Factors that differentiate level of ambulation in hospitalised older adults

SIR—The adverse effects of low mobility in older hospitalised persons are well documented [1, 2]. The amount of time patients are limited to a bed or chair is an independent predictor of functional decline even after controlling for illness severity [3]. Ambulation is a potentially simple intervention to reduce low mobility in-hospital. A number of factors, however, can interact to influence how much a patient actually walks. Identifying factors associated with varied levels of ambulation would help clinicians identify older patients at risk for low levels of mobility. Although, previous studies have investigated perceived barriers to ambulation during hospitalisation from the perspectives of older patients and their primary nurses and physicians [4], no study has examined relevant factors using direct measures of ambulatory activity such as step counts. We recently demonstrated that accelerometer technology can be used to collect continuous information on patient mobility in hospitalised older persons [5]. For this study, our objective was to identify subgroups of patients with shared clinical profiles who differed with respect to mean daily ambulation.