Individual Responsiveness to Physical Exercise Intervention in Acutely Hospitalized Older Adults

• Main Authors: Pedro L. Valenzuela, Javier Ortiz-Alonso, Natalia Bustamante-Ara, María T. Vidán, Gabriel Rodríguez-Romo, Jennifer Mayordomo-Cava, Marianna Javier-González, Mercedes Hidalgo-Gamarra, Myriel López-Tatis, Maria Isabel Valadés-Malagón, Alejandro Santos-Lozano, José Antonio Serra-Rexach, Alejandro Lucia
• Format: Article
• Language: English
• Published: MDPI AG 2020-03-01
• Series: Journal of Clinical Medicine
• Subjects: hospital-associated disability; elders; functional ability; activities of daily living; training
• Online Access: https://www.mdpi.com/2077-0383/9/3/797

We analyzed inter-individual variability in response to exercise among acutely hospitalized oldest-old adults. In this ancillary analysis of a randomized controlled trial, 268 patients (mean age 88 years) were assigned to a control (n = 125, usual care) or intervention group (n = 143, supervised exercise, i.e., walking and rising from a chair [1&#8722;3 sessions/day]). Intervention group patients were categorized as responders, non-responders, or adverse responders (improved, no change, or impaired function in activities of daily living [ADL, Katz index] from hospital admission to discharge, respectively). We analyzed the association between responsiveness to exercise and variables assessed at baseline (2 weeks pre-admission), admission, during hospitalization, at discharge, and during a subsequent 3-month follow-up. An impaired ADL function and worse nutritional status at admission were associated to a greater responsiveness, whereas a better ADL function at admission, longer hospitalization and lower comorbidity index were associated with a poorer response (<i>p</i> &lt; 0.05). Adverse responders had worse outcomes at discharge and during the follow-up (e.g., impaired physical performance and greater fall number) (<i>p</i> &lt; 0.05). Although exercise intervention helps to prevent ADL function decline in hospitalized oldest-old people, a number of them&#8212;particularly those with a better functional/health status at admission and longer hospitalization&#8212;are at higher risk of being adverse responders, which can have negative short/middle-term consequences.