Rest–Activity Patterns in Older Adults with Heart Failure and Healthy Older Adults

Abstract

The purpose of this investigation is to examine differences in rest-activity patterns and sleep characteristics in older adults with heart failure (HF) and healthy older adults. The sample included older adults with HF (n = 20) and a reference group of healthy older adults (n = 20). Traditional cosinor analysis was used to assess three parameters of rest-activity from wrist actigraphy data: amplitude (range of activity), mesor (mean activity), and acrophase (time of peak activity). Traditional sleep characteristics were also determined from actigraphy data: total sleep time (TST), sleep latency (SL), sleep efficiency (SE), and wake after sleep onset (WASO). The HF group demonstrated significantly lower mesor and amplitude than the reference group (p < .01). The HF group had significantly greater TST (p < .01), but the groups had similar SE, SL, and WASO. Despite similar sleep characteristics to healthy older adults, overall rest-activity patterns were significantly dampened in those with HF.

Accelerometer-assessed physical behavior and the association with clinical outcomes in implantable cardioverter-defibrillator recipients: A systematic review

“…found that patients with HF had significantly dampened rest-activity patterns: HF patients demonstrated a lower mean activity, activity range and a flat circadian rhythmicity compared to healthy adults, which suggests that patients do not reach the high levels of daytime activity observed in healthy adults. 45 A similar finding was observed in patients with ischemic HF, who spent 67% of their time in low intensity activities, while the time spent in vigorous intensity activities was low (4.7%). 46 Compared to HF patients, ICD carriers walked more steps per day and reached a higher peak performance (a daily average of the highest step rate values).…”

“…These studies predominantly reported metrics related to PA and sedentary behavior (13 studies), followed by sleep behavior (5 studies) and rest-activity patterns (1 study). First, Liebzeit and colleagues 45 found that patients with HF had significantly dampened rest-activity patterns: HF patients demonstrated a lower mean activity and activity range and a flat circadian rhythmicity compared to healthy adults, which suggests that patients do not reach the high levels of daytime activity observed in healthy adults. A similar finding was observed in patients with ischemic HF, who spent 67% of their time in low-intensity activities, while the time spent in vigorous-intensity activities was low (4.7%).…”

“…studies) References Low physical activity Increased risk of hospitalization and mortality 286 RCT substudy (2); Prospective observational (1). 56 , 57 , 58 HF patients engage in low-intensity activity, have a poor objective sleep continuity and flat circadian rhythmicity N/A 174 Cross-sectional (3); 45 , 46 , 74 Step count and MVPA associated with NYHA class and LVEF † N/A 456 RCT substudy (1); Cross-sectional (2); Pilot study (1); Feasibility study (1) 48 , 49 , 50 , 51 , 52 High step count, MVPA, and sleep time associated with patient-reported QoL, functional status, and cognitive function N/A 331 RCT substudy (3); Feasibility study (1); Cross-sectional (1) 49 , 52 , 53 , 54 , 55 HF = heart failure; ICD = implantable cardioverter-defibrillator; LVEF = left ventricular ejection fraction; MVPA = moderate–to-vigorous physical activity; N/A = not applicable; NYHA = New York Heart Association; PA = physical activity; QoL = quality of life; RCT = randomized controlled trial. † Witham et al did not show an association between NYHA class and accelerometry counts.…”

Advances in accelerometry for cardiovascular patients: a systematic review with practical recommendations

“…The database search yielded 1226 articles; of those, 139 full texts were retrieved, and 59 deemed eligible 10‐67,93 . Hand searching the reference lists of recent reviews identified one additional eligible paper 68 .…”

“…Thirty-two papers reported on observational studies, [10][11][12][13]17,18,20,21,[23][24][25]28,33,36,37,[39][40][41]43,44,46,47,50,52,53,56,60,61,[64][65][66]93 12 on randomized controlled trials, [14][15][16]22,32,45,49,55,62,63,67,68 three on quasi-experimental studies, 31,34,38 and eight on validation studies (of those, four were supervised lab-based studies). 27,29,30,35,…”