Determinants of instrumented sedentary and physical activity behavior in geriatric rehabilitation inpatients: RESORT

Anna Galina Maria Rojer; Britt C.M. Denneman; Puck Brouwer; Keenan A. Ramsey; Marijke C. Trappenburg; Carel G.M. Meskers; Mirjam Pijnappels; Rose Goonan; Celia Marston; Jacqueline E. Kay; W. Kwang Lim; Alisa Turbić; Louis Island; Esmee M. Reijnierse; Andrea B. Maier

doi:10.1016/j.exger.2021.111524

Determinants of instrumented sedentary and physical activity behavior in geriatric rehabilitation inpatients: RESORT

Anna Galina Maria Rojer, Britt C.M. Denneman, Puck Brouwer, Keenan A. Ramsey, Marijke C. Trappenburg, Carel G.M. Meskers, Mirjam Pijnappels, Rose Goonan, Celia Marston, Jacqueline E. Kay, W. Kwang Lim, Alisa Turbić, Louis Island, Esmee M. Reijnierse, Andrea B. Maier^*

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: Physical inactivity in hospitalized older adults is highly prevalent and associated with detrimental health outcomes. Understanding its determinants is important for prognosis and tailoring interventions in geriatric rehabilitation inpatients. Methods: Within the REStORing health of acutely unwell adulTs (RESORT) observational, longitudinal cohort, geriatric rehabilitation inpatients wore an inertial sensor (ActivPAL4) for one week to objectively assess instrumented sedentary behavior (i-SB) and physical activity (i-PA). Determinants were grouped in five geriatric domains: morbidity, cognition/psychology, physical performance, functional performance, and nutritional status. Their association with i-SB (mean sitting, lying, non-upright time) and i-PA (mean number of steps, sit-to-stand transitions and upright time) quintiles were examined using multivariate ordinal logistic regression analyses with Bonferroni correction (p < 0.006). Results: A total of 145 inpatients were included (mean age 83.0, SD 7.7 years; 55.9% females). More comorbidities were associated with a lower daily number of steps (OR:0.91, 95%CI: 0.86–0.96) and lower upright time (OR:0.93, 95%CI: 0.88–0.98). Depressive symptoms (higher Hospital Anxiety and Depression Scale score) were associated with higher non-upright time (OR: 1.12, 95%CI: 1.03–1.21) and lower upright time (OR: 0.89, 95%CI: 0.83–0.96). Better physical performance (higher Functional Ambulation Classification, gait speed, and Short Physical Performance Battery score) was associated with lower i-SB measures (OR range: 0.07–0.78, p < 0.0005) and higher i-PA measures (OR range: 1.35–19.50, p < 0.0005). Higher functional performance (Katz index of Activities of Daily Living score) was associated with lower i-SB measures (OR range: 0.61–0.69, p ≤ 0.003) and higher i-PA measures (OR range: 1.60–3.64, p < 0.0005). Being malnourished was associated with lower i-PA measures (OR range: 0.29–0.32, p ≤ 0.004). Conclusions: Worse morbidity, depressive symptoms, worse physical and functional performance, and worse nutritional status were associated with higher i-SB and lower i-PA. These determinants should be taken into account while designing and promoting multidisciplinary physical activity interventions.

Original language	English
Article number	111524
Pages (from-to)	1-11
Number of pages	11
Journal	Experimental Gerontology
Volume	154
Early online date	21 Aug 2021
DOIs	https://doi.org/10.1016/j.exger.2021.111524
Publication status	Published - 15 Oct 2021

Bibliographical note

Funding Information:
This research was funded by an unrestricted grant of the University of Melbourne received by Prof. Andrea B. Maier, the Medical Research Future Fund (MRFF) provided by the Melbourne Academic Centre for Health (MACH), Melbourne Health Foundation and European Union's Horizon 2020 program (689238 and 675003). The funders had no role in the design, execution, analysis, and interpretation of data or writing of the study.

Funding Information:
The authors thank the multidisciplinary team members of the Royal Melbourne Hospital, Royal Park Campus, involved in the RESORT cohort and the @AgeMelbourne team for their role in the data collection. This research has been funded by an unrestricted grant by the University of Melbourne received by Andrea B. Maier and the Medical Research Future Fund via the Melbourne Academic Center for Health.

Publisher Copyright:
© 2021

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Funding

This research was funded by an unrestricted grant of the University of Melbourne received by Prof. Andrea B. Maier, the Medical Research Future Fund (MRFF) provided by the Melbourne Academic Centre for Health (MACH), Melbourne Health Foundation and European Union's Horizon 2020 program (689238 and 675003). The funders had no role in the design, execution, analysis, and interpretation of data or writing of the study. The authors thank the multidisciplinary team members of the Royal Melbourne Hospital, Royal Park Campus, involved in the RESORT cohort and the @AgeMelbourne team for their role in the data collection. This research has been funded by an unrestricted grant by the University of Melbourne received by Andrea B. Maier and the Medical Research Future Fund via the Melbourne Academic Center for Health.

Keywords

Accelerometry
Geriatric assessment
Motor activity
Physical functional performance
Rehabilitation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.exger.2021.111524

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Rojer, A. G. M., Denneman, B. C. M., Brouwer, P., Ramsey, K. A., Trappenburg, M. C., Meskers, C. G. M., Pijnappels, M., Goonan, R., Marston, C., Kay, J. E., Lim, W. K., Turbić, A., Island, L., Reijnierse, E. M., & Maier, A. B. (2021). Determinants of instrumented sedentary and physical activity behavior in geriatric rehabilitation inpatients: RESORT. Experimental Gerontology, 154, 1-11. Article 111524. https://doi.org/10.1016/j.exger.2021.111524

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title = "Determinants of instrumented sedentary and physical activity behavior in geriatric rehabilitation inpatients: RESORT",

abstract = "Background: Physical inactivity in hospitalized older adults is highly prevalent and associated with detrimental health outcomes. Understanding its determinants is important for prognosis and tailoring interventions in geriatric rehabilitation inpatients. Methods: Within the REStORing health of acutely unwell adulTs (RESORT) observational, longitudinal cohort, geriatric rehabilitation inpatients wore an inertial sensor (ActivPAL4) for one week to objectively assess instrumented sedentary behavior (i-SB) and physical activity (i-PA). Determinants were grouped in five geriatric domains: morbidity, cognition/psychology, physical performance, functional performance, and nutritional status. Their association with i-SB (mean sitting, lying, non-upright time) and i-PA (mean number of steps, sit-to-stand transitions and upright time) quintiles were examined using multivariate ordinal logistic regression analyses with Bonferroni correction (p < 0.006). Results: A total of 145 inpatients were included (mean age 83.0, SD 7.7 years; 55.9% females). More comorbidities were associated with a lower daily number of steps (OR:0.91, 95%CI: 0.86–0.96) and lower upright time (OR:0.93, 95%CI: 0.88–0.98). Depressive symptoms (higher Hospital Anxiety and Depression Scale score) were associated with higher non-upright time (OR: 1.12, 95%CI: 1.03–1.21) and lower upright time (OR: 0.89, 95%CI: 0.83–0.96). Better physical performance (higher Functional Ambulation Classification, gait speed, and Short Physical Performance Battery score) was associated with lower i-SB measures (OR range: 0.07–0.78, p < 0.0005) and higher i-PA measures (OR range: 1.35–19.50, p < 0.0005). Higher functional performance (Katz index of Activities of Daily Living score) was associated with lower i-SB measures (OR range: 0.61–0.69, p ≤ 0.003) and higher i-PA measures (OR range: 1.60–3.64, p < 0.0005). Being malnourished was associated with lower i-PA measures (OR range: 0.29–0.32, p ≤ 0.004). Conclusions: Worse morbidity, depressive symptoms, worse physical and functional performance, and worse nutritional status were associated with higher i-SB and lower i-PA. These determinants should be taken into account while designing and promoting multidisciplinary physical activity interventions.",

keywords = "Accelerometry, Geriatric assessment, Motor activity, Physical functional performance, Rehabilitation",

