Peter Hartley1,2, Roman Romero-Ortuno3, Ian Wellwood1, Christi Deaton1. 1. Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. 2. Department of Physiotherapy, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK. 3. Discipline of Medical Gerontology, Trinity College Dublin, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.
Abstract
AIM: to investigate changes in knee-extension strength and physical function in older adults during and after acute hospital admission, and the contributions of illness severity, frailty and sedentary activity to changes in knee-extension strength. METHODS: prospective repeated-measures cohort study on a sample of participants aged ≥75 recruited within 24 hours of acute hospital admission. Knee-extension, grip strength and functional mobility (de Morton Mobility Index, DEMMI) were measured at recruitment, day 7 (or discharge if earlier), and at follow-up 4-6 weeks later. During the first 7 days, continuous measurement of physical activity and daily measurements of muscle strength were taken. Participants recalled the functional ability they had 2-weeks before admission and self-reported it at follow-up (Barthel Index, BI). RESULTS: sixty-five of 70 participants (median age 84 years) had at least one repeated measure of muscle strength in hospital. Knee-extension strength declined during hospitalisation by 11% (P < 0.001), but did not change post-hospitalisation (P = 0.458). Grip strength did not change during hospitalisation (P = 0.665) or from discharge to follow-up (P = 0.508). General functional ability (BI) deteriorated between 2 weeks before admission and follow-up (P < 0.001). Functional mobility (DEMMI) improved during hospitalisation (P < 0.001), but did not change post-hospitalisation (P = 0.508). A repeated-measures mixed model showed that greater loss in knee-extension strength during hospitalisation was associated with increased sedentary time, frailty and baseline strength and lower baseline inflammatory levels. CONCLUSIONS: our observations add to a growing body of evidence on potential risk factors for hospital-associated deconditioning.
AIM: to investigate changes in knee-extension strength and physical function in older adults during and after acute hospital admission, and the contributions of illness severity, frailty and sedentary activity to changes in knee-extension strength. METHODS: prospective repeated-measures cohort study on a sample of participants aged ≥75 recruited within 24 hours of acute hospital admission. Knee-extension, grip strength and functional mobility (de Morton Mobility Index, DEMMI) were measured at recruitment, day 7 (or discharge if earlier), and at follow-up 4-6 weeks later. During the first 7 days, continuous measurement of physical activity and daily measurements of muscle strength were taken. Participants recalled the functional ability they had 2-weeks before admission and self-reported it at follow-up (Barthel Index, BI). RESULTS: sixty-five of 70 participants (median age 84 years) had at least one repeated measure of muscle strength in hospital. Knee-extension strength declined during hospitalisation by 11% (P < 0.001), but did not change post-hospitalisation (P = 0.458). Grip strength did not change during hospitalisation (P = 0.665) or from discharge to follow-up (P = 0.508). General functional ability (BI) deteriorated between 2 weeks before admission and follow-up (P < 0.001). Functional mobility (DEMMI) improved during hospitalisation (P < 0.001), but did not change post-hospitalisation (P = 0.508). A repeated-measures mixed model showed that greater loss in knee-extension strength during hospitalisation was associated with increased sedentary time, frailty and baseline strength and lower baseline inflammatory levels. CONCLUSIONS: our observations add to a growing body of evidence on potential risk factors for hospital-associated deconditioning.
Authors: Paula M Loveland; Esmee M Reijnierse; Louis Island; Wen Kwang Lim; Andrea B Maier Journal: J Am Geriatr Soc Date: 2022-02-04 Impact factor: 7.538
Authors: Nicholas F Taylor; Katherine E Harding; Amy M Dennett; Samantha Febrey; Krystal Warmoth; Abi J Hall; Luke A Prendergast; Victoria A Goodwin Journal: Age Ageing Date: 2022-01-06 Impact factor: 10.668