Post-discharge light physical activity indicates recovery in acutely hospitalized older adults – the Hospital-ADL study

Abstract

Abstract Background: Physical activity (PA) levels might be a simple overall physical marker of recovery in acutely hospitalized older adults; however cut-off values post discharge are lacking. Our objective was to identify cut-off values for post-discharge PA that indicate recovery among acutely hospitalized older adults and stratified for frailty. Methods: We performed a prospective observational cohort study including acutely hospitalized older adults (≥70 years). Frailty was assessed using Fried’s criteria. PA was assessed using Fitbit up to one week post discharge and quantified in steps and minutes light, moderate or higher intensity. The primary outcome was recovery at 3-months post discharge. ROC-curve analyses were used to determine cut-off values, and logistic regression analyses to calculate odds ratios (ORs). Results: The analytic sample included 174 participants with a mean (standard deviation) age of 79.2 (6.7) years of whom 84/174 (48%) were frail. At 3-months, 109/174 participants (63%) had recovered of whom 48 were frail. In all participants, determined cut-off values were 1369 steps/day (OR: 2.5, 95% confidence interval [CI]: 1.3–4.6) and 76 minutes/day of light intensity PA (OR: 3.0, 95% CI: 1.6–5.8). In frail participants, cut-off values were 1043 steps/day (OR: 3.3, 95% CI: 1.3–8.4) and 72 minutes/day of light intensity PA (OR: 4.2, 95% CI: 1.6–10.8). Determined cut-off values were not significantly associated with recovery in non-frail participants. Conclusions: Post-discharge PA cut-offs indicate the odds of recovery in older adults, especially in frail individuals, however are not equipped for use as a diagnostic test in daily practice. This is a first step in providing a direction for setting rehabilitation goals in older adults after hospitalization.