author = "Rojer, {Anna Galina Maria} and Denneman, {Britt C.M.} and Puck Brouwer and Ramsey, {Keenan A.} and Trappenburg, {Marijke C.} and Meskers, {Carel G.M.} and Mirjam Pijnappels and Rose Goonan and Celia Marston and Kay, {Jacqueline E.} and Lim, {W. Kwang} and Alisa Turbi{\'c} and Louis Island and Reijnierse, {Esmee M.} and Maier, {Andrea B.}",

note = "Funding Information: This research was funded by an unrestricted grant of the University of Melbourne received by Prof. Andrea B. Maier, the Medical Research Future Fund (MRFF) provided by the Melbourne Academic Centre for Health (MACH), Melbourne Health Foundation and European Union's Horizon 2020 program (689238 and 675003). The funders had no role in the design, execution, analysis, and interpretation of data or writing of the study. Funding Information: The authors thank the multidisciplinary team members of the Royal Melbourne Hospital, Royal Park Campus, involved in the RESORT cohort and the @AgeMelbourne team for their role in the data collection. This research has been funded by an unrestricted grant by the University of Melbourne received by Andrea B. Maier and the Medical Research Future Fund via the Melbourne Academic Center for Health. Publisher Copyright: {\textcopyright} 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = oct,

day = "15",

doi = "10.1016/j.exger.2021.111524",

language = "English",

volume = "154",

pages = "1--11",

journal = "Experimental Gerontology",

issn = "0531-5565",

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Rojer, AGM, Denneman, BCM, Brouwer, P, Ramsey, KA, Trappenburg, MC, Meskers, CGM, Pijnappels, M, Goonan, R, Marston, C, Kay, JE, Lim, WK, Turbić, A, Island, L, Reijnierse, EM & Maier, AB 2021, 'Determinants of instrumented sedentary and physical activity behavior in geriatric rehabilitation inpatients: RESORT', Experimental Gerontology, vol. 154, 111524, pp. 1-11. https://doi.org/10.1016/j.exger.2021.111524

TY - JOUR

T1 - Determinants of instrumented sedentary and physical activity behavior in geriatric rehabilitation inpatients: RESORT

AU - Rojer, Anna Galina Maria

AU - Denneman, Britt C.M.

AU - Brouwer, Puck

AU - Ramsey, Keenan A.

AU - Trappenburg, Marijke C.

AU - Meskers, Carel G.M.

AU - Pijnappels, Mirjam

AU - Goonan, Rose

AU - Marston, Celia

AU - Kay, Jacqueline E.

AU - Lim, W. Kwang

AU - Turbić, Alisa

AU - Island, Louis

AU - Reijnierse, Esmee M.

AU - Maier, Andrea B.

N1 - Funding Information: This research was funded by an unrestricted grant of the University of Melbourne received by Prof. Andrea B. Maier, the Medical Research Future Fund (MRFF) provided by the Melbourne Academic Centre for Health (MACH), Melbourne Health Foundation and European Union's Horizon 2020 program (689238 and 675003). The funders had no role in the design, execution, analysis, and interpretation of data or writing of the study. Funding Information: The authors thank the multidisciplinary team members of the Royal Melbourne Hospital, Royal Park Campus, involved in the RESORT cohort and the @AgeMelbourne team for their role in the data collection. This research has been funded by an unrestricted grant by the University of Melbourne received by Andrea B. Maier and the Medical Research Future Fund via the Melbourne Academic Center for Health. Publisher Copyright: © 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/10/15

