Physical Activity During Hospitalization and Hospital-Associated Disability

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.