Just a Few Steps
Could Lead to Big Gains for Hospitalized Senior Citizens
New study says
active elderly patients leave the hospital faster than those who are not
"...mobility is
linked to older people's quality of life, independence, maintenance of
healthy muscle mass"
Dec. 10,2010 -
"You'll be back on your feet in no time" is a phrase familiar to anyone
who's ever had to spend time in a hospital. Now, a new study has shown
that hospitalized elderly patients who literally "get back on their
feet" by taking even short walks around a hospital unit tend to leave
the hospital sooner than their more sedentary peers.
Conducted at the
University of Texas Medical Branch at Galveston and described in a paper
appearing in the current issue of Archives of Internal Medicine,
the study draws on data collected from 162 hospitalized patients over
age 65. Each patient was fitted with a pager-sized "step activity
monitor" attached to his or her ankle an electronic device capable of
counting every step the patient took.
"Using these
monitors, we were able to see a correlation between even relatively
small amounts of increased mobility and shorter lengths of stay in the
hospital," said Steve Fisher, a UTMB Health assistant professor and lead
author on the paper. "We still found this effect after we used a
statistical model to adjust for the differing severities of the
patients' illnesses."
Clinicians have
long recognized the importance of getting patients with orthopedic or
neurologic conditions up and walking as soon as possible, but no such
"standard of care" currently exists for older adults admitted for acute
medical illnesses.
According to the authors of the UTMB Health study,
their work could serve as a first step toward that goal and may also
open the door to other improvements in hospital care for the elderly.
"Mobility is a
key measure in older people's independence and quality of life
generally, and this study suggests that's also true in the hospital
setting," said Fisher. "When we hospitalize elderly people, we set up a
paradoxical situation: you can have a positive outcome of the acute
problem that brought them there, but still have negative consequences as
a result of extended immobility."
Mobility in the
hospital as measured by an activity monitor could potentially become a
kind of vital sign for the elderly, Fisher said, as well as a tool that
would help researchers find the minimal levels of activity necessary to
protect elderly patients from long-term declines in function.
"This is very
preliminary, but it's leading to a lot of questions right now that I
think need to be answered," said UTMB Health professor Glenn Ostir, a
co-author on the paper and director of research for the university's
Acute Care for Elders unit.
"We know from
other research that mobility is linked to older people's quality of
life, independence, maintenance of healthy muscle mass, all these
things. And so we need to look at this and say what is the impact of
mobility in the hospital on the overall health of the older person once
they leave the hospital do they rebound and do better, or do they wind
up in a downward spiral that leads to increased re-hospitalization?
The step
monitors have given us the technology to potentially do this, and we're
excited about the chance to answer these questions and make a positive
difference in people's lives."
The National
Institute on Aging, the National Center for Medical Rehabilitation
Research and UTMB Health's Claude D. Pepper Older Americans Independence
Center supported this research.
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