Y1 - 2021/10/15

N2 - Background: Physical inactivity in hospitalized older adults is highly prevalent and associated with detrimental health outcomes. Understanding its determinants is important for prognosis and tailoring interventions in geriatric rehabilitation inpatients. Methods: Within the REStORing health of acutely unwell adulTs (RESORT) observational, longitudinal cohort, geriatric rehabilitation inpatients wore an inertial sensor (ActivPAL4) for one week to objectively assess instrumented sedentary behavior (i-SB) and physical activity (i-PA). Determinants were grouped in five geriatric domains: morbidity, cognition/psychology, physical performance, functional performance, and nutritional status. Their association with i-SB (mean sitting, lying, non-upright time) and i-PA (mean number of steps, sit-to-stand transitions and upright time) quintiles were examined using multivariate ordinal logistic regression analyses with Bonferroni correction (p < 0.006). Results: A total of 145 inpatients were included (mean age 83.0, SD 7.7 years; 55.9% females). More comorbidities were associated with a lower daily number of steps (OR:0.91, 95%CI: 0.86–0.96) and lower upright time (OR:0.93, 95%CI: 0.88–0.98). Depressive symptoms (higher Hospital Anxiety and Depression Scale score) were associated with higher non-upright time (OR: 1.12, 95%CI: 1.03–1.21) and lower upright time (OR: 0.89, 95%CI: 0.83–0.96). Better physical performance (higher Functional Ambulation Classification, gait speed, and Short Physical Performance Battery score) was associated with lower i-SB measures (OR range: 0.07–0.78, p < 0.0005) and higher i-PA measures (OR range: 1.35–19.50, p < 0.0005). Higher functional performance (Katz index of Activities of Daily Living score) was associated with lower i-SB measures (OR range: 0.61–0.69, p ≤ 0.003) and higher i-PA measures (OR range: 1.60–3.64, p < 0.0005). Being malnourished was associated with lower i-PA measures (OR range: 0.29–0.32, p ≤ 0.004). Conclusions: Worse morbidity, depressive symptoms, worse physical and functional performance, and worse nutritional status were associated with higher i-SB and lower i-PA. These determinants should be taken into account while designing and promoting multidisciplinary physical activity interventions.

AB - Background: Physical inactivity in hospitalized older adults is highly prevalent and associated with detrimental health outcomes. Understanding its determinants is important for prognosis and tailoring interventions in geriatric rehabilitation inpatients. Methods: Within the REStORing health of acutely unwell adulTs (RESORT) observational, longitudinal cohort, geriatric rehabilitation inpatients wore an inertial sensor (ActivPAL4) for one week to objectively assess instrumented sedentary behavior (i-SB) and physical activity (i-PA). Determinants were grouped in five geriatric domains: morbidity, cognition/psychology, physical performance, functional performance, and nutritional status. Their association with i-SB (mean sitting, lying, non-upright time) and i-PA (mean number of steps, sit-to-stand transitions and upright time) quintiles were examined using multivariate ordinal logistic regression analyses with Bonferroni correction (p < 0.006). Results: A total of 145 inpatients were included (mean age 83.0, SD 7.7 years; 55.9% females). More comorbidities were associated with a lower daily number of steps (OR:0.91, 95%CI: 0.86–0.96) and lower upright time (OR:0.93, 95%CI: 0.88–0.98). Depressive symptoms (higher Hospital Anxiety and Depression Scale score) were associated with higher non-upright time (OR: 1.12, 95%CI: 1.03–1.21) and lower upright time (OR: 0.89, 95%CI: 0.83–0.96). Better physical performance (higher Functional Ambulation Classification, gait speed, and Short Physical Performance Battery score) was associated with lower i-SB measures (OR range: 0.07–0.78, p < 0.0005) and higher i-PA measures (OR range: 1.35–19.50, p < 0.0005). Higher functional performance (Katz index of Activities of Daily Living score) was associated with lower i-SB measures (OR range: 0.61–0.69, p ≤ 0.003) and higher i-PA measures (OR range: 1.60–3.64, p < 0.0005). Being malnourished was associated with lower i-PA measures (OR range: 0.29–0.32, p ≤ 0.004). Conclusions: Worse morbidity, depressive symptoms, worse physical and functional performance, and worse nutritional status were associated with higher i-SB and lower i-PA. These determinants should be taken into account while designing and promoting multidisciplinary physical activity interventions.

KW - Accelerometry

KW - Geriatric assessment

KW - Motor activity

KW - Physical functional performance

KW - Rehabilitation

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Determinants of instrumented sedentary and physical activity behavior in geriatric rehabilitation inpatients: RESORT

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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