Javier Ortiz-Alonso1, Natalia Bustamante-Ara2, Pedro L Valenzuela3, Maite Vidán-Astiz4, Gabriel Rodríguez-Romo5, Jennifer Mayordomo-Cava6, Marianna Javier-González7, Mercedes Hidalgo-Gamarra7, Myriel Lopéz-Tatis7, María Isabel Valades-Malagón7, Alejandro Santos-Lozano8, Alejandro Lucia9, José Antonio Serra-Rexach4. 1. Geriatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Biomedical Research Networking Center on Frailty and Healthy Aging, CIBERFES, Madrid, Spain. Electronic address: javier.ortiz@salud.madrid.org. 2. Universidad Autónoma de Chile, Talca, Chile. 3. Systems Biology Department, University of Alcalá, Madrid, Spain. 4. Geriatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Biomedical Research Networking Center on Frailty and Healthy Aging, CIBERFES, Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain. 5. Biomedical Research Networking Center on Frailty and Healthy Aging, CIBERFES, Madrid, Spain; Sports Department, Instituto Nacional de Educación Física, Universidad Politécnica, Madrid, Spain. 6. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Biomedical Research Networking Center on Frailty and Healthy Aging, CIBERFES, Madrid, Spain. 7. Geriatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 8. i+HeALTH, European University Miguel de Cervantes, Valladolid, Spain; Research Institute Hospital 12 de Octubre ('i+12'), Madrid, Spain. 9. Biomedical Research Networking Center on Frailty and Healthy Aging, CIBERFES, Madrid, Spain; Research Institute Hospital 12 de Octubre ('i+12'), Madrid, Spain; Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.
Abstract
OBJECTIVE:Hospitalization-associated disability [HAD, ie, the loss of ability to perform ≥1 basic activities of daily living (ADLs) independently at discharge] is a frequent condition among older patients. The present study assessed whether a simple inpatient exercise program decreases HAD incidence in acutely hospitalized very old patients. DESIGN: In this randomized controlled trial (Activity in Geriatric Acute Care) participants were assigned to a control or intervention group and were assessed at baseline, admission, discharge, and 3 months thereafter. SETTING AND PARTICIPANTS: In total, 268 patients (mean age 88 years, range 75-102) admitted to an acute care for older patients unit of a public hospital were randomized to a control (n = 125) or intervention (exercise) group (n = 143). METHODS: Both groups received usual care, and patients in the intervention group also performed simple supervised exercises (walking and rising from a chair, for a total duration of ∼20 minutes/day). We measured ADL function (Katz index) and incident HAD at discharge and after 3 months (primary outcome) and Short Physical Performance Battery, ambulatory capacity, number of falls, rehospitalization, and death during a 3-month follow-up (secondary outcomes). RESULTS:Median duration of hospitalization was 7 days (interquartile range 4 days). The intervention group had a lower risk of HAD with reference to both baseline [odds ratio (OR) 0.36; 95% confidence interval (CI) 0.17-0.76, P = .007] and admission (OR 0.29; 95% CI 0.10-0.89, P = .030). A trend toward an improved ADL function at discharge vs admission was found in the intervention group compared with controls (OR 0.32; 95% CI ‒0.04 to 0.68; P = .083). No between-group differences were noted for the other endpoints (all P > .05). CONCLUSION AND IMPLICATIONS: A simple inpatient exercise program decreases risk of HAD in acutely hospitalized, very old patients.
RCT Entities:
OBJECTIVE: Hospitalization-associated disability [HAD, ie, the loss of ability to perform ≥1 basic activities of daily living (ADLs) independently at discharge] is a frequent condition among older patients. The present study assessed whether a simple inpatient exercise program decreases HAD incidence in acutely hospitalized very old patients. DESIGN: In this randomized controlled trial (Activity in Geriatric Acute Care) participants were assigned to a control or intervention group and were assessed at baseline, admission, discharge, and 3 months thereafter. SETTING AND PARTICIPANTS: In total, 268 patients (mean age 88 years, range 75-102) admitted to an acute care for older patients unit of a public hospital were randomized to a control (n = 125) or intervention (exercise) group (n = 143). METHODS: Both groups received usual care, and patients in the intervention group also performed simple supervised exercises (walking and rising from a chair, for a total duration of ∼20 minutes/day). We measured ADL function (Katz index) and incident HAD at discharge and after 3 months (primary outcome) and Short Physical Performance Battery, ambulatory capacity, number of falls, rehospitalization, and death during a 3-month follow-up (secondary outcomes). RESULTS: Median duration of hospitalization was 7 days (interquartile range 4 days). The intervention group had a lower risk of HAD with reference to both baseline [odds ratio (OR) 0.36; 95% confidence interval (CI) 0.17-0.76, P = .007] and admission (OR 0.29; 95% CI 0.10-0.89, P = .030). A trend toward an improved ADL function at discharge vs admission was found in the intervention group compared with controls (OR 0.32; 95% CI ‒0.04 to 0.68; P = .083). No between-group differences were noted for the other endpoints (all P > .05). CONCLUSION AND IMPLICATIONS: A simple inpatient exercise program decreases risk of HAD in acutely hospitalized, very old patients.
Authors: Marcelo A S Carneiro; Cristiane M C Franco; Alan L Silva; Pâmela Castro-E-Souza; Gabriel Kunevaliki; Mikel Izquierdo; Edilson S Cyrino; Camila S Padilha Journal: Geroscience Date: 2021-08-28 Impact factor: 7.713
Authors: Pedro L Valenzuela; Alejandro Santos-Lozano; Simone Lista; José A Serra-Rexach; Enzo Emanuele; Alejandro Lucia Journal: J Am Med Dir Assoc Date: 2020-04-28 Impact factor: 4.669