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Haeger C, Mümken SA, Spang RP, Brauer M, Voigt-Antons JN, Gellert P. [What importance does outpatient care have for mobility in rural areas? Results from a GPS study among persons aged 75 and older]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024:10.1007/s00103-024-03917-2. [PMID: 38953972 DOI: 10.1007/s00103-024-03917-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/11/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Out-of-home mobility, defined as active and passive movement through external environments, is a resource for autonomy, quality of life, and self-realization in older age. Various factors influence out-of-home mobility, primarily studied in urban settings. The study aims to examine associated factors in a study population aged 75 and above in rural areas. METHODS Baseline data from the MOBILE trial involving 212 participants aged 75 and above and collected between June 2021 and October 2022 were analyzed. Out-of-home mobility was measured temporally as time out of home (TOH) and spatially as convex hull (CHull) using GPS over seven days. Mixed models considered outpatient care parameters as well as personal, social, and environmental factors along with covariates such as age and gender. RESULTS Participants in the MOBILE study (average age 81.5; SD: 4.1; 56.1% female) exhibited average out-of-home mobility of TOH: 319.3 min (SD: 196.3) and CHull: 41.3 (SD: 132.8). Significant associations were found for age (TOH: ß = -0.039, p < 0.001), social network (TOH: ß = 0.123, p < 0.001), living arrangement (CHull: ß = 0.689, p = 0.035), health literacy (CHull: ß = 0.077, p = 0.008), sidewalk quality (ß = 0.366, p = 0.003), green space ratio (TOH: ß = 0.005, p = 0.047), outpatient care utilization (TOH: ß = -0.637, p < 0.001, CHull: ß = 1.532; p = 0.025), and active driving (TOH: ß = -0.361, p = 0.004). DISCUSSION Previously known multifactorial associations related to objectively measured out-of-home mobility in old age could be confirmed in rural areas. Novel and relevant for research and practice is the significant correlation between out-of-home mobility and outpatient care utilization.
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Affiliation(s)
- Christine Haeger
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - Sandra A Mümken
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Robert P Spang
- Quality Usability Lab, Technische Universität Berlin, Berlin, Deutschland
- Center of Geographic Analyses, Harvard University, Cambridge, MA, USA
| | - Max Brauer
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | | | - Paul Gellert
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
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Sahoo DP, Sahoo SS, Nirala SK, Rath RS, Agarwal N, Panda M, Kakkar R, Pandey S, Singh CM, Joshi HS, Nath B. Validation of the Indian (Hindi) version of the life-space assessment scale among community-dwelling older adults: a multicentric cross-sectional study. BMC Geriatr 2024; 24:500. [PMID: 38844833 PMCID: PMC11157764 DOI: 10.1186/s12877-024-05072-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 05/13/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The Life-Space Assessment (LSA) is an instrument that measures mobility in older adults as they reach different areas, defined as life-spaces extending from home to beyond towns or regions. The purpose of the study was to develop the Hindi version of the LSA (LSA- H) and to investigate the validity and reliability of the Hindi version as well as its cultural adaptation. METHODS A cross-sectional study of two hundred forty-five older adults participated in the study from four different study practice areas. Following forward backwards translation, the LSA-H was developed, and the scores were correlated with those of the Activities-Specific Balance Confidence Scale Hindi (ABC- H), the Physical Health Subscale of the WHO-BREF Questionnaire and the Geriatric Depression Scale: Short Form Hindi (GDS-SFH) to test the criterion and concurrent validity. RESULTS The mean score and standard deviation of the LSA-H questionnaire were 56.53 ± 35.99, those of the Physical Health Subscale of the WHO-BREF instrument were 18.54 ± 7.87, those of the GDS-SFH questionnaire were 6.95 ± 4.21 and those of the ABC- H questionnaire were 54.40 ± 28.96. The Pearson correlation coefficient (r) between the LSA-H score and ABC-H score was 0.707 (p value < 0.0001), that between the LSA-H score and the Physical Health Subscale of the WHO-BREF was 0.766 (p value < 0.0001), and that between the LSA-H score and GDS-SFG score was - 0.674 (p value < 0.0001). CONCLUSION This study demonstrated that the Hindi version of the LSA is a valid and reliable instrument for assessing living space among older adults in the Hindi language in an Indian population. Furthermore, the LSA-H was significantly correlated with other health assessment tools in terms of functional mobility, general health status and mental well-being.
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Affiliation(s)
- Durgesh Prasad Sahoo
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India.
| | - Soumya Swaroop Sahoo
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
| | - Santosh Kumar Nirala
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - Rama Shankar Rath
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Neeraj Agarwal
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India
| | - Meely Panda
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India
| | - Rakesh Kakkar
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
| | - Sanjay Pandey
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - C M Singh
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - Hari Shanker Joshi
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Bhola Nath
- Dept. of Community Medicine, All India Institute of Medical Sciences, Raebareli, India
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Ringsten M, Ivanic B, Iwarsson S, Lexell EM. Interventions to improve outdoor mobility among people living with disabilities: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1407. [PMID: 38882933 PMCID: PMC11177337 DOI: 10.1002/cl2.1407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 06/18/2024]
Abstract
Background Around 15% of the global population live with some form of disabilities and experience worse health outcomes, less participation in the community and are part of fewer activities outside the home. Outdoor mobility interventions aim to improve the ability to move, travel and orient outside the home and could influence the number of activities outside the home, participation and quality of life. However, outdoor mobility interventions may also lead to harm like falls or injuries or have unforeseen effects which could lead to mortality or hospitalization. Objectives To assess the efficacy of interventions aiming to improve outdoor mobility for adults living with disabilities and to explore if the efficacy varies between different conditions and different intervention components. Search Methods Standard, extensive Campbell search methods were used, including a total of 12 databases searched during January 2023, including trial registries. Selection Criteria Only randomized controlled trials were included, focusing on people living with disabilities, comparing interventions to improve outdoor mobility to control interventions as well as comparing different types of interventions to improve outdoor mobility. Data Collection and Analysis Standard methodological procedures expected by Campbell were used. The following important outcomes were 1. Activity outside the home; 2. Engagement in everyday life activities; 3. Participation; 4. Health-related Quality of Life; 5. Major harms; 6. Minor harms. The impact of the interventions was evaluated in the shorter (≤6 months) and longer term (≥7 months) after starting the intervention. Results are presented using risk ratios (RR), risk difference (RD), and standardized mean differences (SMD), with the associated confidence intervals (CI). The risk of bias 2-tool and the GRADE-framework were used to assess the certainty of the evidence. Main Results The screening comprised of 12.894 studies and included 22 studies involving 2.675 people living with disabilities and identified 12 ongoing studies. All reported outcomes except one (reported in one study, some concerns of bias) had overall high risk of bias. Thirteen studies were conducted in participants with disabilities due to stroke, five studies with older adults living with disabilities, two studies with wheelchair users, one study in participants with disabilities after a hip fracture, and one study in participants with cognitive impairments. Skill training interventions versus control interventions (16 studies) The evidence is very uncertain about the benefits and harms of skill training interventions versus control interventions not aimed to improve outdoor mobility among all people living with disabilities both in the shorter term (≤6 months) and longer term (≥7 months) for Activity outside the home; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. Skill training interventions may improve engagement in everyday life activities among people with disabilities in the shorter term (RR: 1.46; 95% CI: 1.16 to 1.84; I 2 = 7%; RD: 0.15; 95% CI: -0.02 to 0.32; I 2 = 71%; 692 participants; three studies; low certainty evidence), but the evidence is very uncertain in the longer term, based on very low certainty evidence. Subgroup analysis of skill training interventions among people living with disabilities due to cognitive impairments suggests that such interventions may improve activity outside the home in the shorter term (SMD: 0.44; 95% CI: 0.07 to 0.81; I 2 = NA; 118 participants; one study; low certainty evidence). Subgroup analysis of skill training interventions among people living with cognitive impairments suggests that such interventions may improve health-related quality of life in the shorter term (SMD: 0.49; 95% CI: 0.12 to 0.88; I 2 = NA; 118 participants; one study; low certainty evidence). Physical training interventions versus control interventions (five studies) The evidence is very uncertain about the benefits and harms of physical training interventions versus control interventions not aimed to improve outdoor mobility in the shorter term (≤6 months) and longer term (≥7 months) for: Engagement in everyday life activities; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. Physical training interventions may improve activity outside the home in the shorter (SMD: 0.35; 95% CI: 0.08 to 0.61; I 2 = NA; 228 participants; one study; low certainty evidence) and longer term (≥7 months) (SMD: 0.27; 95% CI: 0.00 to 0.54; I 2 = NA; 216 participants; one study; low certainty evidence). Comparison of different outdoor mobility interventions (one study) The evidence is very uncertain about the benefits and harms of outdoor mobility interventions of different lengths in the shorter term (≤6 months) and longer term (≥7 months) for Activity outside the home; Engagement in everyday life activities; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. No studies explored the efficacy of other types of interventions. Authors’ Conclusions Twenty-two studies of interventions to improve outdoor mobility for people living with disabilities were identified, but the evidence still remains uncertain about most benefits and harms of these interventions, both in the short- and long term. This is primarily related to risk of bias, small underpowered studies and limited reporting of important outcomes for people living with disabilities. For people with disabilities, skill training interventions may improve engagement in everyday life in the short term, and improve activity outside the home and health-related quality of life for people with cognitive impairments in the short term. Still, this is based on low certainty evidence from few studies and should be interpreted with caution. One study with low certainty evidence suggests that physical training interventions may improve activity outside the home in the short term. In addition, the effect sizes across all outcomes were considered small or trivial, and could be of limited relevance to people living with disabilities. The evidence is currently uncertain if there are interventions that can improve outdoor mobility for people with disabilities, and can improve other important outcomes, while avoiding harms. To guide decisions about the use of interventions to improve outdoor mobility, future studies should use more rigorous design and report important outcomes for people with disabilities to reduce the current uncertainty.
