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

Rojer, Anna Galina Maria
Denneman, Britt C.M.
Brouwer, Puck
Ramsey, Keenan A.
Trappenburg, Marijke C.
Meskers, Carel G.M.
Pijnappels, Mirjam
Goonan, Rose
Marston, Celia
Kay, Jacqueline E.
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Abstract
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.
Keywords
Rehabilitation, Motor activity, Accelerometry, Geriatric assessment, Physical functional performance
Date
2021
Type
Journal article
Journal
Book
Volume
154
Issue
Page Range
1-11
Article Number
ACU Department
Relation URI
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY 4.0
File Access
Open
Notes
© 2021 The Authors. Published by Elsevier Inc
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).