This study aims to investigate the relationship between the number of sarcopenia and frailty comorbidities and the likelihood of achieving a daily step count of 900 or more in older patients hospitalized with pneumonia. The goal is to determine whether the presence of single or dual comorbidities significantly impacts physical activity levels during hospitalization.
We conducted a retrospective analysis of 95 older adults (median age 82 years) with community-acquired pneumonia admitted to Nagasaki Memorial Hospital. Sarcopenia was assessed using the Asian Working Group for Sarcopenia (AWGS) 2019 algorithm, including muscle mass, strength, and physical performance. Frailty was evaluated using the Kihon Checklist, with a score of 8 or higher indicating frailty. Based on these assessments, patients were classified into three groups: no comorbidity, single comorbidity (either sarcopenia or frailty), and dual comorbidity (both sarcopenia and frailty). Physical activity was measured using a 3-axis accelerometer, recording daily step counts for up to 7 days. The primary outcome was achieving a daily step count of 900 or more. Logistic regression was used to evaluate the impact of the comorbidity groups on the likelihood of achieving this step count threshold.
The analysis included three groups: no comorbidity (n = 25, mean step count = 1814), single comorbidity (n = 35, mean step count = 1604), and dual comorbidity (n = 35, mean step count = 752). The dual comorbidity group was significantly less likely to achieve 900 steps per day compared to the no comorbidity group (OR = 12.76, 95% CI [3.26, 49.96], p 0.001). This indicates that the presence of both sarcopenia and frailty severely limits physical activity during hospitalization. In contrast, the single comorbidity group did not show a significant difference compared to the no comorbidity group, suggesting that a single condition may not be as detrimental as the combined presence of both conditions.
The combination of sarcopenia and frailty significantly reduces physical activity in older hospitalized pneumonia patients. These findings emphasize the need for early identification and intervention for patients with dual comorbidities to prevent HAD and promote recovery. Tailored interventions focusing on maintaining or increasing physical activity are necessary for this high-risk group to improve outcomes and reduce the risk of functional decline during hospitalization.
Healthcare providers should prioritize identifying and managing patients with dual comorbidities of sarcopenia and frailty. Interventions such as structured exercise programs and multidisciplinary care plans should be implemented to support mobility and physical function. Further research is needed to develop strategies to promote physical activity and reduce the incidence of HAD in this vulnerable population.
frailty
physical activity