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Affiliation(s)
- Martin Ringsten
- Cochrane Sweden, Research and Development Skåne University Hospital Lund Sweden
- Department of Health Sciences Lund University Lund Sweden
| | | | | | - Eva Månsson Lexell
- Department of Health Sciences Lund University Lund Sweden
- Department of Neurology, Rehabilitation Medicine, Cognitive Medicine and Geriatrics Skåne University Hospital Lund-Malmö Sweden
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Rantakokko M, Matikainen-Tervola E, Aartolahti E, Sihvonen S, Chichaeva J, Finni T, Cronin N. Gait Features in Different Environments Contributing to Participation in Outdoor Activities in Old Age (GaitAge): Protocol for an Observational Cross-Sectional Study. JMIR Res Protoc 2024; 13:e52898. [PMID: 38684085 PMCID: PMC11091809 DOI: 10.2196/52898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/05/2024] [Accepted: 03/22/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The ability to walk is a key issue for independent old age. Optimizing older peoples' opportunities for an autonomous and active life and reducing health disparities requires a better understanding of how to support independent mobility in older people. With increasing age, changes in gait parameters such as step length and cadence are common and have been shown to increase the risk of mobility decline. However, gait assessments are typically based on laboratory measures, even though walking in a laboratory environment may be significantly different from walking in outdoor environments. OBJECTIVE This project will study alterations in biomechanical features of gait by comparing walking on a treadmill in a laboratory, level outdoor, and hilly outdoor environments. In addition, we will study the possible contribution of changes in gait between these environments to outdoor mobility among older people. METHODS Participants of the study were recruited through senior organizations of Central Finland and the University of the Third Age, Jyväskylä. Inclusion criteria were community-dwelling, aged 70 years and older, able to walk at least 1 km without assistive devices, able to communicate, and living in central Finland. Exclusion criteria were the use of mobility devices, severe sensory deficit (vision and hearing), memory impairment (Mini-Mental State Examination ≤23), and neurological conditions (eg, stroke, Parkinson disease, and multiple sclerosis). The study protocol included 2 research visits. First, indoor measurements were conducted, including interviews (participation, health, and demographics), physical performance tests (short physical performance battery and Timed Up and Go), and motion analysis on a treadmill in the laboratory (3D Vicon and next-generation inertial measurement units [NGIMUs]). Second, outdoor walking tests were conducted, including walking on level (sports track) and hilly (uphill and downhill) terrain, while movement was monitored via NGIMUs, pressure insoles, heart rate, and video data. RESULTS A total of 40 people (n=26, 65% women; mean age 76.3, SD 5.45 years) met the inclusion criteria and took part in the study. Data collection took place between May and September 2022. The first result is expected to be published in the spring of 2024. CONCLUSIONS This multidisciplinary study will provide new scientific knowledge about how gait biomechanics are altered in varied environments, and how this influences opportunities to participate in outdoor activities for older people. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/52898.
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Affiliation(s)
- Merja Rantakokko
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
- The Wellbeing Services County of Central Finland, Jyväskylä, Finland
- Institute of Rehabilitation, JAMK University of Applied Sciences, Jyväskylä, Finland
| | | | - Eeva Aartolahti
- Institute of Rehabilitation, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Sanna Sihvonen
- Institute of Rehabilitation, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Julija Chichaeva
- Institute of Rehabilitation, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Taija Finni
- Faculty of Sport and Health Sciences, Neuromuscular Research Centre, University of Jyväskylä, Jyväskylä, Finland
| | - Neil Cronin
- Faculty of Sport and Health Sciences, Neuromuscular Research Centre, University of Jyväskylä, Jyväskylä, Finland
- School of Sport and Exercise, University of Gloucestershire, Gloucester, United Kingdom
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Lindeman K, Karavirta L, Koivunen K, Keskinen KE, Eronen J, Portegijs E, Rantanen T. Longitudinal changes in life-space mobility and autonomy in participation outdoors among Finnish community-dwelling older adults from pre-COVID-19 to through the pandemic. Aging Clin Exp Res 2024; 36:85. [PMID: 38558262 PMCID: PMC10984880 DOI: 10.1007/s40520-024-02734-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Among older people, community mobility was reduced at the beginning of the COVID-19 pandemic, but the longer-term changes are unclear. AIMS To study lower extremity performance and car driving as predictors of changes in older adults' life-space mobility, autonomy in participation outdoors, and the risk of developing restricted life-space mobility from 2017 to 2022. METHODS Life-space mobility (scoring range 0-120) and autonomy in participation outdoors (scoring range 0-20) were assessed in community-dwelling individuals (n = 657) in 2017-2018 (baseline age 75, 80, or 85 years), during the first wave of COVID-19 in 2020, and in 2021-2022. Lower extremity performance was assessed using the Short Physical Performance Battery, and car driving was self-reported at baseline. Data were analysed using generalized estimating equations and Cox regression. RESULTS During the first wave of COVID-19 in 2020, life-space mobility decreased on average by 10.3 (SD 21.6) points and partially recovered in 2021-2022 (+ 2.7, SD 21.8). The same pattern was observed for autonomy in participation outdoors. Non-drivers and those with impaired lower extremity performance had a 2.4-to-3.6-fold adjusted risk of developing restricted life-space mobility over the follow-up period compared to drivers with intact lower extremity performance. CONCLUSIONS For older people, the recovery of community mobility was incomplete after the restrictions stemming from the pandemic were lifted. Older adults with impaired lower extremity performance and who did not drive were particularly vulnerable to developing restricted life-space mobility, a situation that could lead to social isolation and reduced well-being.
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Affiliation(s)
- Katja Lindeman
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland.
| | - Laura Karavirta
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Kaisa Koivunen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Kirsi E Keskinen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Johanna Eronen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Erja Portegijs
- Center of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
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Mattila OP, Rantanen T, Rantakokko M, Karavirta L, Cronin N, Rantalainen T. Laboratory-assessed gait cycle entropy for classifying walking limitations among community-dwelling older adults. Exp Gerontol 2024; 188:112381. [PMID: 38382681 DOI: 10.1016/j.exger.2024.112381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 02/23/2024]
Abstract
Among older people, walking difficulty results from actual and perceived declines in physical capacities and environmental requirements for walking. We investigated whether the physiological complexity of the gait cycle covaries with experience of walking difficulty. Walking difficulty, gait speed, and gait cycle complexity were evaluated among 702 community-dwelling older people aged 75, 80, and 85 years who took part in the six-minute walking test in the research laboratory. Walking difficulty for 500 m was self-reported. Complexity was quantified as trunk acceleration multiscale entropy during the gait cycle. Complexity was then compared between those with no reported walking difficulty, walking with modifications but no difficulty, and those reporting walking difficulty. Higher entropy differentiated those reporting no difficulty walking from those reporting walking difficulties, while those reporting having modified their walking, but no difficulty formed an intermediate group that could not be clearly distinguished from the other categories. The higher complexity of the gait cycle is associated with slower gait speed and the presence of self-reported walking difficulty. Among older people, gait cycle complexity which primarily reflects the biomechanical dimensions of gait quality, could be a clinically meaningful measure reflecting specific features of the progression of walking decline. This encourages further investigation of the sensitivity of gait cycle complexity to detect early signs of gait deterioration and to support targeted interventions among older people.
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Affiliation(s)
- Olli-Pekka Mattila
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland.
| | - Taina Rantanen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland.
| | - Merja Rantakokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland; Wellbeing Services County of Central Finlad, Finland.
| | - Laura Karavirta
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland.
| | - Neil Cronin
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland.
| | - Timo Rantalainen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland.
