Sedentary behaviour and activity patterns of older adults in an acute hospital setting: An exploratory study.
Laura J Brown, Samantha J Warne, Chun Ngai Liu and 4 others
Older adults in hospital took a mean of 657 steps a day and spent about 20 hours sitting or lying.
More steps correlated with better function, but the main barriers were outside the patient: staffing, space, and nothing purposeful to do.
Key findings
1Patients accumulated a mean of 657 steps per day and were sedentary (lying or sitting) for approximately 20 hours, or 83% of their waking day.
2Daily step count correlated with functional independence (FIM score, r = 0.37, p < 0.05), and sit-to-stand transitions also correlated with FIM (r = 0.30, p < 0.05). Frailty (CFS) correlated with poorer function (r = −0.54, p < 0.05).
3Most patients identified more extrinsic barriers to activity than intrinsic ones: lack of purposeful activity, insufficient staffing, falls-prevention restrictions, and environmental limitations such as decreased space and no walking paths.
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What it does not show
Single-site study with 49 patients, so the findings describe one hospital's wards and may not generalise. Mean device wear time was only 2 days, capturing a snapshot rather than a pattern across the full admission (median LOS was 12 days). 67% of participants were female, limiting generalisability to male patients. Patients with cognitive impairment (AMT-10 below 6) were excluded, so the findings do not apply to the substantial proportion of hospitalised older adults with delirium or dementia. The Hawthorne effect was acknowledged: the presence of the device and research attention may have altered activity behaviour. No sample size calculation was performed; the study was explicitly exploratory and not powered to detect specific effect sizes. Recruitment spanned different wards, and ward was not controlled for in the statistical analysis.
Declared interests
The authors declared no conflicts of interest. The research was funded by Curtin University, School of Allied Health, and the Charlies Foundation for Research.
The easy way to misread this
Do not read the low step counts as a patient motivation problem. Eleven patients reported they needed assistance to move or were in too much pain, and the most frequently cited barriers were staffing, space, and lack of purposeful activity, all outside the patient's control. The correlations with FIM are modest (r = 0.30 to 0.37) and observational, so they do not show that increasing steps will improve function.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →