|WANIGATUNGA, AMAL - Johns Hopkins University|
|GILL, THOMAS - Yale University|
|MARSH, ANTHONY - Wake Forest University|
|SHU, FANG-CHI - Wake Forest School Of Medicine|
|YAGHJYAN, LUSINE - University Of Florida|
|WOODS, ADAM - University Of Florida|
|GLYNN, NANCY - University Of Pittsburgh|
|KING, ABBY - Stanford University|
|NEWTON, ROBERT - Pennington Biomedical Research Center|
|FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|PAHOR, MARCO - University Of Florida|
|MANINI, TODD - University Of Florida|
Submitted to: Journal of the American Geriatrics Society
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/3/2018
Publication Date: 11/19/2018
Citation: Wanigatunga, A.A., Gill, T.M., Marsh, A.P., Shu, F., Yaghjyan, L., Woods, A.J., Glynn, N.W., King, A.C., Newton, R.L., Fielding, R.A., Pahor, M., Manini, T.M. 2018. Effect of hospitalizations on physical activity patterns in mobility-limited older adults. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.15631.
Interpretive Summary: We compared effect of hospitalizations on patterns of sedentary(sitting)/physical activity (exercising) time in mobility-limited older adults assigned to either structured physical activity or health education. We used the Lifestyle for Independence in Elders (LIFE) study data to examine this. A total of 1,341 sedentary men and women aged 70-89 years wore a hip-fitted accelerometer (activity monitor like a "Fit-bit") for seven consecutive days every six months throughout the study. We found that participants who were hospitalized during the study increased sedentary time similarly in those assigned to structured physical activity or health education. Being hospitalized was also associated with reduced physical activity time. Following hospitalization, there was no evidence of recovery to pre-hospitalization levels of activity. Participating in a physical activity intervention prior to hospitalization had expected benefits, but participants remained susceptible to the detrimental effects of being hospitalized on their daily activity levels. There was no evidence of improved activity recovery following a hospitalization in participants assigned to physical activity.
Technical Abstract: Objective: To evaluate the effect of hospitalizations on patterns of sedentary/physical activity time in mobility-limited older adults randomized to either structured physical activity or health education. Design: Secondary analysis of an investigator-blinded, parallel-group, randomized trial conducted at 8 US centers between February 2010-December 2013. Participants: 1,341 sedentary men and women aged 70-89 years at baseline who wore a hip-fitted accelerometer 7 consecutive days at baseline and 6, 12, and 24 months post-randomization. Measurements: Participants were randomized to either a physical activity (PA; n=669) intervention that included aerobic, resistance, and flexibility training or to a health education (HE; n=672) intervention that consisted of workshops on older adult health and light upper-extremity stretching. Accelerometer patterns were characterized as bouts of sedentary (<100 counts/min; >/=1, >/=10, >/=30, >/=60 lengths) and activity (100+ counts/min; >/=1, >/=2, >/=5, >/=10 lengths) time. Each participant was categorized as having 0, 1-3, or >/=4 cumulative hospital days prior to each accelerometer assessment. Results: Hospitalization increased sedentary time similarly in both intervention groups (8 and 16 minutes/day for 1-3 and >/=4 cumulative hospital days, respectively). Hospitalization was also associated with reduced physical activity time across all bouts <10 minutes (>/=1: -7 and -16; >/=2: -5 and -11; >/=5: -3 and -4 minutes/day for 1-3 and >/= 4 cumulative hospital days, respectively). There was no evidence of recovery to pre-hospitalization levels (time effect p-values > 0.41). When compared with HE, PA reduced sedentary time in bouts <30 minutes (-8 to -10 minutes/day) and increased total activity (+3 to +6 minutes/day). However, the hospital-related changes were similar between the intervention groups (interaction effect p-values > 0.26). Conclusion: Participating in a physical activity intervention prior to hospitalization had expected benefits, but participants remained susceptible to hospitalization's detrimental effects on their daily activity levels. There was no evidence of improved activity recovery following a hospitalization.