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Batool SS, Tanveer S, Chatrath SK, Batool SA. Biopsychosocial determinant of quality of life of older adults in Pakistan and Canada. Front Psychiatry 2024; 15:1364443. [PMID: 38528977 PMCID: PMC10961405 DOI: 10.3389/fpsyt.2024.1364443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/16/2024] [Indexed: 03/27/2024] Open
Abstract
Background The rapidly rising average age of the older adults has brought various global healthcare challenges. A core challenge is how to enhance their quality of life (QoL). Objective The objective of the current study was to test the significance of biopsychosocial determinants of quality of life of older adults in Pakistan and Canada. Methodology A cross-sectional survey was carried out on a conveniently approached purposive sample of 1,005 older adults (Pakistani = 557 and Canadian = 448) of age range between 60 years and 80 years. The data were collected via demographic datasheet, World Health Organization Quality of Life Brief Scale, Health and Lifestyle Questionnaire, General Self-Efficacy Scale, Rosenberg Self-Esteem Scale, and Berlin Social Support Scale. Results The results of hierarchical regression analysis showed that biopsychosocial factors (viz., health and lifestyle, chronic illness, self-efficacy, self-esteem, and social support) significantly predicted (R 2 = .27, and.68) quality of life of older adults in Pakistan and Canada, respectively, after controlling the demographic variables. Significant differences were found between Pakistani and Canadian older adults on biopsychosocial factors: Canadian older adults scored significantly higher on health and lifestyle, self-efficacy, and quality of life, and older adults in Pakistan scored significantly higher on self-esteem and social support. Conclusion A significant amount of better QoL of older adults can be achieved through enhancing the biopsychosocial correlates of their QoL, both in Pakistan and Canada.
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Affiliation(s)
| | - Samra Tanveer
- Department of Psychology, Government College University, Lahore, Pakistan
| | | | - Syeda Azra Batool
- School of Economics, Bahauddin Zakariya University, Multan, Pakistan
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Bevilacqua G, D'Angelo S, Westbury LD, Harvey NC, Dennison EM. Musculoskeletal health and life-space mobility in older adults: Findings from the Hertfordshire Cohort Study. Health Place 2024; 86:103184. [PMID: 38295757 DOI: 10.1016/j.healthplace.2024.103184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/29/2024]
Abstract
This study explores the relationship between musculoskeletal conditions of ageing and life-space mobility (LSM) in 1110 community-dwelling older adults from the Hertfordshire Cohort Study. LSM is a novel measure which captures ability to mobilise within the home, locally and more widely. Among men, older age, care receipt, not driving a car, lower wellbeing, and reduced physical function were associated with lower LSM, while in women only driving status and physical function were associated with LSM. Osteoporosis, arthritis, and fractures had no significant associations with LSM in either gender. These findings provide support for sex-specificity in the determinants of LSM and inform novel approaches to improving mobility and health in older age.
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Affiliation(s)
- Gregorio Bevilacqua
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Stefania D'Angelo
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Leo D Westbury
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Nicholas C Harvey
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK; National Institute for Health and Care Research (NIHR), Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
| | - Elaine M Dennison
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK; National Institute for Health and Care Research (NIHR), Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK; School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand.
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Liu S, Rosso AL, Baillargeon EM, Weinstein AM, Rosano C, Torres-Oviedo G. Novel attentional gait index reveals a cognitive ability-related decline in gait automaticity during dual-task walking. Front Aging Neurosci 2024; 15:1283376. [PMID: 38274986 PMCID: PMC10808635 DOI: 10.3389/fnagi.2023.1283376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Gait automaticity refers to the ability to walk with minimal recruitment of attentional networks typically mediated through the prefrontal cortex (PFC). Reduced gait automaticity (i.e., greater use of attentional resources during walking) is common with aging, contributing to an increased risk of falls and reduced quality of life. A common assessment of gait automaticity involves examining PFC activation using near-infrared spectroscopy (fNIRS) during dual-task (DT) paradigms, such as walking while performing a cognitive task. However, neither PFC activity nor task performance in isolation measures automaticity accurately. For example, greater PFC activation could be interpreted as worse gait automaticity when accompanied by poorer DT performance, but when accompanied by better DT performance, it could be seen as successful compensation. Thus, there is a need to incorporate behavioral performance and PFC measurements for a more comprehensive evaluation of gait automaticity. To address this need, we propose a novel attentional gait index as an analytical approach that combines changes in PFC activity with changes in DT performance to quantify automaticity, where a reduction in automaticity will be reflected as an increased need for attentional gait control (i.e., larger index). Methods The index was validated in 173 participants (≥65 y/o) who completed DTs with two levels of difficulty while PFC activation was recorded with fNIRS. The two DTs consisted of reciting every other letter of the alphabet while walking over either an even or uneven surface. Results As DT difficulty increases, more participants showed the anticipated increase in the attentional control of gait (i.e., less automaticity) as measured by the novel index compared to PFC activation. Furthermore, when comparing across individuals, lower cognitive function was related to higher attentional gait index, but not PFC activation or DT performance. Conclusion The proposed index better quantified the differences in attentional control of gait between tasks and individuals by providing a unified measure that includes both brain activation and performance. This new approach opens exciting possibilities to assess participant-specific deficits and compare rehabilitation outcomes from gait automaticity interventions.
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Affiliation(s)
- Shuqi Liu
- Sensorimotor Learning Laboratory, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
| | - Andrea L. Rosso
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Emma M. Baillargeon
- Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrea M. Weinstein
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Caterina Rosano
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Gelsy Torres-Oviedo
- Sensorimotor Learning Laboratory, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
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10
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Taylor RA, Bakitas M, Wells R, Dionne‐Odom JN, Kennedy R, Williams GR, Frank J, Li P. Restricted life-space mobility impacts physical but not mental quality of life in older cancer survivors. Cancer Med 2023; 13:e6850. [PMID: 38140781 PMCID: PMC10807608 DOI: 10.1002/cam4.6850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/04/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Older cancer survivors often value quality of life (QOL) over survival. Life-space mobility (LSM), defined as the individual's spatial geographic mobility range, is an important QOL indicator in older adults with chronic illnesses; however, this relationship is unexplored in older cancer survivors. METHODS We examined the longitudinal associations and causal relationships between LSM and QOL in 153 older cancer survivors (≥65 years) from the University of Alabama at Birmingham (UAB) Study of Aging. LSM was assessed using the UAB Life-Space Assessment-Composite score (LSA-C), and QOL was assessed by the SF-12 Mental Component Score (MCS12) and Physical Component Score (PCS12) at 0 (study entry), 6, 18, 36, 54, and 72 months. We examined the causal relationship between LSM and QOL using a cross-lagged panel model (CLPM). RESULTS The cohort (n = 153) was 76 years old on average and predominantly White (58%), female (58%), and married (55%). Longitudinal analyses found LSM decreased over time (p < 0.0001), and this decrease was associated with decreased QOL (PCS12, p < 0.0001, MCS12, p < 0.0001). In the CLPM causal analysis, lower LSM resulted in worse PCS12 (p < 0.001), but not worse MSC12. CONCLUSIONS Restricted LSM resulted in worse physical QOL over 72 months in a sample of 153 older cancer survivors. Developing and evaluating interventions to preserve greater LSM could be a promising approach to improving QOL.
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Affiliation(s)
- Richard A. Taylor
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Marie Bakitas
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Rachel Wells
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - J. Nicholas Dionne‐Odom
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of Medicine—Division of Gerontology, Geriatrics, and Palliative CareUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Richard Kennedy
- Department of Medicine—Division of Gerontology, Geriatrics, and Palliative CareUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Grant R. Williams
- Department of Medicine—Division of Hematology & OncologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Jennifer Frank
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Peng Li
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
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11
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Eliassen M, Sørensen BA, Hartviksen TA, Holm S, Zingmark M. Emplacing reablement co-creating an outdoor recreation model in the rural Arctic. Int J Circumpolar Health 2023; 82:2273013. [PMID: 37883476 PMCID: PMC10997308 DOI: 10.1080/22423982.2023.2273013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
Reablement aims to enable older persons with functional decline to re-engage in meaningful activities. The benefits of engagement in outdoor activities are significant; however, reablement services primarily target function in indoor environments whereas descriptions of outdoor activities are sparse. The aim of this study was to create a model that integrates outdoor recreation into reablement. We therefore elaborated on an experienced based co-design methodology to create a model that integrates outdoor recreation for older persons in reablement in an Arctic, rural context in northern Norway. Stakeholders (N = 35), including reablement participants, participated in workshops, focus groups, and individual interviews. Based on the results, we co-created a person-centred model for outdoor recreation in reablement, including an assessment tool that can guide reablement staff in goal-setting practices. Accordingly, we argue that cherished locations holds significant meaning in the lives of older people and warrant recognition in reablement programmes. There is a need to evaluate the effects and feasibility of the model and the possibility for its implementation in other health care settings.
