Prominent physical inactivity in acute dementia care: Psychopathology seems to be more important than the dose of sedative medication

• Published in: International journal of geriatric psychiatry 2019-02, Vol.34 (2), p.308-314
• Main Authors: Fleiner, Tim, Gersie, Marleen, Ghosh, Sayantan, Mellone, Sabato, Zijlstra, Wiebren, Haussermann, Peter
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anesthesia; Antipsychotic Agents - therapeutic use; Antipsychotics; Benzodiazepines; Benzodiazepines - therapeutic use; body‐worn motion sensors; Cross-Sectional Studies; Data processing; Dementia; Dementia - drug therapy; Dementia - physiopathology; Dementia - psychology; Dementia disorders; Diazepam; Emotional behavior; Exercise; Exercise - physiology; Exercise - psychology; Female; Geriatric psychiatry; Health risk assessment; hospital dementia care; Humans; Hypnotics and Sedatives - therapeutic use; Male; Motor Activity - physiology; Olanzapine; Physical activity; Psychopathology; Psychotropic drugs; Sedentary Behavior; Walking
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.5021

Introduction To objectively quantify patients' physical activity and analyze the relationships between physical activity levels, psychopathology, and sedative medication in acute hospital dementia care. Materials and Methods In this cross‐sectional study, we assessed the patients' physical activity based on data collection by hybrid motion sensors attached on their lower back. Daily doses of antipsychotics have been converted to olanzapine‐equivalents and daily benzodiazepine medication is reported as diazepam‐equivalents. We assessed patients' neuropsychiatric symptoms with the Neuropsychiatric Inventory and the Cohen‐Mansfield Agitation Inventory. Results We analyzed motion sensor data from 64 patients (MMSE M = 18.6). On average, patients were lying for 11.5 hours, sitting/standing sedentary for 10.3 hours, sitting/standing active for 1.0 hours, and walking for 1.2 hours per day. The analysis revealed no correlations between patients' physical activity and antipsychotic or benzodiazepine medication. More severe neuropsychiatric symptoms were associated with a decrease in the patients' physical activity (r = .32, P = .01). In particular, patients with apathy symptoms were less physically active than patients without apathy symptoms. Discussion The results reveal that most of the patients in acute dementia care had very low levels of physical activity. Their physical inactivity may be due to the severity of their neuropsychiatric symptoms, especially apathy. Antipsychotic and benzodiazepine medication appeared to have less impact on patients' physical activity. Dementia care should pay more attention to prevent physical inactivity in patients.