Aarden JJ1, Van der Schaaf M1, Reichardt LA2, Van Seben R2, Van der Esch M3, Bosch JA4, Twisk JWR5, Buurman BM2, Engelbert RHH1, Van Egmond M6
1Amsterdam UMC, Location AMC, Rehabilitation, Amsterdam, Netherlands, 2Amsterdam UMC, Location AMC, Geriatric Medicine, Amsterdam, Netherlands, 3Reade, Rheumatology, Amsterdam, Netherlands, 4University of Amsterdam, Clinical Psychology, Amsterdam, Netherlands, 5Amsterdam UMC, Location VUMC, Epidemiology and Biostatistics, Amsterdam, Netherlands, 6Amsterdam UMC, Rehabilitation, Amsterdam, Netherlands
Background: After acute hospitalization, 30 to 60% of older adults experience functional decline, resulting in limitations of activities of daily life, unplanned hospital readmissions to hospital or even death. The first signs of functional decline can often be observed in the inability to perform mobility tasks, such as raising from a chair or walking.
Purpose: The objectives of this study were to determine
(i) the course of mobility of acute hospitalized older persons and
(ii) the association between muscle strength and the the of mobility over time including influencing factors.
Methods: A multicenter, prospective, observational cohort study on older persons who were acutely admitted to one of the 6 participating hospitals was conducted by a multidisciplinary team. Mobility was assessed by the De Morton Mobility Index (DEMMI) and muscle strength by the JAMAR. Measurements were taken at admission, discharge, one month and three months post-discharge. The longitudinal association between muscle strength and mobility was analysed with a linear mixed model and controlled for potential confounders such as age, gender, cognitive impairment, fear of falling and depressive symptoms.
Results: A total of 401 older persons were included with a mean (SD) age of 79.6 (6.7) years. Mobility improved significantly from 57 points at admission up to 68 points at three months post-discharge. No improvement was observed from one- up to three months post-discharge. Even after controlling for potential demographic and psychological confounders, muscle strength was associated with the course of mobility (β=0.64; p 0.01). Age, cognitive impairment, fear of falling and depressive symptoms were identified as confounders and gender as an effect modifier
Conclusion(s): For the development of an intervention to improve mobility in acute hospitalized older persons, a multifactorial approach (muscle strength in combination with factors such as fear of falling and depressive symptoms) focusing on the first month following hospital discharge is warranted.
Implications: This study showed that muscle strength in relation with other factors is an important starting point, for acute hospitalized older adults. Physical therapists might have an important role in the rehabilitation of older adults after hospitalization.
Keywords: Mobility, Muscle strength, Older adults
Funding acknowledgements: This study was supported by NWO-ZonMw) (grant number 16156071) and a personal doctoral grant for J.J.Aarden, MSc.
Purpose: The objectives of this study were to determine
(i) the course of mobility of acute hospitalized older persons and
(ii) the association between muscle strength and the the of mobility over time including influencing factors.
Methods: A multicenter, prospective, observational cohort study on older persons who were acutely admitted to one of the 6 participating hospitals was conducted by a multidisciplinary team. Mobility was assessed by the De Morton Mobility Index (DEMMI) and muscle strength by the JAMAR. Measurements were taken at admission, discharge, one month and three months post-discharge. The longitudinal association between muscle strength and mobility was analysed with a linear mixed model and controlled for potential confounders such as age, gender, cognitive impairment, fear of falling and depressive symptoms.
Results: A total of 401 older persons were included with a mean (SD) age of 79.6 (6.7) years. Mobility improved significantly from 57 points at admission up to 68 points at three months post-discharge. No improvement was observed from one- up to three months post-discharge. Even after controlling for potential demographic and psychological confounders, muscle strength was associated with the course of mobility (β=0.64; p 0.01). Age, cognitive impairment, fear of falling and depressive symptoms were identified as confounders and gender as an effect modifier
Conclusion(s): For the development of an intervention to improve mobility in acute hospitalized older persons, a multifactorial approach (muscle strength in combination with factors such as fear of falling and depressive symptoms) focusing on the first month following hospital discharge is warranted.
Implications: This study showed that muscle strength in relation with other factors is an important starting point, for acute hospitalized older adults. Physical therapists might have an important role in the rehabilitation of older adults after hospitalization.
Keywords: Mobility, Muscle strength, Older adults
Funding acknowledgements: This study was supported by NWO-ZonMw) (grant number 16156071) and a personal doctoral grant for J.J.Aarden, MSc.
Topic: Older people; Disability & rehabilitation
Ethics approval required: Yes
Institution: Amsterdam UMC
Ethics committee: Institutional Review Board
Ethics number: Protocol ID: AMC2015_150
All authors, affiliations and abstracts have been published as submitted.
