ABSTRACT
Introduction: Despite current recommendations, hospitalized older adults, particularly those with dementia, continue to spend little time engaged in physical activity when hospitalized. The purpose of this study was to 1) describe activity among hospitalized older adults with dementia and 2) test the association between specific factors (age, gender, race, cognitive status, comorbidities, baseline function, quality of care interactions, admission diagnosis, and hospital setting) and their physical activity. Methods: This was a descriptive study utilizing baseline data on the first 155 participants of a randomized clinical trial testing the impact of Function Focused Care for Acute Care using the Evidence Integration Triangle (FFC-AC-EIT). This study's major outcome variable of physical activity was based on accelerometry data (MotionWatch8) over the first 24 hours of admission. Three regression models were tested using linear regression and the stepwise approach. Results: The 155 participants had a mean age of 83.5 years old, were 67.7% female, and 65.2% white. The participants spent an average of 1.3% of time in vigorous activity, 3.9% of time in moderate activity, 14.7% of time in low activity, and 80.1% of time in sedentary activity during the first 24 hours of hospitalization. Less cognitive impairment was associated with greater moderate activity (b=-93.408, p=.007) and better baseline mobility was associated with greater low activity (b=-949.453, p=.049). Alternatively, we found that higher age (b=189.350, p=.047), worse baseline mobility (b=2371.364, p=0.004), and non-white race (b=6705.916, p=<0.001) were associated with sedentary behavior. The examined factors for the moderate activity, low activity, and sedentary behavior models only explained 15%, 8%, and 22% of the variance respectively. Conclusions: The findings from this study support the limited time spent in activity for older adults with dementia when hospitalized. This research highlights patient profiles that are particularly vulnerable to sedentary behavior in the hospital and should be identified for activity interventions. Future research should consider other factors such as providers' racial bias, COVID-19 related health professional staffing shortages and burn out, and patient motivation.