Handgrip strength shows no improvements in geriatric patients with persistent inflammation during hospitalization.

PURPOSE: Hospital-associated deconditioning due to a combination of illness and inactivity is a serious problem for elderly adults. Here we investigate whether persistence in inflammatory status affects changes in physical function during short-term hospitalization.

METHODS: This was a prospective observational study in elderly medical patients at a geriatric department. Measurements were obtained at admission and one week after admission and included de Morton Mobility Index (DEMMI) test, 30-second chair stand test (30-s CST), 4-m gait speed (4-m GST) test, handgrip strength, activity levels determined with ActivPALs, and concentrations of circulating C-reactive protein (CRP) from blood samples. Only patients with inflammation (C-reactive protein levels ≥10mg·L-1 ) at admission were included in this study. They were divided into those with continued inflammation (CI: CRP remained ≥10mg·L-1 ) and those that became non-inflammatory (BN: CRP decreased to <10mg·L-1 ) after one week of admission.

RESULTS: On admission 214 patients (67% female) with a median (IQR) age of 86 (81-91) years were categorized as inflammatory. There were no baseline differences in physical function between CI (n=138, 67% female) and BN (n=76, 68% female). DEMMI-score increased similarly in both groups (P<0.05). When normalized to days between tests, only changes in handgrip strength were significantly different between the CI- and BN-group (-0.05 [-0.27-0.28] vs. 0.16 [-0.10-0.41] kg·day-1 , respectively, P<0.01). There was a positive association between changes in CRP and length of hospital stay (rs =0.30, P<0.001).

CONCLUSION: Hospitalized geriatric patients admitted with inflammation showed only moderate improvement of general mobility during hospital stay, regardless of changes in their inflammatory status. However, handgrip strength increased only in those patients who became non-inflammatory during hospitalization.