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Affiliation(s)
- Marianne Eliassen
- Department of Health and Care Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Bodil A. Sørensen
- Department of Research, Development and Innovation, Municipality of Vestvågøy. Postboks 203, Leknes, Norway
| | - Trude A. Hartviksen
- Department of Health and Care Sciences, UiT, The Arctic University of Norway, Municipality of Vestvågøy. Postboks 203, Leknes, Norway
| | - Solrun Holm
- Department of Research, Development and Innovation, Municipality of Vestvågøy. Postboks 203, Leknes, Norway
| | - Magnus Zingmark
- Department of Epidemiology and Global Health, Faculty of medicine, Umeå University, Umeå, Sweden
- Health and Social Care administration, Municipality of Östersund, Health and Social Care Administration, Östersund, Sweden
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12
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Wang GM, Teng MY, Yu WJ, Ren H, Cui XS. Life-space mobility among community-dwelling older persons: A scoping review. Geriatr Nurs 2023; 54:108-117. [PMID: 37722235 DOI: 10.1016/j.gerinurse.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/24/2023] [Accepted: 08/24/2023] [Indexed: 09/20/2023]
Abstract
To describe and analyze the current research status of life-space mobility of the older persons in community. The literature in PubMed, Web of Science, Cochrane Library, Embase, EBSCOhost, Scopus, OpenGrey, SinoMed, CNKI, WanFang, and VIP databases was computer searched, and the time frame was build to May 23, 2023. A total of 42 literatures were included, including 35 in English and 7 in Chinese, 30 of which were cross-sectional studies. Theoretical models related to spatial mobility included the "concentric circles" model and the "cone" model. 33 literatures reported the prevalence or level of spatial mobility limitations, and 9 assessment instruments were used, The influencing factors can be divided into four categories. 9 literatures reported on the adverse effects, and 9 literatures reported on the prevention and intervention. The limitation of life-space mobility is a common and under-recognized phenomenon among the older persons in the community,with serious adverse effects, complex and diverse influencing factors.
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Affiliation(s)
- Gui-Meng Wang
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China
| | - Meng-Yuan Teng
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China
| | - Wen-Jing Yu
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China
| | - Hui Ren
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China
| | - Xiang-Shu Cui
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China.
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13
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Alghofaili AA, Aladel AI, Alsoghier AM, Othman F, Shoqeair MM, Alqahtani SM, Alnughaimish AM, Alanazi BA, AI Mosallam SA, Alharbi AS, Alquraishi M. Association of Oral and General Health with Nutritional Status of Older Adults Attending Two Medical Centers in Riyadh, Saudi Arabia: A Cross-Sectional Study. Nutrients 2023; 15:4032. [PMID: 37764815 PMCID: PMC10534773 DOI: 10.3390/nu15184032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/06/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Malnutrition could profoundly affect older adults' oral health and quality of life, whereas oral health might, in turn, impact dietary intake and nutritional status. The present study aimed to investigate the association between general and oral health and nutritional status among older adults attending nutrition clinics at two main medical centers in Riyadh, Saudi Arabia. A cross-section study was carried out among adult patients (≥60 years) who attended a geriatric clinic or nutrition clinic at King Khalid University Hospital or King Abdulaziz Medical City, Riyadh. A validated clinician's Mini Nutritional Assessment Short-Form (MNA-SF), Oral Health Impact Profile-5 (OHIP-5), and 36-Item Short Form Survey (SF-36) were collected from each participant. A total of 261 participants with a mean age of 72.14 (±8.97) years were recruited. Diabetes (71%) and hypertension (80%) were present in the majority of patients. The overall MNA-SF score was (10 ± 3). Based on the categorization of the MNA-SF score, 65.9% were classified as malnourished or at risk of malnutrition. Participants with OHIP-5 scores higher than the median (>5) were more likely to be malnourished than those with scores at or lower than 5 (p < 0). The adjusted odd ratio for the MNA-SF score categories indicated that for a one-unit increase in the total SF-36 score, the odds of the malnourished category are 0.94 times less than the risk of malnutrition and normal nutritional status, with OR 0.97 (95% CI 0.94-0.95). Malnutrition or being at risk of malnutrition is likely associated with poor general and oral health. Healthcare providers need to incorporate dietitians into care plans to promote the nutritional health of older adults.
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Affiliation(s)
- Alghaliyah A. Alghofaili
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia or (A.A.A.); (B.A.A.); (S.A.A.M.); (M.A.)
| | - Alanoud I. Aladel
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia or (A.A.A.); (B.A.A.); (S.A.A.M.); (M.A.)
| | - Abdullah M. Alsoghier
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Fatmah Othman
- Epidemiology and Biostatistics Department, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 11426, Saudi Arabia;
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
| | - Mustafa M. Shoqeair
- Department of Clinical Nutrition, King Khalid University Hospital (KKUH), Riyadh 12372, Saudi Arabia (S.M.A.); (A.M.A.); (A.S.A.)
| | - Saud M. Alqahtani
- Department of Clinical Nutrition, King Khalid University Hospital (KKUH), Riyadh 12372, Saudi Arabia (S.M.A.); (A.M.A.); (A.S.A.)
| | - Ali M. Alnughaimish
- Department of Clinical Nutrition, King Khalid University Hospital (KKUH), Riyadh 12372, Saudi Arabia (S.M.A.); (A.M.A.); (A.S.A.)
| | - Badryh A. Alanazi
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia or (A.A.A.); (B.A.A.); (S.A.A.M.); (M.A.)
| | - Sara A. AI Mosallam
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia or (A.A.A.); (B.A.A.); (S.A.A.M.); (M.A.)
| | - Azzam S. Alharbi
- Department of Clinical Nutrition, King Khalid University Hospital (KKUH), Riyadh 12372, Saudi Arabia (S.M.A.); (A.M.A.); (A.S.A.)
| | - Mohammed Alquraishi
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia or (A.A.A.); (B.A.A.); (S.A.A.M.); (M.A.)
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14
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Maresova P, Krejcar O, Maskuriy R, Bakar NAA, Selamat A, Truhlarova Z, Horak J, Joukl M, Vítkova L. Challenges and opportunity in mobility among older adults - key determinant identification. BMC Geriatr 2023; 23:447. [PMID: 37474928 PMCID: PMC10360303 DOI: 10.1186/s12877-023-04106-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Attention is focused on the health and physical fitness of older adults due to their increasing age. Maintaining physical abilities, including safe walking and movement, significantly contributes to the perception of health in old age. One of the early signs of declining fitness in older adults is limited mobility. Approximately one third of 70-year-olds and most 80-year-olds report restrictions on mobility in their apartments and immediate surroundings. Restriction or loss of mobility is a complex multifactorial process, which makes older adults prone to falls, injuries, and hospitalizations and worsens their quality of life while increasing overall mortality. OBJECTIVE The objective of the study is to identify the factors that have had a significant impact on mobility in recent years and currently, and to identify gaps in our understanding of these factors. The study aims to highlight areas where further research is needed and where new and effective solutions are required. METHODS The PRISMA methodology was used to conduct a scoping review in the Scopus and Web of Science databases. Papers published from 2007 to 2021 were searched in November 2021. Of these, 52 papers were selected from the initial 788 outputs for the final analysis. RESULTS The final selected papers were analyzed, and the key determinants were found to be environmental, physical, cognitive, and psychosocial, which confirms the findings of previous studies. One new determinant is technological. New and effective solutions lie in understanding the interactions between different determinants of mobility, addressing environmental factors, and exploring opportunities in the context of emerging technologies, such as the integration of smart home technologies, design of accessible and age-friendly public spaces, development of policies and regulations, and exploration of innovative financing models to support the integration of assistive technologies into the lives of seniors. CONCLUSION For an effective and comprehensive solution to support senior mobility, the determinants cannot be solved separately. Physical, cognitive, psychosocial, and technological determinants can often be perceived as the cause/motivation for mobility. Further research on these determinants can help to arrive at solutions for environmental determinants, which, in turn, will help improve mobility. Future studies should investigate financial aspects, especially since many technological solutions are expensive and not commonly available, which limits their use.
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Affiliation(s)
- Petra Maresova
- Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
| | - Ondrej Krejcar
- Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic.
- Malaysia-Japan International Institute of Technology, Universiti Teknologi Malaysia Kuala Lumpur, Jalan Sultan Yahya Petra, 54100, Kuala Lumpur, Malaysia.
| | | | | | - Ali Selamat
- Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
- Malaysia-Japan International Institute of Technology, Universiti Teknologi Malaysia Kuala Lumpur, Jalan Sultan Yahya Petra, 54100, Kuala Lumpur, Malaysia
| | - Zuzana Truhlarova
- Faculty of Education, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
| | - Jiri Horak
- Faculty of Mining and Geology, VSB-Technical University of Ostrava, 17. Listopadu 2172/15, Ostrava-Poruba, 708 00, Czech Republic
| | - Miroslav Joukl
- Philosophical Faculty, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
| | - Lucie Vítkova
- Philosophical Faculty, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
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15
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Seinsche J, Jansen CP, Roth S, Zijlstra W, Hinrichs T, Giannouli E. Multidimensional interventions to increase life-space mobility in older adults ranging from nursing home residents to community-dwelling: a systematic scoping review. BMC Geriatr 2023; 23:412. [PMID: 37415132 PMCID: PMC10327334 DOI: 10.1186/s12877-023-04118-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 06/19/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Life-space mobility (LSM) is an important aspect of older adults' real-life mobility. Studies have shown that restricted LSM is a risk factor for many adverse outcomes such as low quality of life and mortality. Therefore, an increasing number of interventions aim to enhance LSM. However, the intervention approaches differ in terms of their type/content, duration, targeted populations, but also in terms of their outcome measures and assessment tools. Especially the latter impairs the comparability of studies with otherwise similar interventional approaches and thus also the interpretation of their results. Therefore, this systematic scoping review aims to provide an overview of the intervention components, assessment tools, and effectiveness of studies aiming to improve LSM in older adults. METHODS A systematic literature search was carried out in PubMed and Web of Science. We considered studies in older adults of any design that included an intervention approach and at least one outcome of LSM. RESULTS 27 studies were included in the review. These studies analyzed healthy community-dwelling as well as frail older adults in need of care or rehabilitation and nursing home residents with a mean age between 64 and 89. The percentage of female participants ranged from 3 to 100%. The types of interventions were of the following: physical, counseling, multidimensional, miscellaneous. Multidimensional interventions consisting of physical interventions plus any of the following or a combination of counseling/education/motivation/information appear to be most effective in increasing LSM. Older adults with mobility impairments were more responsive to these multidimensional interventions compared to healthy older adults. Most of the studies used the questionnaire-based Life-Space Assessment to quantify LSM. CONCLUSIONS This systematic scoping review provides a comprehensive overview of a heterogenous stock of literature investigating LSM-related interventions in older adults. Future meta-analyses are needed to provide a quantitative evaluation of the effectiveness of LSM interventions and recommendations.
