How Physically Active Are Geriatric Inpatients? A Cross-Sectional Study

Background Physical activity and mobility of hospitalized geriatric patients are very low, according to international data, which hinders recovery and regaining functional independence. In Switzerland, data on physical activity behavior in this population is lacking. This multi-center observational cross-sectional study aimed a) to quantify physical activity levels using accelerometry and b) to assess the relationship with clinical characteristics, mobility, and muscle strength in acute geriatric inpatients in Switzerland.

Methods Physical activity of inpatients from two geriatric acute care hospitals (Kantonsspital Winterthur and Geriatrische Klinik St. Gallen) was tracked over 5 days using the ActivPAL inertial measurement sensor. The sensor recorded step count, cadence, activity duration, and posture classification (i.e., lying, sitting, standing, walking). Clinical assessments and questionnaires, including the De Morton Mobility Index (DEMMI), cognition (Mini Mental State Examination), the Charlson Comorbidity Index (CCI), and lower limb strength (hand-held dynamometer) were performed to analyze associations with physical activity parameters using backward stepwise multiple linear regression.

Results A total of 89 patients were included in the final analysis, with 64% being women. The mean age was 83.7 years (SD 6.9 years). During waking hours, participants spent an average of 75% of their time sitting, 12% standing, 11% lying down, and only 2% walking. Overall, sedentary activities accounted for 86% of an average inpatient day’s awake time. During the remaining 14%, patients took a median of 946 steps (IQR 1485) at an average gait speed of 0.68 m/s. The median walking duration was 16 minutes (IQR 18). In the final regression model, the DEMMI score, the CCI, and the presence of a urinary catheter emerged as the most significant predictors, collectively explaining 26% of the variance in upright time (F(3,63) = 8.72, p < 0.001, f² = 0.35).

Conclusion Our sample is largely inactive, walking just above the critical threshold of 900 steps/day, which is associated with hospital-associated functional decline. Factors such as mobility status, comorbidities, and the presence of a urinary catheter significantly influence physical activity levels. Therefore, it is recommended for health-care professionals to take efforts in increasing physical activity of geriatric inpatients.