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A few steps could lead to big gains for
hospitalized seniors
December 13, 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.
ABOUT UTMB Health: Established in 1891,
Texas' first academic health center
comprises four health sciences schools,
three institutes for advanced study, a
research enterprise that includes one of
only two national laboratories dedicated to
the safe study of infectious threats to
human health, and a health system offering a
full range of primary and specialized
medical services throughout Galveston County
and the Texas Gulf Coast region. UTMB Health
is a component of the University of Texas
System.