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Affiliation(s)
- Julia Seinsche
- Department of Health Sciences & Technology, Institute of Human Movement Sciences & Sport, ETH Zurich, Zurich, Switzerland
| | | | - Sandro Roth
- Division of Sports and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Basel, Switzerland
| | - Wiebren Zijlstra
- Institute of Movement & Sport Gerontology, German Sport University Cologne, Cologne, Germany
| | - Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Basel, Switzerland
| | - Eleftheria Giannouli
- Department of Health Sciences & Technology, Institute of Human Movement Sciences & Sport, ETH Zurich, Zurich, Switzerland
- Division of Sports and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Basel, Switzerland
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16
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Szewczenko A, Lach E, Bursiewicz N, Chuchnowska I, Widzisz-Pronobis S, Sanigórska M, Elsner K, Bal D, Sutor M, Włodarz J, Ober J. Urban Therapy-Urban Health Path as an Innovative Urban Function to Strengthen the Psycho-Physical Condition of the Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6081. [PMID: 37372668 DOI: 10.3390/ijerph20126081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/04/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023]
Abstract
The current approach to stimulating elderly physical activity mostly uses medical rehabilitation methods or popular forms of outdoor recreation. In the context of an ageing population, there is a growing demand for innovative rehabilitation methods that use information technology. In this article, we present the Urban Health Path as an innovative form of activation for older people using urban therapy, where the architectural elements, such as details, façade features, and urban furniture, inspire movement and attentiveness in the experience of space. The concept is supported by a mobile application that takes into account the specific preferences of older users. Our concept of the physical and cognitive activation of older people was the result of a user-centred design approach and it was tested as a prototype solution. At the same time, the aim of this article is to identify opportunities and limitations for the implementation of this type of solution in other urban spaces. The article presents the process of developing a solution using the Design Thinking method. The process was focused on the needs and preferences of older people. The results of the research project indicate the main important guidelines for implementing the Urban Health Path as a new form of urban facility in the city space.
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Affiliation(s)
- Anna Szewczenko
- Faculty of Architecture, Silesian University of Technology, Akademicka 7, 44-100 Gliwice, Poland
| | - Ewa Lach
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Natalia Bursiewicz
- Institute of History and Archival Studies, Pedagogical University of KEN, Podchorążych 2, 30-084 Cracow, Poland
| | - Iwona Chuchnowska
- Faculty of Biomedical Engineering, Silesian University of Technology, Roosvelta 40, 41-800 Zabrze, Poland
| | - Sylwia Widzisz-Pronobis
- Faculty of Architecture, Silesian University of Technology, Akademicka 7, 44-100 Gliwice, Poland
| | - Marta Sanigórska
- Faculty of Architecture, Silesian University of Technology, Akademicka 7, 44-100 Gliwice, Poland
| | - Klaudia Elsner
- Faculty of Architecture, Silesian University of Technology, Akademicka 7, 44-100 Gliwice, Poland
| | - Daria Bal
- Faculty of Architecture, Silesian University of Technology, Akademicka 7, 44-100 Gliwice, Poland
| | - Mateusz Sutor
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Jakub Włodarz
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Józef Ober
- Department of Applied Social Sciences, Faculty of Organization and Management, Silesian University of Technology, Roosevelta 26-8, 41-800 Zabrze, Poland
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Oliva A, West JS, Smith SL, Huang RJ, Riska KM. Association Between Hearing Handicap and Life-Space Mobility in a Patient Population. Am J Audiol 2023; 32:360-368. [PMID: 37059051 PMCID: PMC10468117 DOI: 10.1044/2023_aja-22-00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 10/07/2022] [Accepted: 01/21/2023] [Indexed: 04/16/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate the association between self-reported hearing handicap and life-space mobility utilizing the Life-Space Questionnaire (LSQ). Life-space mobility reflects how an individual moves through their daily physical and social environment, and the role of hearing loss in life-space mobility is not fully understood. We hypothesized that those with higher self-reported hearing handicap would be more likely to demonstrate restricted life-space mobility. METHOD A total of 189 older adults (M age = 75.76 years, SD = 5.81) completed a mail-in survey packet including the LSQ and Hearing Handicap Inventory for the Elderly (HHIE). Participants were categorized into one of three groups ("no/none," "mild/moderate," or "severe" hearing handicap) according to HHIE total score. LSQ responses were dichotomized to either "nonrestricted/typical" or "restricted" life-space mobility groups. Logistic regression models were performed to analyze life-space mobility differences among the groups. RESULTS Logistic regression results demonstrated no statistically significant association between hearing handicap and LSQ. CONCLUSIONS The results of this study indicate that there is no association between self-reported hearing handicap and life-space mobility as evaluated using a mail-in version of the LSQ. This counters other studies that have demonstrated that life space is associated with chronic illness, cognitive functioning, and social and health integration.
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Affiliation(s)
| | - Jessica S. West
- Duke Center for the Study of Aging and Human Development, Durham, NC
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Sherri L. Smith
- Department of Head & Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC
- Duke Center for the Study of Aging and Human Development, Durham, NC
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
- Durham Veterans Affairs Health Care System, NC
| | | | - Kristal M. Riska
- Department of Head & Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC
- Duke Center for the Study of Aging and Human Development, Durham, NC
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van Biljon HM, van Niekerk L, Plastow NA, Swanepoel L. Out-of-home life spaces valued by urban older adults with limited income. Afr J Disabil 2023; 12:1177. [PMID: 37293267 PMCID: PMC10244872 DOI: 10.4102/ajod.v12i0.1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/27/2023] [Indexed: 06/10/2023] Open
Abstract
Background Access to, and occupational performance in, out-of-home-life-spaces is linked to health, wellbeing and quality of life for older adults. There is little evidence of how this relates to older adults with limited resources in an African urban context. Objectives To describe the out-of-home-life-spaces accessed and valued by older adults with limited resources, living in an urban South African setting. Method An exploratory concurrent mixed methods study saw 84 rehabilitation clinicians conduct 393 face-to-face interviews with older adults. Clinicians produced reflective field notes and participated in focus groups. Quantitative data were analysed using descriptive statistics with SPSS Version X. Qualitative data were analysed through inductive content analysis. Results Older adults walked, used mini-bus taxis or private vehicles to get to places of worship, medical facilities, shops, family and friends and special interest gatherings on a weekly or monthly frequency. Lack of funds was the main barrier. Older adults aspired to travel, go on holiday and to visit out-of-town family homes. Conclusion Exploring the daily lived experience of older, urban South Africans with limited resources brought to light the value they attribute to participation in activities that contribute to the wellbeing of their families and communities. Such activities are found in a variety of life spaces. Contribution Results could inform policy makers and service providers in their planning of community mobility, transportation services and health care, for older adults with limited resources.
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Affiliation(s)
- Hester M van Biljon
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lana van Niekerk
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nicola A Plastow
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lizette Swanepoel
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Hinrichs T, Rössler R, Infanger D, Weibel R, Schär J, Peters EM, Portegijs E, Rantanen T, Schmidt-Trucksäss A, Engelter ST, Peters N. Self-reported life-space mobility in the first year after ischemic stroke: longitudinal findings from the MOBITEC-Stroke project. J Neurol 2023:10.1007/s00415-023-11748-5. [PMID: 37140729 PMCID: PMC10157571 DOI: 10.1007/s00415-023-11748-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Life-space mobility is defined as the size of the area in which a person moves about within a specified period of time. Our study aimed to characterize life-space mobility, identify factors associated with its course, and detect typical trajectories in the first year after ischemic stroke. METHODS MOBITEC-Stroke (ISRCTN85999967; 13/08/2020) was a cohort study with assessments performed 3, 6, 9 and 12 months after stroke onset. We applied linear mixed effects models (LMMs) with life-space mobility (Life-Space Assessment; LSA) as outcome and time point, sex, age, pre-stroke mobility limitation, stroke severity (National Institutes of Health Stroke Scale; NIHSS), modified Rankin Scale, comorbidities, neighborhood characteristics, availability of a car, Falls Efficacy Scale-International (FES-I), and lower extremity physical function (log-transformed timed up-and-go; TUG) as independent variables. We elucidated typical trajectories of LSA by latent class growth analysis (LCGA) and performed univariate tests for differences between classes. RESULTS In 59 participants (mean age 71.6, SD 10.0 years; 33.9% women), mean LSA at 3 months was 69.3 (SD 27.3). LMMs revealed evidence (p ≤ 0.05) that pre-stroke mobility limitation, NIHSS, comorbidities, and FES-I were independently associated with the course of LSA; there was no evidence for a significant effect of time point. LCGA revealed three classes: "low stable", "average stable", and "high increasing". Classes differed with regard to LSA starting value, pre-stroke mobility limitation, FES-I, and log-transformed TUG time. CONCLUSION Routinely assessing LSA starting value, pre-stroke mobility limitation, and FES-I may help clinicians identify patients at increased risk of failure to improve LSA.
