A Cross-Lagged Panel Model Testing the Impact of Physical Activity During Hospitalization on 1- and 6-Month Discharge Physical Activity and Adverse Events Among Older Adults With Dementia.
Shijun Zhu, Barbara Resnick, Marie Boltz and 6 others
PMID 40651495WHAT IT FOUND
Older adults with dementia who were more physically active at hospital discharge had lower odds of falling and being rehospitalized within one month.
Activity levels did not drop after these adverse events occurred, suggesting discharge mobility is a key protective factor.
Key findings
01Higher physical activity at discharge was associated with a lower chance of falling (OR=.779) and rehospitalization (OR=.796) within one month post-discharge.
02Falls, emergency room visits, or rehospitalizations at one month did not predict lower physical activity levels at six months.
03Physical activity levels were maintained over time, averaging 12.69 at one month and 13.34 at six months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
Physical activity was measured via subjective self-report and caregiver recall, not objective accelerometry, which may introduce bias. Adverse events (falls, ER visits) were also based on recall rather than medical records, potentially leading to underreporting. The study analyzed data from a trial designed to test a specific intervention, not primarily to study the causal link between activity and adverse events, though the statistical model controlled for the intervention. Participants were recruited from only two states (Pennsylvania and Maryland), limiting generalizability to other regions. Key confounders such as sensory impairment, depression, and physical resilience were not measured or controlled for in the model.
Declared interests
The authors declare no conflicts of interest. The study was supported by the National Institute of Nursing Research (NINR) and the National Institute on Aging (NIA).
The easy way to misread this
Do not interpret the lack of association between one-month activity and six-month adverse events as evidence that long-term activity is unimportant. The study only showed that discharge activity predicted immediate (one-month) outcomes; it did not capture the full complexity of long-term health maintenance or the impact of comorbidities that may emerge later.