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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
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Mobility During an Acute Medical Hospitalization: A Prospective Cohort Study.

Fabian D Liechti1, Joachim M Schmidt Leuenberger2, Martin L Verra2

  • 1Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

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|October 11, 2025
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Summary

Daily activity increased during hospitalization, improving discharge outcomes. Mobility gains plateaued after one week, suggesting a critical window for interventions in older patients.

Keywords:
Hospitalizationagedhospital to home transitionphysical therapy modalitiesquality in health care

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Area of Science:

  • Gerontology
  • Clinical Medicine
  • Rehabilitation Science

Background:

  • Hospitalization significantly impacts patient daily activity and mobility.
  • Understanding changes in these factors is crucial for predicting post-discharge outcomes.

Purpose of the Study:

  • To describe changes in daily activity proportion and mobility during acute hospitalization.
  • To assess the association of these changes with institutionalization and survival within 3 months.

Main Methods:

  • Secondary analysis of a randomized controlled trial involving 162 adult patients on internal medicine wards.
  • Continuous measurement of daily activity using accelerometers and assessment of mobility using the de Morton Mobility Index.
  • Logistic regression and linear mixed-effects models were used to analyze predictors and longitudinal changes.

Main Results:

  • Daily activity proportion increased in 37% of patients and was associated with baseline mobility.
  • Mobility improved in 64% of patients, primarily in the first week, but stagnated or declined thereafter.
  • Increased daily activity was linked to a higher likelihood of living at home post-discharge, while mobility was not. Neither predicted survival.

Conclusions:

  • Daily activity and mobility changes during hospitalization differ and relate to distinct outcomes.
  • A plateau in mobility after one week highlights a critical window for interventions, especially for older patients.
  • Targeted interventions during early hospitalization may improve post-discharge living arrangements.