Inactivity, disability, and death are all interlinkedBMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g2804 (Published 29 April 2014) Cite this as: BMJ 2014;348:g2804
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We read with interest the recent editorial which once again highlights the importance of tackling physical inactivity. However, one group of people that is perhaps even more vulnerable to the adverse effects of physical inactivity are older people in hospital.
This highly prevalent problem has been identified for some time now with it being reported as early as in the early 1980s . Low levels of mobility have been shown to be associated with worse outcomes that include functional decline, institutionalisation, and mortality . Despite this, our preliminary findings from our physical activity study of older people in hospital using accelerometers worn 24 hours a day has shown that the prevalence of physical inactivity (or to be more precise – immobility) is still seriously prevalent despite the problem being identified almost 35 years ago.
Our cohort of 32 patients (18 male, 14 female) were recruited from 2 general medical wards in a university hospital. Mean(SD) for age was 86(6.2) years. Barthel index mean was 13(3.3), Elderly Mobility Scale was 11(3.9), and MMSE was 23(5.2). Data showed that a median time active (standing and stepping around) was only 30 minutes (IQR 33) per day and this was not influenced by length of stay.
Instead of just focussing on treating the acute illness or organ failure, perhaps it is time to consider interventions to improve physical activity in hospital for older people as part overall standard hospital treatment?
1. Godlove C., Richard L., Rodwell G. Time for Action: an observation study of elderly people in four different care environments. University of Sheffield Joint Unit of Social Services Research. 1982
2. Brown CJ., Friedkin RJ., Inouye SK. Prevalence and outcomes of low mobility in hospitalised older patients. J Am Geriatr Soc.2004.52:1263-1270
Competing interests: No competing interests