Measurement of Physical Activity Among Hospitalized Older Adults Living With Dementia.
Barbara Resnick, Marie Boltz, Elizabeth Galik and 6 others
PMID 38904657WHAT IT FOUND
Hospitalized older adults with dementia spent a mean of 20 hours of the first 24 hours sedentary.
Nurse reported very little walking, bathing or grooming. Accelerometer activity may reflect agitation or hand movements, not useful mobility.
Key findings
01In the first 24 hours after enrollment, participants averaged 20 hours of sedentary activity, 2 hours and 50 minutes of low activity, 43 minutes of moderate activity and 15 minutes of vigorous activity.
02Nurse-reported activity was low: less than one walking, wheeling, bathing or grooming activity, about one dressing and toileting activity, and close to three eating activities over 24 hours.
03Accelerometer-measured activity and sedentary time were associated with disinhibition, delirium severity, psychotropic medication use, walking, toileting and agitation; the models explained 11%, 14%, 10% and 16% of variance.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 204 of 368 baseline participants had usable actigraphy data. Participants came from 10 hospitals in Maryland and Pennsylvania, so the sample may not represent other settings. Staff-reported behaviors and activities were based on recall and may not have captured all events. The sample had few behavioral symptoms, and people with the most severe symptoms may not have consented or assented. Accelerometry may count nonfunctional movement, and the regression models explained only a small share of variance. Delirium was not separated into hyperactive and hypoactive types.
Declared interests
The authors have no conflicts of interest and nothing to declare. The article is tagged as NIH extramural research support.
The easy way to misread this
Do not conclude that these patients were physically active enough to maintain function. The accelerometer counted movement that may have come from agitation, disinhibition, delirium or repetitive hand movements, and nurse-reported walking, bathing and grooming were very low.