Acute medical illness and subsequent hospitalization are associated with several negative
health consequences in older adults, even when the acute disease that caused the hospital
admission is successfully treated.
1
,2
Loss of function in activities of daily living following hospitalization increases
the risk of new disabilities, hospital readmissions, institutionalization, and death,
and also increases the likelihood of developing cognitive impairment.
3
In fact, hospital-acquired cognitive impairment is independently associated with
multiple adverse outcomes, including increased length of hospital stay, nursing home
admissions, and mortality.
4
Recent research indicates that physical exercise is a safe and effective strategy
to enhance physical performance and cognition in older adults admitted to an acute
care for the older unit.
5
,6
However, no studies have explored the physiological mechanisms underlying these improvements
with regard to brain and muscle function after an intra-hospital exercise program.
Functional near-infrared spectroscopy is a noninvasive technology that can measure
muscle and neural activation by assessing changes in oxygenated and deoxygenated hemoglobin
levels during the performance of a motor or cognitive task in a clinical practice
condition.
7
Nevertheless, the findings across trials are inconsistent and it remains unclear
whether there is a specific pattern to the changes in hemodynamics according to age
and other determinants such as cognitive and functional status, and how these changes
should be interpreted.
7
Therefore, we aimed to examine the effects of an intra-hospital exercise program
on brain function, specifically the prefrontal cortex region, and also on muscle function
in hospitalized older patients, assessed by functional near-infrared spectroscopy
imaging.To read this article in full you will need to make a payment
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References
- Effects of exercise interventions on the functional status of acutely hospitalised older adults: A systematic review and meta-analysis.Ageing Res Rev. 2020; (61101076)
- Iatrogenic nosocomial disability diagnosis and prevention.J Am Med Dir Assoc. 2016; 17: 762-764
- Association between acute care and critical illness hospitalization and cognitive function in older adults.JAMA. 2010; 303: 763-770
- The six-item cognitive impairment test is associated with adverse outcomes in acutely hospitalized older patients: a prospective cohort study.Dement Geriatr Cogn Disord Extra. 2018; 8: 259-267
- Assessing the impact of physical exercise on cognitive function in older medical patients during acute hospitalization: Secondary analysis of a randomized trial.PLoS Med. 2019; 16: e1002852
- Effect of exercise intervention on functional decline in very elderly patients during acute hospitalization: A randomized clinical trial.JAMA Intern Med. 2019; 179: 28-36
- Functional near-infrared spectroscopy to study cerebral hemodynamics in older adults during cognitive and motor tasks: A review.Front Aging Neurosci. 2019; 11: 367
- Multicomponent physical exercise program VIVIFRAIL.(Available at:) (2017. Accessed September 20, 2020)
- A new method to detect cerebral blood flow waveform in synchrony with chest compression by near-infrared spectroscopy during CPR.Am J Emerg Med. 2013; 31: 1504-1508
- Association of hospitalization, critical illness, and infection with brain structure in older adults.J Am Geriatr Soc. 2018; 66: 1919-1926
Article info
Publication history
Published online: January 21, 2021
Footnotes
The authors declare no conflict of interest.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
