scholarly journals Predictors of physical activity in older adults experiencing an emergency hospital admission: a prospective cohort study

2020 ◽  
Author(s):  
Peter Hartley ◽  
Amanda L Dewitt ◽  
Faye Forsyth ◽  
Roman Romero-Ortuno ◽  
Christi Deaton
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cohort Study ◽  
Hospital Admission ◽  
Illness Severity ◽  
Acute Illness ◽  
Functional Mobility ◽  
Early Warning Score ◽  
Accelerometer Data ◽  
Optimal Model

Abstract Background Reduced mobility may be responsible for functional decline and acute sarcopenia in older hospitalised patients. The drivers of reduced in-hospital mobility are poorly understood, especially during the early phase of acute hospitalisation. We investigated predictors of in-hospital activity during a 24-hour period in the first 48 hours of hospital admission in older adults. Methods This was a secondary analysis of a prospective repeated measures cohort study. Participants aged 75 years or older were recruited within the first 24 hours of admission. At recruitment, patients underwent a baseline assessment including measurements of pre-morbid functional mobility, cognition, frailty, falls efficacy, co-morbidity, acute illness severity, knee extension strength and grip strength, and consented to wear accelerometers to measure physical activity during the first 7 days (or until discharge if earlier). In-hospital physical activity was defined as the amount of upright time (standing or walking). To examine the predictors of physical activity, we limited the analysis to the first 24 hours of recording to maximise the sample size as due to discharge from hospital there was daily attrition. We used a best subset analysis including all baseline measures. The optimal model was defined by having the lowest Bayesian information criterion in the best-subset analyses. The model specified a maximum of 5 covariates and used an exhaustive search. Results Seventy participants were recruited but eight were excluded from the final analysis due to lack of accelerometer data within the first 24 hours after recruitment. Patients spent a median of 0.50 hours (IQR: 0.21; 1.43) standing or walking. The optimal model selected the following covariates: functional mobility as measured by the de Morton Mobility Index and two measures of illness severity, the National Early Warning Score, and serum C-reactive protein. Conclusions Physical activity, particularly in the acute phase of hospitalisation, is very low in older adults. The association between illness severity and physical activity may be explained by symptoms of acute illness being barriers to activity. Interdisciplinary approaches are required to identify early mobilisation opportunities.

scholarly journals Predictors of physical activity in older adults early in an emergency hospital admission: a prospective cohort study

2020 ◽  
Author(s):  
Peter Hartley ◽  
Amanda L Dewitt ◽  
Faye Forsyth ◽  
Roman Romero-Ortuno ◽  
Christi Deaton
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cohort Study ◽  
Hospital Admission ◽  
Illness Severity ◽  
Acute Illness ◽  
Functional Mobility ◽  
Early Warning Score ◽  
Accelerometer Data ◽  
Optimal Model

Abstract Background: Reduced mobility may be responsible for functional decline and acute sarcopenia in older hospitalised patients. The drivers of reduced in-hospital mobility are poorly understood, especially during the early phase of acute hospitalisation. We investigated predictors of in-hospital activity during a 24-hour period in the first 48 hours of hospital admission in older adults. Methods: This was a secondary analysis of a prospective repeated measures cohort study. Participants aged 75 years or older were recruited within the first 24 hours of admission. At recruitment, patients underwent a baseline assessment including measurements of pre-morbid functional mobility, cognition, frailty, falls efficacy, co-morbidity, acute illness severity, knee extension strength and grip strength, and consented to wear accelerometers to measure physical activity during the first 7 days (or until discharge if earlier). In-hospital physical activity was defined as the amount of upright time (standing or walking). To examine the predictors of physical activity, we limited the analysis to the first 24 hours of recording to maximise the sample size as due to discharge from hospital there was daily attrition. We used a best subset analysis including all baseline measures. The optimal model was defined by having the lowest Bayesian information criterion in the best-subset analyses. The model specified a maximum of 5 covariates and used an exhaustive search.Results: Seventy participants were recruited but eight were excluded from the final analysis due to lack of accelerometer data within the first 24 hours after recruitment. Patients spent a median of 0.50 hours (IQR: 0.21; 1.43) standing or walking. The optimal model selected the following covariates: functional mobility as measured by the de Morton Mobility Index and two measures of illness severity, the National Early Warning Score, and serum C-reactive protein.Conclusions: Physical activity, particularly in the acute phase of hospitalisation, is very low in older adults. The association between illness severity and physical activity may be explained by symptoms of acute illness being barriers to activity. Interdisciplinary approaches are required to identify early mobilisation opportunities.

