）。营养不良与较低的 i-PA 测量值相关（OR 范围：0.29–0.32，p ≤ 0.004）。