10 days in a hospital bed leads to 10 years’ worth of lost muscle mass in people over age 80

Dan Thomas is an ST6 working in Liverpool. He is the BGS Clinical Quality Group Trainee Rep and the Deputy Media Editor. He tweets @dan26wales

‘10 days in a hospital bed leads to 10 years’ worth of lost muscle mass in people over age 80’

I have lost count of the number of times I have quoted this fact, I use it when teaching on frailty, and I have used it when assessing people in the emergency department to explain the risks of hospital induced deconditioning. I regularly hear other Geriatricians use this fact. It is emblazoned across much of the #EndPJParalysis material, and is quoted (unreferenced) on the NHS improvement website.

Autumn Speaker Series: Exercise during periods of decompensation. What is the current evidence?

Stephen Lim is a Clinical Research Fellow and a Specialist Registrar in Geriatric Medicine in Academic Geriatric Medicine at the University of Southampton. His research interest is in physical activity and deconditioning in hospital. He will be speaking at the upcoming BGS Autumn Meeting in London. He tweets at @StephenERLim

Hospital-associated deconditioning is high on the agenda across hospitals in the UK and many hospital trusts have jumped on the ‘endPJparalysis’ bandwagon to encourage patients to get up and get moving, – and rightly so! It is encouraging to see that healthcare professionals and non-clinical staff members are increasingly aware that prolonged bedrest and immobility is bad medicine.

During an acute illness, older people are at risk of worsening sarcopenia and consequently a decline in physical function. The hospital environment, altered mental state, physiological stresses and poor nutrition (as a sequelae of the acute illness), are some of the important risk factors contributing to a loss of function.

Sit up, Get Dressed, Keep Moving: Deconditioning Syndrome Awareness and Prevention Campaign: why is everyone talking about it?

Dr Amit Arora is a consultant geriatrician at the University Hospital of North Midlands and has served as Chairman of England Council of the British Geriatrics Society. He and his team have developed the campaign “Sit up, Get Dressed, Keep Moving” which is being adopted in many NHS hospitals and abroad.

In David Mitchell’s recent article “‘Get Out of Bed!’ scheme is more symptom than solution for the NHS” which was published on the Guardian website he appreciates the simplicity and value of the campaign but questions whether the campaign is financially motivated.

I congratulate and thank Mitchell for raising awareness about benefits of early functional normalisation: “The Principle that people who have been hospitalized should re-start normal life as soon as they can is already well established”. He further writes that “it’s suspicious that a campaign exclusively pushing the idea of getting up and going home should coincide so precisely with the NHS’s dire shortage of money.”  I would like to detail how the campaign started and how it is free from any ‘spin’.