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Affiliation(s)
- Timo Hinrichs
- Division of Sport and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland.
| | - Roland Rössler
- Division of Sport and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
- Basel Mobility Center, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
| | - Denis Infanger
- Division of Sport and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Robert Weibel
- Department of Geography, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Janine Schär
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
- Neurology and Stroke Center, Klinik Hirslanden, Zurich, Switzerland
| | - Eva-Maria Peters
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
| | - Erja Portegijs
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Arno Schmidt-Trucksäss
- Division of Sport and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Stefan T Engelter
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Nils Peters
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
- Neurology and Stroke Center, Klinik Hirslanden, Zurich, Switzerland
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
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20
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Rössler R, Rommers N, Kim EK, Iendra L, Sofios A, Giannouli E, Portegijs E, Rantanen T, Infanger D, Bridenbaugh S, Engelter ST, Schmidt-Trucksäss A, Weibel R, Peters N, Hinrichs T. Timed up-and-go performance is associated with objectively measured life space in patients 3 months after ischemic stroke: a cross-sectional observational study. J Neurol 2023; 270:1999-2009. [PMID: 36547716 PMCID: PMC9772599 DOI: 10.1007/s00415-022-11524-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Stroke is a common cause of mobility limitation, including a reduction in life space. Life space is defined as the spatial extent in which a person moves within a specified period of time. We aimed to analyze patients' objective and self-reported life space and clinical stroke characteristics. METHODS MOBITEC-Stroke is a prospective observational cohort study addressing poststroke mobility. This cross-sectional analysis refers to 3-month data. Life space was assessed by a portable tracking device (7 consecutive days) and by self-report (Life-Space Assessment; LSA). We analysed the timed up-and-go (TUG) test, stroke severity (National Institutes of Health Stroke Scale; NIHSS), and the level of functional outcome (modified Rankin Scale; mRS) in relation to participants' objective (distance- and area-related life-space parameters) and self-reported (LSA) life space by multivariable linear regression analyses, adjusted for age, sex, and residential area. RESULTS We included 41 patients, mean age 70.7 (SD11.0) years, 29.3% female, NIHSS score 1.76 (SD1.68). We found a positive relationship between TUG performance and maximum distance from home (p = 0.006), convex hull area (i.e. area enclosing all Global Navigation Satellite System [GNSS] fixes, represented as a polygon linking the outermost points; p = 0.009), perimeter of the convex hull area (i.e. total length of the boundary of the convex hull area; p = 0.008), as well as the standard ellipse area (i.e. the two-dimensional ellipse containing approximately 63% of GNSS points; p = 0.023), in multivariable regression analyses. CONCLUSION The TUG, an easily applicable bedside test, seems to be a useful indicator for patients' life space 3 months poststroke and may be a clinically useful measure to document the motor rehabilitative process.
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Affiliation(s)
- Roland Rössler
- Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland.
- Basel Mobility Center, Department of Geriatric Medicine Felix Platter, Basel, Switzerland.
| | - Nikki Rommers
- Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Eun-Kyeong Kim
- Department of Geography, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research (LISER), Esch-sur-Alzette, Luxembourg
| | - Laura Iendra
- Neurology und Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
- Department of Neurology & Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Alexander Sofios
- Department of Geography, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Eleftheria Giannouli
- Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
- Department of Health Sciences & Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Erja Portegijs
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Taina Rantanen
- Faculty of Sport and Health Sciences & Gerontology Research Center, University of Jyvaskyla, Jyvaskyla, Finland
| | - Denis Infanger
- Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Stephanie Bridenbaugh
- Basel Mobility Center, Department of Geriatric Medicine Felix Platter, Basel, Switzerland
| | - Stefan T Engelter
- Neurology und Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
- Department of Neurology & Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Robert Weibel
- Department of Geography, University of Zurich, Zurich, Switzerland
| | - Nils Peters
- Neurology und Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
- Department of Neurology & Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland
- Neurology and Stroke Center, Klinik Hirslanden, Zurich, Switzerland
| | - Timo Hinrichs
- Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
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21
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Saito H, Sato M, Kobayashi M, Saito T, Shimura T, Yotsumoto K, Hanai Y, Tanizaki Y, Usuda S. Predictors of life-space mobility in patients with fracture 3 months after discharge from convalescent rehabilitation ward: a prospective longitudinal study. J Phys Ther Sci 2023; 35:223-229. [PMID: 36866010 PMCID: PMC9974330 DOI: 10.1589/jpts.35.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/09/2022] [Indexed: 03/04/2023] Open
Abstract
[Purpose] To identify predictors of life-space mobility in patients with fracture three months after discharge from convalescent rehabilitation ward. [Participants and Methods] This is a prospective longitudinal study that included patients aged 65 or older with a fracture who were scheduled for discharge home from the convalescent rehabilitation ward. Baseline measurements included sociodemographic variables (age, gender, and disease), the Falls Efficacy Scale-International, maximum walking speed, the Timed Up & Go test, the Berg Balance Scale, the modified Elderly Mobility Scale, the Functional Independence Measure, the revised version of Hasegawa's Dementia Scale, and the Vitality Index up to two weeks before discharge. As a follow-up, the life-space assessment was measured three months after discharge. In the statistical analysis, multiple linear and logistic regression analyses were performed with the life-space assessment score and the life-space level of "places outside your town" as dependent variables. [Results] The Falls Efficacy Scale-International, the modified Elderly Mobility Scale, age, and gender were selected as predictors in the multiple linear regression analysis, whereas in the multiple logistic regression analysis, the Falls Efficacy Scale-International, age, and gender were selected as predictors. [Conclusion] Our study emphasized the importance of fall-related self-efficacy and motor function for life-space mobility. The findings of this study suggest that when considering post-discharge living, therapists should conduct an appropriate assessment and adequate planning.
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Affiliation(s)
- Hiroyuki Saito
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan, Gunma University Graduate School of Health Sciences,
Japan,Corresponding author. Hiroyuki Saito (E-mail: )
| | - Miyuki Sato
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Masaki Kobayashi
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Toru Saito
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Takafumi Shimura
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Kentaro Yotsumoto
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Yota Hanai
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Yoshio Tanizaki
- Geriatrics Research Institute and Hospital: 3-26-8
Ootomo-machi, Maebashi-shi, Gunma 371-0847, Japan
| | - Shigeru Usuda
- Gunma University Graduate School of Health Sciences,
Japan
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22
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Seinsche J, de Bruin ED, Carpinella I, Ferrarin M, Moza S, Rizzo F, Salatino C, Giannouli E. Older adults' needs and requirements for a comprehensive exergame-based telerehabilitation system: A focus group study. Front Public Health 2023; 10:1076149. [PMID: 36711352 PMCID: PMC9875084 DOI: 10.3389/fpubh.2022.1076149] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/19/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction Telerehabilitation in older adults using information and communication technologies (ICTs) provides therapy, which is potentially equally effective as traditional rehabilitation, yet more accessible. This study aimed to analyze the needs and requirements of older adults (OA) and healthcare-professionals (HP) toward ICTs and telerehabilitation in general as well as toward a specific novel exergame-based telerehabilitation system (COCARE system, Dividat). Materials and methods The COCARE telerehabilitation system enables individual training based on exergames, as well as an assessment system and a digital centralized case management. Six focus groups with in total 34 participants were conducted. A mixed-methods approach was used comprising questionnaires and semi-structured interviews. Results Both OA and HP would engage to an exergame-based telerehabilitation program. Major motivating factors are the relevance of such a training for health and the entertainment component of exergames. Main requirements are simplification of the system, variety, a personalized training, a constantly available contact person, and comprehensive instructions for use. Besides, HP praised the system's motivational effect, but remained concerned about risk of falls and social isolation. Conclusion ICTs for telerehabilitation are accepted by OA and HP but should be adapted hardware- and software-wise to address OA' age-stemming vulnerabilities (e.g., risk of falls) and low ICT literacy.
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Affiliation(s)
- Julia Seinsche
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Movement Control and Learning, ETH Zurich, Zurich, Switzerland,*Correspondence: Julia Seinsche ✉
| | - Eling D. de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Movement Control and Learning, ETH Zurich, Zurich, Switzerland,Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
| | | | | | | | | | | | - Eleftheria Giannouli
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Movement Control and Learning, ETH Zurich, Zurich, Switzerland,Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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23
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Ringsten M, Iwarsson S, Lexell EM. PROTOCOL: Interventions to improve outdoor mobility among adults with disability. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1280. [PMID: 36908835 PMCID: PMC9538711 DOI: 10.1002/cl2.1280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows: to assess the efficacy of interventions aiming to improve outdoor mobility for people with disability and to explore if the efficacy varies between different populations and different intervention components.
