Experts at the American Geriatrics Society (AGS) today unveiled a list of recommendations to help health systems prioritize a vital function for us all as we age: mobility.
Experts at the American Geriatrics Society (AGS) today unveiled a list of recommendations to help health systems prioritize a vital function for us all as we age: mobility. Mobility refers to our ability to move freely and easily (on our own or with assistance).
Published today in the Journal of the American Geriatrics Society (JAGS), the AGS white paper focuses on assessing mobility for hospitalized older adults, offering a roadmap for shifting health care's focus away from negative markers of mobility loss and toward a deeper appreciation of ways mobility can be proactively assessed and often preserved to promote high-quality, person-centered care.
"Being able to maintain mobility is a top priority for many older adults facing a hospital stay," said Heidi Wald, MD, Vice President for Clinical Performance and Interim Vice President for Quality and Safety at SCL Health in Colorado and one of the lead authors on the AGS white paper.
"So it is surprising that mobility still is not a widely recognized outcome when we look at the quality of care. With this new summary of research and recommendations, we hope will move our health system toward assessing mobility more appropriately and ideally preventing mobility loss as we age," said Wald.
A hospital stay
Most people already lose muscle strength and mass as they age, for example, but hospitalized older adults can lose up to 10% of their muscle strength per week of bed rest during a hospital stay.
More than a third of hospital patients over age 70 is discharged with a major disability that was not present before their admission, with many also experiencing increased hospital stays and poorer abilities to perform the activities of daily living due in part to mobility loss.
While the loss of mobility is common as we age, AGS experts note that nothing is commonplace about the impact of this trend on overall well-being.
"Mobility loss is critical in what we call the 'cascade' to dependence—a slippery slope that can start with small declines in movement but can ultimately lead to falls, further hospitalizations, and a general loss of independence," Dr. Wald observed.
"Thankfully, there are ways we can prevent and perhaps even reverse that cascade—but that means doing more to assess and address mobility in a coordinated fashion," Dr. Wald observed.
In their new white paper, representatives from the AGS Quality and Performance Measurement Committee reviewed existing research on mobility loss during hospitalization, including the implications of low mobility, the current state of mobility assessment, and ways we can use new and existing tools to promote routine evaluation of how well mobility is preserved following hospital stays.
While standardized programs across all hospitals may be difficult to develop, the AGS expert panel arrived at seven recommendations they believe leverage the best existing science in effective ways for the whole of our national health system.
Recommendation 1: Promote mobility assessment in acute care.
Recommendation 2: Advocate for more research funding.
Recommendation 3: Develop consensus on standard methods to assess mobility.
Recommendation 4: Minimize the burden of mobility measurement.
Recommendation 5: Evaluate the feasibility of a mobility quality measure.
Recommendation 6: Reframe the current regulatory focus on falls in acute care to a focus on safe mobility.
Recommendation 7: Develop resources for acute-care providers.