Nicolás Martínez-Velilla1,2,3, Mirian Garrués-Irisarri4, Berta Ibañez-Beroiz5,6,7, Jenifer Gil-Cabañas8, Analía Richarte-García9, Fernando Idoate-Saralegui10, Patricia Corte de Paz11, Koldo Cambra5,6,7. 1. Department of Geriatrics, Complejo Hospitalario de Navarra, Pamplona, Spain. mvelilla@yahoo.com. 2. Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Pamplona, Spain. mvelilla@yahoo.com. 3. IdiSNa, Navarra for Health Research, Pamplona, Spain. mvelilla@yahoo.com. 4. Department of Physiology, Universidad del País Vasco, Bizkaia Campus, Bilbao, Spain. 5. Navarrabiomed-Fundación Miguel Servet, Pamplona, Spain. 6. Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Pamplona, Spain. 7. IdiSNa, Navarra for Health Research, Pamplona, Spain. 8. Health Science Department, Universidad Publica de Navarra, Pamplona, Spain. 9. Residencia Beloso Alto, Pamplona, Spain. 10. Radiology Department, Clínica San Miguel, Pamplona, Spain. 11. Clínica Rehabilitación, Servicio Navarro de Salud, Pamplona, Spain.
Abstract
BACKGROUND: Most hospitalized older adults have reduced functional and physiological reserves, rendering them more vulnerable to the effects of a series of circumstances beyond the existence of health conditions unrelated to the reason for the hospitalization, usually worsening the hospitalization outcome. Despite the theoretical support for the idea that mobility improvement in the hospitalized patient carries multiple benefits, this idea has not been fully translated into clinical practice. AIMS: Our objective was to assess if an exercise intervention involving patients and families could modify the cognitive and affective progression of hospitalized older patients, from admission to discharge and 30 days after discharge. METHODS: This was a prospective intervention study with blinded outcome progression. Patients were recruited over a 3-month period and prospectively followed up. The intervention consisted in a supervised individualized graduated exercise program and education of ward and team staff, patients and caregivers to actively encourage mobility and functional independence. RESULTS:A total of 29 patients were recruited. Mean age was 86.1 (SD 4.92), and 18 (62 %) were women. At discharge, we found a significant improvement in Mini-mental State Examination (p = 0.008), Trail making Test-A (p = 0.03), and verbal fluency (p = 0.019). One month after discharge, Geriatric Depression Scale-Yesavage and Delirium Rating Scale-revised-98 remained statistically different. CONCLUSIONS: This pilot study shows that an exercise program is feasible, and can be suitable to prevent cognitive and affective decline during acute hospitalization of older adults. It is a challenge for the new models of hospitalization to change the actual disease-centered view to the patient-centered view, optimizing traditionally neglected aspects such as functional, cognitive and affective recovery after hospitalization.
RCT Entities:
BACKGROUND: Most hospitalized older adults have reduced functional and physiological reserves, rendering them more vulnerable to the effects of a series of circumstances beyond the existence of health conditions unrelated to the reason for the hospitalization, usually worsening the hospitalization outcome. Despite the theoretical support for the idea that mobility improvement in the hospitalized patient carries multiple benefits, this idea has not been fully translated into clinical practice. AIMS: Our objective was to assess if an exercise intervention involving patients and families could modify the cognitive and affective progression of hospitalized older patients, from admission to discharge and 30 days after discharge. METHODS: This was a prospective intervention study with blinded outcome progression. Patients were recruited over a 3-month period and prospectively followed up. The intervention consisted in a supervised individualized graduated exercise program and education of ward and team staff, patients and caregivers to actively encourage mobility and functional independence. RESULTS: A total of 29 patients were recruited. Mean age was 86.1 (SD 4.92), and 18 (62 %) were women. At discharge, we found a significant improvement in Mini-mental State Examination (p = 0.008), Trail making Test-A (p = 0.03), and verbal fluency (p = 0.019). One month after discharge, Geriatric Depression Scale-Yesavage and Delirium Rating Scale-revised-98 remained statistically different. CONCLUSIONS: This pilot study shows that an exercise program is feasible, and can be suitable to prevent cognitive and affective decline during acute hospitalization of older adults. It is a challenge for the new models of hospitalization to change the actual disease-centered view to the patient-centered view, optimizing traditionally neglected aspects such as functional, cognitive and affective recovery after hospitalization.
Authors: Ana Myriam Lavín-Pérez; Daniel Collado-Mateo; Xián Mayo; Gary Liguori; Liam Humphreys; Robert James Copeland; Alfonso Jiménez Journal: Sci Rep Date: 2021-07-23 Impact factor: 4.379