scholarly journals Predictors of physical activity in older adults experiencing an emergency hospital admission: a prospective cohort study

2020 ◽  
Author(s):  
Peter Hartley ◽  
Amanda L Dewitt ◽  
Faye Forsyth ◽  
Roman Romero-Ortuno ◽  
Christi Deaton
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cohort Study ◽  
Hospital Admission ◽  
Illness Severity ◽  
Acute Illness ◽  
Functional Mobility ◽  
Early Warning Score ◽  
Accelerometer Data ◽  
Optimal Model

Abstract BackgroundReduced mobility may be responsible for functional decline and acute sarcopenia in older hospitalised patients. The drivers of reduced in-hospital mobility are poorly understood, especially during the early phase of acute hospitalisation. We investigated predictors of in-hospital activity during the first 24 hours of hospital admission in older adults. MethodsThis was a secondary analysis of a prospective repeated measures cohort study. Participants aged 75 years or older were recruited within the first 24 hours of admission. At recruitment, patients underwent a baseline assessment including measurements of pre-morbid functional mobility, cognition, frailty, falls efficacy, co-morbidity, acute illness severity, knee extension strength and grip strength, and consented to wear accelerometers to measure physical activity during the first 7 days (or until discharge if earlier). In-hospital physical activity was defined as the amount of upright time (standing or walking). To examine the predictors of physical activity, we used a best subset analysis including all baseline measures. The optimal model was defined by having the lowest Bayesian information criterion in the best-subset analyses. The model specified a maximum of 5 covariates and used an exhaustive search.ResultsSeventy participants were recruited but eight were excluded from the final analysis due to lack of accelerometer data within the first 24 hours after recruitment. Patients spent a median of 0.50 hours (IQR: 0.21; 1.43) standing or walking. The optimal model selected the following covariates: functional mobility as measured by the de Morton Mobility Index and two measures of illness severity, the National Early Warning Score, and serum C-reactive protein.ConclusionsPhysical activity, particularly in the acute phase of hospitalisation, is very low in older adults. The association between illness severity and physical activity may be explained by symptoms of acute illness being barriers to activity. Interdisciplinary approaches are required to identify early mobilisation opportunities.

scholarly journals Predictors of physical activity in older adults early in an emergency hospital admission: a prospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Peter Hartley ◽  
Amanda L. DeWitt ◽  
Faye Forsyth ◽  
Roman Romero-Ortuno ◽  
Christi Deaton
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cohort Study ◽  
Hospital Admission ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Emergency Hospital ◽  
Emergency Hospital Admission

The Effect of Sensor Placement and Number on Physical Activity Recognition and Energy Expenditure Estimation (Preprint)

2020 ◽  
Author(s):  
Anis Davoudi ◽  
Mamoun T. Mardini ◽  
Dave Nelson ◽  
Fahd Albinali ◽  
Sanjay Ranka ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Energy Expenditure ◽  
Activity Recognition ◽  
Recognition Accuracy ◽  
Body Position ◽  
Computer Work ◽  
Accelerometer Data ◽  
Upper Arm ◽  
Lifestyle Activities

