Physical Activity as Prevention of Hospital-Associated Disability in Acutely Hospitalized Older Adults - How Much is Enough and What do the Patients Prefer?
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 170
- 试验地点
- 1
- 主要终点
- Hospital-associated disability
研究概览
简要总结
This study examines physical activity during and after hospitalization in acutely hospitalized older adults and its association with hospital-associated disability (HAD).
Older adults have low levels of physical activity during acute hospitalization, which is associated with an increased risk of HAD. HAD is a decline in the ability to perform activities of daily living that occurs in relation to hospitalization and cannot be explained by the acute illness alone. HAD affects up to 30% of acutely hospitalized older adults and is associated with adverse outcomes, including an increased risk of discharge to a nursing home, readmission, and mortality. Furthermore, patients who develop HAD are at risk of not regaining their pre-admission functional level and experiencing persistent functional decline after discharge.
Physical activity and exercise are recommended as strategies to prevent HAD. However, many acutely hospitalized older adults have limited capacity or motivation to engage in structured exercise. It therefore remains unclear how much physical activity during hospitalization is sufficient to reduce the risk of HAD and which types of physical activity patients are able and prefer to perform. The study will also examine patients' ability and preferences for different types of physical activity during hospitalization and explore their motivation, barriers, and preferences for physical activity after discharge.
The results may help identify clinically relevant levels of physical activity during hospitalization and contribute to more patient-centered approaches to supporting physical activity and preventing functional decline during and after hospitalization.
详细描述
This study is a prospective cohort study investigating physical activity, functioning, and hospital-associated disability (HAD) in acutely hospitalized older adults. The study also examines patients' ability, preferences, motivation, and barriers related to physical activity during hospitalization and after discharge.
Physical activity levels are generally low among older adults during acute hospitalization and are associated with an increased risk of HAD. Physical activity and exercise are recommended as strategies to prevent functional decline during hospitalization. However, there is currently no clear threshold for how much physical activity is needed to reduce the risk of HAD. Furthermore, many acutely hospitalized older adults have limited capacity or motivation to engage in structured exercise, highlighting the need to understand which forms and levels of physical activity are both clinically relevant and feasible from the patients' perspective.
The study will include 170 adults aged 65 years or older who are acutely admitted to the Department of Geriatrics or the Department of Cardiology at Copenhagen University Hospital - Hvidovre. Participants will be consecutively recruited within 48 hours of admission and followed during hospitalization and at 1, 4, and 8 weeks after discharge.
During hospitalization:
At inclusion, participants will undergo a baseline assessment consisting of clinical tests and questionnaires assessing functioning, mobility, frailty, health literacy, general health, physical activity, and demographic characteristics.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Aged 65 years or older
- •Acutely admitted to the Department of Geriatrics or the Department of Cardiology
排除标准
- •In isolation
- •Unable to provide informed consent
- •Unable to speak and understand Danish
- •Unable to take one step
研究组 & 干预措施
Acutely Hospitalized Older Adults
A prospective cohort of 170 adults aged 65 years or older acutely admitted to the Department of Geriatrics or the Department of Cardiology at Copenhagen University Hospital - Hvidovre. Participants will be consecutively recruited within 48 hours of admission and followed during hospitalization and at 1, 4, and 8 weeks after discharge.
干预措施: Physical Activity During and After Hospitalization (Other)
结局指标
主要结局
Hospital-associated disability
时间窗: At inclusion and 1, 4 and 8 weeks after discharge
Hospital-associated disability (HAD) is defined as a new decline in functional independence in at least one activity compared with the participant's pre-admission level. Functional independence is assessed using three components: six basic activities of daily living from the Katz Index (bathing, dressing, toileting, transferring, continence, and feeding); five instrumental activities of daily living inspired by the Lawton IADL Index (shopping, housekeeping, laundry, food preparation, and medication management); and four mobility-related activities (walking 400 meters without rest, climbing or descending one flight of stairs without rest, carrying 5 kg, and driving a car). Each activity is scored as unable to perform (0), able to perform with assistance (1), or able to perform independently (2). Participants with a decline in independence in at least one activity compared with their retrospectively assessed pre-admission level are classified as having HAD.
Imagined ability to perform physical activity during hospitalization
时间窗: At inclusion
Participants' imagined ability to perform physical activity during hospitalization will be assessed by asking whether they can imagine performing the activity daily during hospitalization. Imagined ability will be assessed for hallway walking (200 steps) and resistance exercise (three sets of 8-12 sit-to-stand repetitions) and group-based functionel training.
Actual ability to perform physical activity during hospitalization
时间窗: At inclusion
Participants' actual ability to perform physical activity during hospitalization will be assessed by asking them to perform hallway walking (200 steps) and resistance exercise (three sets of 8-12 sit-to-stand repetitions). For each activity, actual ability will be categorized as able to complete the activity as defined, 0) unable to complete the activity, 1) able to complete the activity with assistance and 2) able to complete the activity independently. Reasons for inability to complete an activity will be recorded.
Preferred type of physical activity during hospitalization
时间窗: At inclusion
Participants will be asked which type of physical activity they prefer: hallway walking, resistance training and group-based functional training. (Group-based functional training will be assessed as a preference only and will not be physically performed as part of the assessment).
次要结局
- Mean Daily steps(From inclusion through hospital discharge, an average of 5 days; and 7 consecutive days before the 8-week follow-up)
- Mean daily uptime(From inclusion through hospital discharge, an average of 5 days; and 7 consecutive days before the 8-week follow-up)
- Mean daily walking(From inclusion through hospital discharge, an average of 5 days; and 7 consecutive days before the 8-week follow-up)
- Mean daily standing(From inclusion through hospital discharge, an average of 5 days; and 7 consecutive days before the 8-week follow-up)
- Mean daily lying/sitting(From inclusion through hospital discharge, an average of 5 days; and 7 consecutive days before the 8-week follow-up)
研究者
Lea Kromann Etzerodt
Principal Investigator (PhD scientist)
Copenhagen University Hospital, Hvidovre