Factors Influencing Outcomes of a Telehealth-Based Physical Activity Program in Older Veterans Postdischarge

Hospital-to-home transitions are influenced by hospitalization factors, associated posthospital syndromes, and postdischarge health care application. The objective of this study was to examine how these factors influenced outcomes of a pilot intervention using Veterans Affairs Video Connect (VVC) to enhance function and physical activity in older adults posthospital discharge.

Twenty-four older adults (mean age, 74 years) participated in a 6-month pilot VVC physical activity intervention designed to enhance functional ability, physical performance, and physical activity.

Participants with mild to moderate cognitive impairment had less improvement in activities of daily living (median, 0; IQR, 0 to 1) than those with no impairment (median, 0; IQR, -0.75 to 0; effect size [ES], -1.1; P = .04). Participants with ≥ 1 readmission experienced a greater increase in Rosow-Breslau mobility disability score (median, 0; IQR, -0.5 to 1) than participants who were not readmitted (median, 0; IQR, -1.25 to 0.25; ES, 1.0; P = .03). Longer hospital length of stay was correlated with an increase in Nagi score (ρ, 0.45; 95% CI, 0.01 to 0.75), and higher number of medication changes was correlated with a decrease in Rosow-Breslau mobility disability score (ρ, -0.47; 95% CI, -0.76 to -0.02).

In a cohort of older adults undergoing a 6-month pilot VVC-based physical activity intervention posthospital discharge, improvements in mobility and disability were most likely in those who had no cognitive impairment and were not readmitted. Larger sample and qualitative investigations are necessary to optimize outcomes for those who meet these clinical profiles.