For older patients, hospital admission is a significant risk factor for functional decline and loss of independence. It has been known for over 20 years that nearly 20% of older adults who were previously able to self-mobilize were no longer able to walk without assistance at discharge from medicine units. Many complications of bedrest occur and can be significantly deleterious, including loss of muscle mass, increased fall risk, atelectasis with subsequent pneumonia and respiratory failure, pressure ulcers, delirium, venous thrombo-embolism, prolonged hospital stay and increased risk of institutionalization. Several programs which increase mobility in inpatients- including Acute Care of the Elderly (ACE) units, Enhanced Recovery After Surgery (ERAS), Mobilization of Vulnerable Elders (MOVE) and the Hospital Elder Life Program (HELP)- have proved able of reducing Hospital-associated disability (HAD). Early mobilization (occurring in the first 24 hours) and importantly three times each day is the key-point that has come out of these programs. The introduction of an exercise program for acutely hospitalized elderly medical patients showed meaningful improvements not only at discharge but also after 1-year follow-up. Comprehensive geriatric assessment in hospitalized elderly patients can not be separated from increasing mobility with nursing and patient’s family help.

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