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Mobility program linked to less functional decline in older inpatients

Functional worsening at discharge occurred in 29.7% of older patients after the program began, compared with 49.7% before it.

Paper by Fabrizio Turrini, Giovanni Esposito, Veronica Zanni, +6 more authorsChiara Benatti · Internal Medicine - Ramazzini Hospital
Figure 1. Study flow diagram Flow diagram showing patient screening, exclusions, safety population, and discharged-alive, analytic cohort before and after implementation of the HESM pathway.
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Figure 1. Study flow diagram Flow diagram showing patient screening, exclusions, safety population, and discharged-alive, analytic cohort before and after implementation…Study flow diagram Flow diagram showing patient screening, exclusions, safety population, and discharged-alive, analytic cohort before and after implementation of the HESM pathway.Turrini et al.

Our read

Interventions
Studied:
Preprint: cohort study of 600 older medical inpatients discharged alive, 90 days
What changed:
Functional decline at discharge was 20.0 percentage points lower after the mobility program than before implementation
The catch:
Differences in comorbidity burden and unrecorded frailty could explain the lower functional decline
Why it’s aging research:
Biological age, frailty, function, multimorbidity or death.

Editor of record: Boris Djordjevic · AgingResearch.News

Paper
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Six hundred patients aged 65 or older who left an Italian internal medicine ward alive were studied in a before-and-after observational cohort. Researchers compared 300 patients receiving usual care with 300 admitted after a structured early mobility program began. A team assessed patients within 24 hours of admission and planned at least two movement sessions daily once they were clinically stable. Activities included bed exercises, standing and walking.

At discharge, functional worsening—measured by disability or daily-activity scores—occurred in 49.7% before implementation and 29.7% afterward, a 20.0-percentage-point difference. Deaths within 90 days after discharge occurred in 20.7% before and 11.7% afterward. Both associations remained after statistical adjustment. Falls were infrequent and similar between groups.

Why it matters

Older adults can lose independence during a hospital stay. These findings support mobility-focused care pathways as an approach to preserving their ability to manage daily life.

Caveats

Patients entered the groups at different times, so other changes in care or patient health could have contributed to the results; functional and post-discharge analyses included only hospital survivors. The preprint has not been peer-reviewed, and its single-hospital population excluded people requiring strict bed rest or with an end-of-life condition.

From the paper

Participants

We included 600 discharged-alive patients aged ≥ 65 years admitted to an internal medicine ward in Italy, 300 before and 300 after HESM implementation.

Methods

Result

Functional worsening occurred in 149/300 patients before and 89/300 after implementation (49.7% vs 29.7%; absolute risk reduction 20.0 percentage points, 95% CI 12.3–27.7; number needed to treat 5).

Results

Absolute difference

Functional worsening occurred in 149/300 patients before and 89/300 after implementation (49.7% vs 29.7%; absolute risk reduction 20.0 percentage points, 95% CI 12.3–27.7; number needed to treat 5).

Results

Limitation

The before–after design is inherently vulnerable to temporal confounding, and causal inference cannot be established.

Limitations, Strengths and weaknesses of the study

Quoted word for word from the full text on researchsquare.com.

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