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

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 11.5h, sitting/standing sedentary for 10.3h, sitting/standing active for 1.0h and walking for 1.2h 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.