Daytime Physical Activity and Sleep in Hospitalized Older Adults: Association with Demographic Characteristics and Disease Severity.
Daytime Physical Activity and Sleep in Hospitalized Older Adults: Association with Demographic Characteristics and Disease Severity.
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DOI：
10.1111/jgs.13520
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发表时间：
2015-07
影响因子：
6.3
通讯作者：
Arora VM
中科院分区：
文献类型：
--
作者：
Beveridge C;Knutson K;Spampinato L;Flores A;Meltzer DO;Van Cauter E;Arora VM
评估住院老年人日间体力活动、睡眠持续时间和效率的客观测量值，并探讨与人口统计学特征和疾病严重程度的相关性。前瞻性队列研究。芝加哥大学医学中心普通内科病房。50岁及以上的社区住院患者（N = 120）使用腕部加速度计测量体力活动和睡眠。查尔森科摩罗指数和停留时间的信息从图表中收集。随机效应线性回归分析被用来研究住院睡眠和体力活动之间的关系。从2010年3月到2013年5月，120名参与者至少在2个晚上和1个干预日佩戴腕关节活动监测仪。清醒期间的活动水平中位数为77计数/分钟（四分位数范围为51-121计数/分钟），这一活动水平大致相当于坐着看电视（65计数/分钟）。活动间隔前一晚的平均睡眠时间为289 ± 157分钟，活动间隔前一晚的平均睡眠效率为65.2 ± 26.9%。年龄最大的参与者的平均活动计数/分钟最低（年龄最大的四分位数62，95%置信区间（CI）= 50-75;年龄最小的四分位数121，95% CI = 98-145，趋势检验P < .001）和Charlson合并症指数最高的患者（最高三分位数71，95%CI = 60-83;最低三分位数125，95%CI = 104-147，趋势检验P = 0.01）。控制疾病严重程度和人口统计学特征，住院患者每多睡一小时，活动减少3次/分钟（95%CI =-5.65至0.43，P = 0.02）。老年人、病情较重的成年人在住院期间的身体活动较少。与社区研究相反，睡眠更多的住院患者并不更活跃。这可能突出了医院比社区更需要睡眠。
To assess objectively measured daytime physical activity and sleep duration and efficiency in hospitalized older adults and explore associations with demographic characteristics and disease severity. Prospective cohort study. University of Chicago Medical Center general medicine wards. Community-dwelling inpatients aged 50 and older (N = 120) Physical activity and sleep were measured using wrist accelerometers. Information on Charlson Comorbidity Index and length of stay was collected from charts. Random-effects linear regression analysis was used to examine the association between in-hospital sleep and physical activity. From March 2010 to May 2013, 120 participants wore wrist actigraphy monitors for at least 2 nights and 1 intervening day. Median activity level over the waking period was 77 counts/min (interquartile range 51–121 counts/min), an activity level that approximately corresponds to sitting while watching television (65 counts/min). Mean sleep duration the night before the activity interval was 289 ± 157 minutes, and mean sleep efficiency the night before the activity interval was 65.2 ± 26.9%. Mean activity counts/min were lowest for the oldest participants (oldest quartile 62, 95% confidence interval (CI) = 50–75; youngest quartile 121, 95% CI = 98–145, trend test P < .001) and those with highest Charlson Comorbidity Index (highest tertile 71, 95% CI = 60–83; lowest tertile 125, 95% CI = 104–147, trend test P = .01). Controlling for severity of illness and demographic characteristics, activity declined by 3 counts/min (95% CI = −5.65 to −0.43, P = .02) for each additional hour of inpatient sleep. Older, sicker adults are less physically active during hospitalization. In contrast to studies in the community, inpatients who slept more were not more active. This may highlight that need for sleep is greater in the hospital than in the community.