Tests of walking speed have been used in a wide range of populations. However, methodologies and descriptions of walking tests vary widely from study to study, which makes comparison difficult. There is a need to find consensus for a standardized walking test methodology.

Social media platforms can reach large numbers of otherwise hard-to-engage individuals, may allow others to intervene following an expression of suicidal ideation online, and provide an anonymous, accessible and non-judgmental forum for sharing experiences. Challenges include difficulties controlling user behaviour and accurately assessing risk, issues relating to privacy and confidentiality and the possibility of contagion. Social media appears to hold significant potential for suicide prevention; however, additional research into its safety and efficacy is required.

OBJECTIVES To describe the amount and patterns of ambulatory activity in hospitalized older adults over consecutive hospital days. DESIGN Observational cohort study. SETTING University teaching hospital Acute Care for Elderly (ACE) unit. PARTICIPANTS Adults aged 65 and older (N = 239) who wore a step activity monitor during their hospital stay. MEASUREMENTS Total number of steps per 24-hour day. Mean daily steps were calculated based on number of days the step activity monitor was worn. RESULTS Mean age was 76.6 ± 7.6; 55.1% of participants were female. Patients took a mean number of 739.7 (interquartile range 89–1,014) steps per day during their hospital stay. Patients with shorter stays tended to ambulate more on the first complete day of hospitalization and had a markedly greater increase in mobility on the second day than patients with longer lengths of stay. There were no significant differences in mean daily steps according to illness severity or reason for admission. CONCLUSION Objective information on patient mobility can be collected for hospitalized older persons. Findings may increase understanding of the level of ambulation required to maintain functional status and promote recovery from acute illness.

OBJECTIVES Our goal was to objectively assess total steps and minutes active in the first and last 24-hours of hospitalization and examine associations with survival post-discharge in hospitalized older patients. DESIGN A prospective study. SETTING A 20-bed Acute Care for Elders (ACE) hospital unit. PARTICIPANTS Two hundred and twenty-four older adults admitted to an ACE hospital unit. MEASUREMENTS A StepWatch Activity Monitor collected information on total steps and minutes of activity in the first and last 24-hours of hospitalization. The main outcome was 2-year survival from hospital discharge date. RESULTS Patients were active for about 80 minutes in the first 24-hours of hospitalization. Minutes active increased about 28 minutes in the last 24-hours of hospitalization for patients aged 65–84, but were essentially unchanged for those aged 85 or older. The median step count for patients was low, with a median of 478 and 846 steps in the first and last 24-hours of hospitalization, respectively. Multivariate survival models showed that in the first and last 24-hours of hospitalization each 100 step increase was associated with a 2% (HR 0.98; 95% CI 0.96–1.00) and 3% (HR 0.97; 95% CI 0.94–0.99) decreased risk of death over 2-years, respectively. A decline in steps from first to last 24-hours of hospitalization was associated with more than a four-fold increase risk of death (HR 4.21; 95% CI 1.65–10.77) two-years post discharge. CONCLUSION Accelerometers could provide meaningful information about the walking activity of patients. Of importance is the potential to apply objective information about the patient’s functional status to improve the delivery of healthcare and health outcomes.

There are no therapeutic guidelines regarding ambulation for older adults hospitalized for acute illness. 1 The importance of early ambulation to recovery in other patient populations is well established. 2,3 For example, time to ambulation after hip fracture surgery is a predictor of complications such as prolonged length of stay (LOS). 4 In the present study, we examined the association between ambulation and LOS in geriatric patients admitted for acute illnesses. We hypothesized that increase in ambulation within the 48 hours after admission would predict LOS after adjusting for risk factors. MethodsPatients 65 years or older admitted to an Acute Care for Elders unit were studied. A Step Activity Monitor (SAM) was placed on patients at admission, and participants were instructed to walk as usual. Data were collected over 4 months in 2009. Patients with an orthopedic surgical diagnosis or a contraindication to wearing the SAM (eg, bilateral leg infection or severe edema) were excluded. Patients (N=162) who spent 2 or more days in hospital were included in the analysis. Institutional review board approval was obtained.The SAM is a pager-sized accelerometer attached at the ankle. It will not record leg movements in bed and has been shown to be 98% accurate in clinical populations. [5][6][7] Steps were recorded in 1-minute intervals synchronized to a 24-hour clock, resulting in a temporal series of 1440 observations per day. Total steps were summed for each 24-hour day. A step change score was calculated using the difference in step totals between the first and second day. Mean daily steps were calculated using the number of complete days the SAM was worn. Demographic and clinical characteristics were obtained from medical records.