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Affiliation(s)
- Martin Ringsten
- Cochrane Sweden, Research and DevelopmentSkåne University HospitalLundSweden
- Department of Health SciencesLund UniversityLundSweden
| | | | - Eva Månsson Lexell
- Department of Health SciencesLund UniversityLundSweden
- Department of Neurology, Rehabilitation Medicine, Cognitive Medicine and GeriatricsSkåne University HospitalLund‐MalmöSweden
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24
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Cattaneo F, Buondonno I, Cravero D, Sassi F, D’Amelio P. Musculoskeletal Diseases Role in the Frailty Syndrome: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11897. [PMID: 36231199 PMCID: PMC9565922 DOI: 10.3390/ijerph191911897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Frailty syndrome severely burdens older age, and musculoskeletal diseases are of paramount importance in its development. The aim of this study is to unravel the contribution of musculoskeletal diseases to frailty syndrome. This is a case-control study, and we enrolled 55 robust community-dwelling age- and gender-matched patients, with 58 frail and pre-frail subjects. Frailty was diagnosed according to the Fried criteria (FP), and the Fragility Index (FI) was calculated. In all the subjects, a comprehensive geriatric assessment was carried out. Their nutritional status was evaluated by the Mini Nutritional Assessment and Bioelectrical Impedance Analyses. Their bone density (BMD), bone turnover, muscle mass, strength and performance were evaluated. Here, we show that the prevalence of frailty varies according to the diagnostic criteria used and that FP and FI showed a moderate to good agreement. Despite age and gender matching, frail subjects had lower muscle strength, performance and BMD. Their quality of life and cognitive performance were reduced in the frail subjects compared to the robust ones. Muscular strength and performance, together with mood, significantly predicted the diagnosis of frailty, whereas BMD and bone turnover did not. In conclusion, we show that sarcopenia plays a pivotal role in predicting the diagnosis of frailty, whereas osteoporosis does not.
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Affiliation(s)
- Francesco Cattaneo
- Department of Public Health Sciences and Pediatrics, University of Torino, 10126 Torino, Italy
| | - Ilaria Buondonno
- Geriatric and Bone Disease Unit, Department of Internal Medicine, University of Torino, 10126 Torino, Italy
| | - Debora Cravero
- Geriatric and Bone Disease Unit, Department of Internal Medicine, University of Torino, 10126 Torino, Italy
| | - Francesca Sassi
- Geriatric and Bone Disease Unit, Department of Internal Medicine, University of Torino, 10126 Torino, Italy
| | - Patrizia D’Amelio
- Geriatric and Bone Disease Unit, Department of Internal Medicine, University of Torino, 10126 Torino, Italy
- Service of Geriatric Medicine & Geriatric Rehabilitation, Department of Medicine, University of Lausanne Hospital (CHUV), 1011 Lausanne, Switzerland
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25
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Pérez-Trujillo M, Curcio CL, Duque-Méndez N, Delgado A, Cano L, Gomez F. Predicting restriction of life-space mobility: a machine learning analysis of the IMIAS study. Aging Clin Exp Res 2022; 34:2761-2768. [PMID: 36070079 DOI: 10.1007/s40520-022-02227-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/09/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Some studies have employed machine learning (ML) methods for mobility prediction modeling in older adults. ML methods could be a helpful tool for life-space mobility (LSM) data analysis. AIM This study aimed to evaluate the predictive value of ML algorithms for the restriction of life-space mobility (LSM) among elderly people and to identify the most important risk factors for that prediction model. METHODS A 2-year LSM reduction prediction model was developed using the ML-based algorithms decision tree, random forest, and eXtreme gradient boosting (XGBoost), and tested on an independent validation cohort. The data were collected from the International Mobility in Aging Study (IMIAS) from 2012 to 2014, comprising 372 older patients (≥ 65 years of age). LSM was measured by the Life-Space Assessment questionnaire (LSA) with five levels of living space during the month before assessment. RESULTS According to the XGBoost algorithm, the best model reached a mean absolute error (MAE) of 10.28 and root-mean-square error (RMSE) of 12.91 in the testing portion. The variables frailty (39.4%), mobility disability (25.4%), depression (21.9%), and female sex (13.3%) had the highest importance. CONCLUSION The model identified risk factors through ML algorithms that could be used to predict LSM restriction; these risk factors could be used by practitioners to identify older adults with an increased risk of LSM reduction in the future. The XGBoost model offers benefits as a complementary method of traditional statistical approaches to understand the complexity of mobility.
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Affiliation(s)
- Manuel Pérez-Trujillo
- Departamento de Informática y Computación, Facultad de Administración, Grupo GAIA, Universidad Nacional de Colombia, Manizales, Colombia
| | - Carmen-Lucía Curcio
- Research Group in Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Manizales, Colombia.
| | - Néstor Duque-Méndez
- Departamento de Informática y Computación, Facultad de Administración, Grupo GAIA, Universidad Nacional de Colombia, Manizales, Colombia
| | - Alejandra Delgado
- Research Group in Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Manizales, Colombia
| | - Laura Cano
- Research Group in Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Manizales, Colombia
| | - Fernando Gomez
- Research Group in Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Manizales, Colombia
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26
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Chitalu P, Tsui A, Searle SD, Davis D. Life-space, frailty, and health-related quality of life. BMC Geriatr 2022; 22:646. [PMID: 35931955 PMCID: PMC9356461 DOI: 10.1186/s12877-022-03355-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/30/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Life-space and frailty are closely linked to health-related quality of life and understanding their inter-relationship could indicate potential intervention targets for improving quality of life. We set out to examine the relationship between frailty and life-space and their relative impact on quality of life measures. METHODS Using cross-sectional data from a population-representative cohort of people aged ≥ 70 years, we assessed quality of life with the EuroQol Health Index tool (5-levels) (EQ-5D-5L). We also undertook a life-space assessment and derived a frailty index. Linear regression models estimated EQ-5D-5L scores (dependent variable) using life-space assessment, frailty index and interactions between them. All models were adjusted by age, sex, lifestyle, and social care factors. RESULTS A higher EQ-5D Index was associated with higher life-space (0.02 per life-space assessment score, 95%CI: 0.01 to 0.03, p < 0.01) and decreasing frailty (-0.1 per SD, 95%CI: -0.1 to -0.1, p < 0.01). There was evidence of an interaction between life-space and frailty, where the steepest gradient for life-space and EQ-5D was in those with the highest frailty (interaction term = 0.02 per SD of frailty, 95%CI: 0.01 to 0.03, p < 0.01). CONCLUSION Individuals with the highest frailty were twice as likely to have higher quality of life in association with a larger life-space. Interventions designed to improve quality of life in frail older people could focus on increasing a person's life-space.
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Affiliation(s)
- Petronella Chitalu
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Alex Tsui
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Samuel D Searle
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, WC1E 7HB, UK.,Division of Geriatric Medicine, Dalhousie University, Nova Scotia, Canada
| | - Daniel Davis
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, WC1E 7HB, UK
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Zhang S. Application Research of Public Art in the Design of Old People's Rehabilitation Space Based on Virtual Information Interaction Platform From the Perspective of Developing Economies. Front Public Health 2022; 10:917330. [PMID: 35712298 PMCID: PMC9197336 DOI: 10.3389/fpubh.2022.917330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/03/2022] [Indexed: 11/26/2022] Open
Abstract
To solve the problem of the design of the old people's recuperation space, the virtual information interaction platform is used to study the public art application in the design of the old people's recuperation space. Firstly, the principles of interactive design are expounded, and secondly, the existing institutions for the old people are investigated. Under the premise of optimizing the functions of the facilities, the concepts of humanistic care, emotional care and humanization in public art are integrated into the design of the old people's rehabilitation space, to solve the long-term negative impression of the old people's repression and indifference to the old people's care institutions. The construction of the scene allows the old people to experience some operations with the help of the virtual information interaction platform. In the modern elderly rehabilitation space, the attention and application of public art design will inevitably bring spiritual and material help to the old people in their later years, and create a happy, peaceful, and comfortable elderly life for them. The survey results manifest that 65.3% of urban old people and 71.8% of rural old people feel that they cannot keep up with the pace of development. Through the analysis and discussion of the physiological and psychological characteristics of the old people, the whole survey denotes that the physiological functions of the old people are declining, which seriously affects their normal life. Therefore, the design of the rehabilitation space for the old people should not only meet the basic needs of life, but also analyze the space design from the perspective of humanization and emotion. An ecological, natural, and human settlement environment has been established. The recuperation space is designed for the needs of different old people, which helps the old people to eliminate loneliness, enhance their value of the old people, and make life full of joy and meaning for the old people.
