Pilot study examining the association between ambulatory activity and falls among hospitalized older adults

Objective: To examine the ambulatory activity of older patients who had a documented fall during hospitalization for acute illness. Design: A retrospective case-control design was used in a pilot study of patients (n=10; <65y) who had a documented fall during their hospital stay and matched controls (n=25) who did not fall. Setting: Acute care medical/surgical unit. Participants: Men and women 65 years and older who wore a step activity monitor while hospitalized. Interventions: Not applicable. Main Outcome Measures: Fall incidents during the hospital stay were documented by the nurse in a standardized patient safety event report in accordance with hospital policy. The number of steps per 24-hour interval, time spent walking, and total number of activity episodes were determined for patients and controls. Results: On average ± SD, patients who fell took 480.3±432.2 steps per hospital day, spent 53.8±36.9 minutes walking, and engaged in 25.8±16.9 episodes of activity. Mean daily steps, time spent walking, and number of activity episodes for patients who did not fall were 680.1±876.0, 50.1±58.6, and 21.6±23.8, respectively. Logistic regression results indicated no association between the fall outcome and mean daily steps (odds ratio=.95; 95% confidence interval, 0.841.06). Conclusions: Ambulatory activity among patients who fell varied widely. Mean daily steps, time spent walking, and number of episodes of activity were comparable with matched controls who did not fall. Patient falls were more likely to be associated with cognitive and hospital environmental factors than actual amount of walking.