Comportamento sedentário e fragilidade na pessoa idosa hospitalizada: estudo longitudinal

Abstract

Introduction: Sedentary behavior (SB) can lead to adverse health outcomes in older adults. During hospitalization, older adults tend to experience an increase in SB, which may remain elevated after discharge. Additionally, hospitalization is considered a stressful event and may contribute to the development or worsening of frailty syndrome. Some studies suggest an association between frailty and SB; however, this relationship is not well understood in the post-hospitalization period. This study aimed to evaluate the relationship between the trajectory of SB and the trajectory of frailty in older adults during the first month after hospital discharge. Methods: This was a longitudinal study in which older adults were assessed at hospital discharge and one month after discharge. SB was measured using the ActivPAL3™ micro accelerometer, and frailty was assessed using the Clinical Frailty Scale (CFS). The association between SB and frailty trajectories was examined using Generalized Estimating Equations (GEE) models. Statistical analyses were conducted using Jamovi software, with statistical significance set at p < 0.05. Results: In the first month after hospital discharge, older adults showed a mean reduction of 57 minutes of SB per day (p = 0.008). Moreover, men spent an average of 122 more minutes per day in SB compared with women (p = 0.002). Each additional year of age was associated with an average increase of 4.88 minutes of SB per day (p = 0.027), and each additional point in the CFS over the 30 days after discharge was associated with an average increase of 37.43 minutes per day of SB (p < 0.001). Conclusion: The findings highlight the importance of considering sedentary behavior as a clinically relevant and potentially modifiable outcome during the hospital-to-home transition period.