A Cross-Lagged Panel Model Testing the Impact of Physical Activity During Hospitalization on 1- and 6-Month Discharge Physical Activity and Adverse Events Among Older Adults With Dementia

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association Pub Date : 2025-07-24 DOI:10.1016/j.jamda.2025.105767

Shijun Zhu PhD , Barbara Resnick PhD, CRNP , Marie Boltz PhD, CRNP , Elizabeth Galik PhD, CRNP , Rachel McPherson PhD , Ashley Kuzmik DrPH, MPH , Chris Wells PT, PhD , Soyeon Shim MSN , Eunji Lee MSN

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引用次数: 0

Abstract

Objective

The objective of this study was to examine the effects of physical activity during hospital stay on falls, emergency room visits, and rehospitalizations among older patients with dementia at 1 and 6 months post discharge.

Design

This is a secondary data analysis. Bidirectional analysis using panel data from a cluster randomized clinical trial was utilized.

Setting and Participants

The sample comprised 455 older adults with dementia from a clustered randomized clinical trial among 12 hospitals in 2 east coast states.

Methods

The bidirectional relationships between physical activity at 1 and 6 months and falls, emergency room visits, and rehospitalizations at 1 and 6 months post discharge and their relations with physical activity at discharge were assessed using cross-lagged panel models, accounting for the autoregression of physical activity and adverse events over time. Age, race, gender, cognitive status, admission location, comorbidity, and intervention groups were controlled in the modeling.

Results

Physical activity at hospitalization discharge showed autoregressive associations for the 3 time points. Patients with a higher level of physical activity at discharge had a lower chance of falling (β = −0.250, SE = 0.094, OR = 0.779, P = .008) and rehospitalizations (β = −0.228, SE = 0.092, OR = 0.796, P = .013) within 1 month post discharge. Falls, emergency room visits, or rehospitalizations at 1 month were not significantly associated with physical activity, or any adverse events at 6 months.

Conclusions and Implications

The findings from this study highlighted the significance and value of engaging older adults, particularly those living with dementia, in physical activity when hospitalized, as this reduced the likelihood of adverse events such as falls and rehospitalization at least in the first month post discharge.

查看原文本刊更多论文

一个检验住院期间身体活动对老年痴呆患者出院1个月和6个月身体活动和不良事件影响的交叉滞后面板模型

目的：本研究的目的是检查住院期间体育活动对老年痴呆患者出院后1个月和6个月的跌倒、急诊室就诊和再住院的影响。设计：这是二次数据分析。采用来自聚类随机临床试验的面板数据进行双向分析。环境和参与者：样本包括455名老年痴呆症患者，来自2个东海岸州12家医院的随机临床试验。方法：采用交叉滞后面板模型评估出院后1至6个月体力活动与跌倒、急诊就诊和出院后1至6个月再住院之间的双向关系，以及它们与出院时体力活动的关系，考虑体力活动和不良事件随时间的自回归。模型控制年龄、种族、性别、认知状况、入院地点、合并症和干预组。结果：住院出院时的体力活动在3个时间点呈自回归相关性。出院时体育活动水平较高的患者在出院后1个月内跌倒（β = -0.250, SE = 0.094, OR = 0.779, P = 0.008）和再住院（β = -0.228, SE = 0.092, OR = 0.796, P = 0.013）的几率较低。1个月时跌倒、急诊室就诊或再住院与6个月时的身体活动或任何不良事件无显著相关性。结论和意义：这项研究的结果强调了老年人，特别是那些患有痴呆症的老年人，在住院期间参与体育活动的重要性和价值，因为这减少了诸如跌倒和出院后第一个月再次住院等不良事件的可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Medical Directors Association 医学-老年医学

CiteScore

11.10

自引率

6.60%

发文量

472

审稿时长

44 days

期刊介绍： JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates. The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality