Determinants of participation in a post-hospitalization physical exercise program for older adults

Abstract

Background Older patients often experience a decline in physical function and cognitive status after hospitalization. Although interventions involving physical exercise are effective in improving functional performance, participation in physical exercise interventions among older individuals is low. We aimed to identify factors that contribute to exercise refusal among post-hospitalized older patients. Methods A cross-sectional study of recruitment data from a randomized controlled trial was conducted involving 495 hospitalized people ≥70 years old. Sociodemographic and clinical data were obtained from the Basque Public Health System database. We determined physical function with the Short Physical Performance Battery (SPPB), nutritional status with the Mini-Nutritional Assessment, frailty according to the Fried phenotype criteria, and cognitive function with the Short Portable Mental Status Questionnaire (SPMSQ). Student’s t, Mann-Whitney U, or chi-squared tests were applied for bivariate analysis. Parameters significantly associated with participation were introduced in a logistic multivariate regression model. Results Among the analyzed patients, 88.8% declined participation in the physical exercise program. Multivariate regression revealed that older age (OR: 1.13; 95% CI: 1.07–1.19), poor nutritional status (OR: 0.81; 95% CI: 0.69–0.95), and reduced home accessibility (OR: 0.27; 95% CI: 0.08–0.94) were predictors of participation refusal. Moreover, patients who declined participation had worse performance on the SPPB (P < 0.05) and its tests of balance, leg strength, and walking speed (P < 0.05). No differences were found between groups in other variables. Conclusions This study confirms low participation of older adults in a post-hospitalization physical exercise program. Non-participation was associated with increased age, poor nutritional status, and reduced home accessibility. Our findings support the need for intervention design that accounts for these factors to increase older patient participation in beneficial exercise programs. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12619000093189, (date: January 22, 2019, retrospectively registered).

Nutritional status and physical performance using handgrip and SPPB tests in hospitalized older adults

“…Members of the research team, with a wide experience in clinical settings, revisited the daily list of patients admitted to the internal service in order to assess eligibility. The reasons for hospitalization can be found in a study published by our research group [22] and coincide with those that can be expected for a geriatric population. The average length of hospital stay for older adults admitted to this hospital ward was 7.9 ± 5.2 days.…”

Correlation analysis of physical fitness and its impact on falls in 2130 community- dwelling older adults: a retrospective cross-sectional study

“…Although exercise programs may benefit an individual’s functional performance, older adults are less inclined to participate in such programs. The authors recommend that nutritional supplements be incorporated into intervention designs to encourage older adults’ participation in exercise programs [ 27 ]. Overall, a combination of physical activity and adequate nutrition benefits older adults, and the establishment of healthy lifestyles should be prioritized in any health promotion program.…”

Jarduera fisikoa, guztion osasuna eta ongizatea hobetzeko tresna

“…Bereziki, frogatu da programak taldean egiten direnean bizi-kalitatea gehiago hobetzen dela [66]. Dena den, nahiz eta onurak nabariak izan, harrigarria da ospitaleratuak izan diren pertsona nagusiek ariketa fisikoko programetan duten parte-hartzea baxua izatea; izan ere, % 10 ingurukoa da, gure taldeak egindako ikerketa baten arabera [67]. Ikerketa horretan behatu zen zenbait faktore aldagarri -nutrizio-egoera eta etxeko irisgarritasuna, besteak beste-direla parte-hartzearen mugatzaile garrantzitsuenak.…”

“…Ekaia, ale berezia 2021,[53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72] Jon Irazusta, Begoña Sanz, Ana Rodriguez-Larrad…”