BACKGROUND Research shows the feasibility of human activity recognition using Wearable accelerometer devices. Different studies have used varying number and placement for data collection using the sensors. OBJECTIVE To compare accuracy performance between multiple and variable placement of accelerometer devices in categorizing the type of physical activity and corresponding energy expenditure in older adults. METHODS Participants (n=93, 72.2±7.1 yrs) completed a total of 32 activities of daily life in a laboratory setting. Activities were classified as sedentary vs. non-sedentary, locomotion vs. non-locomotion, and lifestyle vs. non-lifestyle activities (e.g. leisure walk vs. computer work). A portable metabolic unit was worn during each activity to measure metabolic equivalents (METs). Accelerometers were placed on five different body positions: wrist, hip, ankle, upper arm, and thigh. Accelerometer data from each body position and combinations of positions were used in developing Random Forest models to assess activity category recognition accuracy and MET estimation. RESULTS Model performance for both MET estimation and activity category recognition strengthened with additional accelerometer devices. However, a single accelerometer on the ankle, upper arm, hip, thigh, or wrist had only a 0.03 to 0.09 MET increase in prediction error as compared to wearing all five devices. Balanced accuracy showed similar trends with slight decreases in balanced accuracy for detection of locomotion (0-0.01 METs), sedentary (0.13-0.05 METs) and lifestyle activities (0.08-0.04 METs) compared to all five placements. The accuracy of recognizing activity categories increased with additional placements (0.15-0.29). Notably, the hip was the best single body position for MET estimation and activity category recognition. CONCLUSIONS Additional accelerometer devices only slightly enhance activity recognition accuracy and MET estimation in older adults. However, given the extra burden of wearing additional devices, single accelerometers with appropriate placement appear to be sufficient for estimating energy expenditure and activity category recognition in older adults.

Physical Activity and Association Between Frailty and All-Cause and Cardiovascular Mortality in Older Adults: Population-Based Prospective Cohort Study

2018 ◽  
Vol 66 (11) ◽  
pp. 2097-2103 ◽  
Author(s):  
Sara Higueras-Fresnillo ◽  
Verónica Cabanas-Sánchez ◽  
Esther Lopez-Garcia ◽  
Irene Esteban-Cornejo ◽  
José R. Banegas ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Cardiovascular Mortality ◽  
Prospective Cohort ◽  
Population Based

Associations between participation in, intensity of, and time spent on leisure time physical activity and risk of inflammatory bowel disease among older adults (PA-IBD): A prospective cohort study

2020 ◽  
Author(s):  
Nathalie Fogh Rasmussen ◽  
Bodil Hammer Bech ◽  
Katrine Hass Rubin ◽  
Vibeke Andersen
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cohort Study ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Physically Active ◽  
The Third ◽  
Inflammatory Bowel ◽  
Do It Yourself ◽  
Dose Response Effect

Abstract Background Inflammatory bowel diseases (IBDs) are diseases of the immune system that share some genetic and lifestyle-related predisposing factors. Increasing incidences have been reported in all age groups. Based on experimental studies suggesting a role of physical activity on intestinal inflammation, this study aimed to investigate the association between leisure time physical activity and the risk of IBD in older adults. Methods The study is a prospective cohort study using Danish registry data and questionnaire data from the Danish “Diet, Cancer and Health” cohort. The outcome IBD was defined as having at least two diagnoses of Crohn’s disease or ulcerative colitis registered in the National Patient Registry during follow-up between December 1993 and May 1997 until December 2018. Cox proportional hazard models were used to estimate hazard ratios for IBD onset associated with being physically active and with levels of the metabolic equivalent of task (MET) hours/week of physical activity and hours/week spent on six types of physical activity. Results In total, 54 645 men and women aged 50-64 years were included, and thereof 529 cases. When comparing physically active with inactive participants measured by MET hours/week there was no statistically significant difference in risk of IBD (0.89 [0.13; 6.27]), neither when measured as participation in six types of activities. Results did not indicate any dose-response effect when comparing quartile groups of MET hours/week or of five of the six types of activities. For do-it-yourself-work, the third quartile of hours/week was associated with a higher risk of IBD compared to the second quartile (HR=1.44 [1.10 ; 1.90]. No effect modification was found. Conclusions There was no association between physical activity and risk of IBD when comparing physically active with inactive participants. Neither did the results indicate any dose-response effect when comparing quartile groups of MET hours/week. Do-it-yourself work, however, seemed to be associated with a higher risk of IBD when comparing the third quartile with the second quartile. The study has clinical relevance by its contribution to the explanatory field of the causes of IBD. However, further research is needed to clarify associations between physical activity and risk of IBD.

scholarly journals National Early Warning Score 2 (NEWS2) and 3-level triage scale as risk predictors in frail older adults in the emergency department

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kirsi Kemp ◽  
Janne Alakare ◽  
Veli-Pekka Harjola ◽  
Timo Strandberg ◽  
Jukka Tolonen ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Hospital Admission ◽  
Early Warning ◽  
Early Warning Score ◽  
Predictive Values ◽  
Frail Older Adults ◽  
High Dependency ◽  
National Early Warning Score ◽  
Risk Predictors

Abstract Background The aim of the emergency department (ED) triage is to recognize critically ill patients and to allocate resources. No strong evidence for accuracy of the current triage instruments, especially for the older adults, exists. We evaluated the National Early Warning Score 2 (NEWS2) and a 3-level triage assessment as risk predictors for frail older adults visiting the ED. Methods This prospective, observational study was performed in a Finnish ED. The data were collected in a six-month period and included were ≥ 75-year-old residents with Clinical Frailty Scale score of at least four. We analyzed the predictive values of NEWS2 and the three-level triage scale for 30-day mortality, hospital admission, high dependency unit (HDU) and intensive care unit (ICU) admissions, a count of 72-h and 30-day revisits, and ED length-of-stay (LOS). Results A total of 1711 ED visits were included. Median for age, CFS, LOS and NEWS2 were 85 years, 6 points, 6.2 h and 1 point, respectively. 30-day mortality was 96/1711. At triage, 69, 356 and 1278 of patients were assessed as red, yellow and green, respectively. There were 1103 admissions, of them 31 to an HDU facility, none to ICU. With NEWS2 and triage score, AUCs for 30-day mortality prediction were 0.70 (0.64–0.76) and 0.62 (0.56–0.68); for hospital admission prediction 0.62 (0.60–0.65) and 0.55 (0.52–0.56), and for HDU admission 0.72 (0.61–0.83) and 0.80 (0.70–0.90), respectively. The NEWS2 divided into risk groups of low, medium and high did not predict the ED LOS (p = 0.095). There was a difference in ED LOS between the red/yellow and as red/green patient groups (p < 0.001) but not between the yellow/green groups (p = 0.59). There were 48 and 351 revisits within 72 h and 30 days, respectively. With NEWS2 AUCs for 72-h and 30-day revisit prediction were 0.48 (95% CI 0.40–0.56) and 0.47 (0.44–0.51), respectively; with triage score 0.48 (0.40–0.56) and 0.49 (0.46–0.52), respectively. Conclusions The NEWS2 and a local 3-level triage scale are statistically significant, but poor in accuracy, in predicting 30-day mortality, and HDU admission but not ED LOS or revisit rates for frail older adults. NEWS2 also seems to predict hospital admission.

scholarly journals Leisure-Time Physical Activity and Cancer Risk Among Older Adults: A Cohort Study

2020 ◽  
Vol 4 (2) ◽  
pp. 115-125 ◽  
Author(s):  
Gali Cohen ◽  
David M. Steinberg ◽  
Lital Keinan-Boker ◽  
Or Shaked ◽  
Abigail Goshen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cohort Study ◽  
Cancer Risk ◽  
Leisure Time ◽  
Leisure Time Physical Activity

scholarly journals A diagnosis of knee osteoarthritis does not predict physical activity 2 years later in older adults: findings from the Hertfordshire Cohort Study

2019 ◽  
Vol 39 (8) ◽  
pp. 1405-1411
Author(s):  
Michael A. Clynes ◽  
Camille Parsons ◽  
Mark H. Edwards ◽  
Jonathan H. Tobias ◽  
Kevin Deere ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cohort Study ◽  
Knee Osteoarthritis ◽  
Hertfordshire Cohort Study
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