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Affiliation(s)
- Shaoqing Zhang
- College of Landscape Architecture and Art, Henan Agricultural University, Zhengzhou, China
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Moreira MTC, Gomes CS, Pinto JM. Influence of personal mastery on mobility disability among older adults: A systematic review. Arch Gerontol Geriatr 2022; 102:104750. [PMID: 35714474 DOI: 10.1016/j.archger.2022.104750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Personal mastery is a psychological resource recognized as a domain of quality of life that helps individuals cope with life strains. Despite its relevance, there is a lack surrounding the relationship between mobility disability and personal mastery. This study aimed to investigate the influence of personal mastery on mobility disability among older adults and identify the mechanisms that underlie this influence. METHODS A systematic review was conducted by searching four databases (i.e., PubMed, Scopus, ScienceDirect, and the Virtual Health Library of the Latin American and Caribbean Center on Health Sciences Information) using combinations of the following words: mastery, personal mastery, self-control, mobility, disability, older adults, older people, and aging. We summarized and analyzed the findings of cross-sectional and longitudinal/prospective studies. RESULTS Twenty-one studies were included. There was high heterogeneity in how the studies had assessed mobility disability. Although a majority of the studies had used the Pearlin's Self-Mastery Scale (PSMS) to assess personal mastery, there were variations in the number of response anchors and scoring strategies that were used. Nevertheless, findings revealed that personal mastery influences mobility disability by acting as a protective resource against adverse outcomes among older adults. The authors of the reviewed articles had provided physiological and behavioral explanations for their findings. CONCLUSIONS Higher level of personal mastery can protect older adults from mobility disability, because it confers a sense of personal control, which in turn promotes positive physiological functioning and health behaviors. This knowledge contributes to the maintenance of physical functioning in old age.
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Affiliation(s)
| | - Cintia Sulino Gomes
- Undergraduate Program in Physical Therapy, Federal University of Triangulo Mineiro, Brazil.
| | - Juliana Martins Pinto
- Laboratory of Physical Therapy and Public Health, Department of Physical Therapy, Institute of Health Sciences, Federal University of Triangulo Mineiro, Brazil.
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Jadczak AD, Edwards S, Visvanathan R. Life-Space Mobility in Aged Care Residents: Frailty in Residential Aged Care Sector Over Time Study Findings. J Am Med Dir Assoc 2022; 23:1869.e1-1869.e6. [DOI: 10.1016/j.jamda.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/14/2022] [Accepted: 04/20/2022] [Indexed: 11/27/2022]
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Ryder‐Burbidge C, Wieler M, Nykiforuk CI, Jones CA. Life-Space Mobility and Parkinson's Disease. A Multiple-Methods Study. Mov Disord Clin Pract 2022; 9:351-361. [PMID: 35402649 PMCID: PMC8974890 DOI: 10.1002/mdc3.13406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 01/21/2023] Open
Abstract
Background Life-space mobility (LSM) captures a broad spectrum of mobility in physical and social environments; however, it has not been extensively studied in Parkinson's disease. Using a multiple-methods approach, individual, social and environmental factors that impact LSM were explored in PD. Methods Two hundred twenty-seven participants with PD (n = 113) and a comparative group without PD (n = 114) were recruited from the community. Within a cross-sectional survey, LSM (University of Alabama Birmingham Life-Space Assessment, LSA) was compared in the two groups. Using multiple linear regression, socio-demographics, lifestyle behaviors, medical, mobility and social factors were examined to identify factors that explained LSM. A qualitative narrative inquiry was completed to augment the findings from the survey; 10 participants with PD were interviewed regarding facilitators and barriers to mobility. Results The mean overall LSA-composite score for the PD group was 64.2 (SD = 25.8) and 70.3 (SD = 23.1) for the community comparative group (mean difference = 6 points, 95%CI:-0.4, 12.5) indicating most participants moved independently beyond their neighborhoods. A higher proportion of the PD group required assistance with mobility than the community comparison group. Not driving, receiving caregiving, lower social participation, and lower monthly family finances were associated with restricted LSM in the PD group. Data from qualitative interviews supported quantitative findings and offered insights into the features of the built environment that facilitate and restrict mobility. Conclusion Individual, social and environmental factors are associated with the LSM among persons with PD. Clinicians and policy-makers should include both individual and community-based factors when developing interventions to encourage the LSM of the PD population.
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Affiliation(s)
| | - Marguerite Wieler
- Department of Physical TherapyUniversity of AlbertaEdmontonAlbertaCanada
| | | | - C. Allyson Jones
- School of Public Health, University of AlbertaEdmontonAlbertaCanada,Department of Physical TherapyUniversity of AlbertaEdmontonAlbertaCanada
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Togashi Y, Fujita T, Ohashi T, Jinbo R, Kasahara R. Effect of life-space mobility on subjective well-being in aged home-based rehabilitation users with different levels of independence in activities of daily living. J Phys Ther Sci 2022; 34:18-21. [PMID: 35035073 PMCID: PMC8752280 DOI: 10.1589/jpts.34.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/05/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The relationship between quality of life and life-space mobility in
community-dwelling older adults has recently been reported. The present study aimed to
elucidate this relationship in home-based rehabilitation users with limited life-space
mobility and loss of independence in activities of daily living. [Participants and
Methods] The study population comprised 33 home-based rehabilitation users. The
participants were expected to have a wide range of the level of independence in activities
of daily living; therefore, they were categorized into three groups according to the
Barthel Index score: independent (95–100 points), moderately disabled (90–65 points), and
severely disabled (60–0 points) groups. We examined the relationships among the
Philadelphia Geriatric Center Morale Scale, Life-Space Assessment, and Barthel Index
scores and age. [Results] We detected a strong positive correlation between the
Philadelphia Geriatric Center Morale Scale and Life-Space Assessment scores in the
independent group; however, no significant correlations were observed in the moderately
and severely disabled groups. [Conclusion] Our findings suggest a relationship between
subjective well-being and life-space mobility in home-based rehabilitation users who are
mostly independent in activities of daily living. However, owing to the small sample size
and characteristics of the scales used in this study, further studies are warranted to
verify these results.
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Affiliation(s)
- Yui Togashi
- Hobara Regional Comprehensive Support Center, Japan
| | - Takaaki Fujita
- Department of Occupational Therapy, School of Health Sciences, Fukushima Medical University: 10-6 Sakaemachi, Fukushima City, Fukushima 960-8516, Japan
| | - Takuro Ohashi
- Department of Rehabilitation, Kita-Fukushima Medical Center, Japan
| | - Ryohei Jinbo
- Department of Rehabilitation, Kita-Fukushima Medical Center, Japan
| | - Ryuichi Kasahara
- Department of Rehabilitation, Kita-Fukushima Medical Center, Japan
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Lima MDCCD, Perracini MR, Guerra RO, Borim FDSA, Yassuda MS, Neri AL. Precisão da medida de mobilidade no espaço de vida para discriminar fragilidade e sarcopenia em idosos. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2022. [DOI: 10.1590/1981-22562022025.210219.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Identificar o perfil de mobilidade nos espaços de vida em idosos que vivem na comunidade e estabelecer a precisão dos pontos de corte desse instrumento para discriminar entre níveis de fragilidade, fragilidade em marcha e de risco de sarcopenia. Método Estudo observacional e metodológico com 391 participantes com 72 anos e mais (80,4±4,6), que responderam ao Life Space Assessment (LSA) e a medidas de rastreio de fragilidade e risco de sarcopenia usando respectivamente o fenótipo de fragilidade e o SARC-F. Os pontos de corte para fragilidade e risco de sarcopenia foram determinados por meio da Curva ROC (Receiver Operating Characteristic) com intervalos de confiança de 95%. Resultados A média da pontuação no LSA foi 53,6±21,8. Os pontos de corte de melhor acurácia diagnóstica foram ≤54 pontos para fragilidade em marcha (AUC= 0,645 95%; p<0,001) e ≤60 pontos para risco de sarcopenia (AUC= 0,651 95%; p<0,001). Conclusão A capacidade de idosos de se deslocar nos vários níveis de espaços de vida, avaliado pelo LSA demonstrou ser uma ferramenta viável que pode contribuir no rastreio de fragilidade em marcha e de risco de sarcopenia e, com isso, prevenir desfechos negativos.
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Matsuda K, Ariie T, Okoba R, Hamachi N, Suzuki A, Kaneko H, Morita M. Gender Differences in Life-space Mobility-associated Factors and Structures in Community-dwelling Older People. Prog Rehabil Med 2022; 7:20220023. [PMID: 35611094 PMCID: PMC9090662 DOI: 10.2490/prm.20220023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/11/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives: This cross-sectional study sought to examine gender dissimilarities in factors and
structures associated with life-space mobility (LSM) in community-dwelling older
people. Methods: This study included a total of 294 older people living in Okawa, Fukuoka Prefecture,
Japan. The subjects’ body mass index (BMI) and skeletal muscle mass index (SMI) were
evaluated. Furthermore, the age, gender, and LSM of the participants were assessed. LSM
was assessed using a framework based on social isolation, fall self-efficacy, mobility,
cognitive function, and lower limb muscle strength. Path analysis was performed to
assess LSM-associated factors and their respective effect sizes (ESs), and male and
female LSM models were established. Results: Path analysis identified SMI and social isolation as direct factors and cognitive
function as an indirect factor associated with LSM in both men and women. In the male
LSM model, the direct factors in descending order of ES were BMI, social isolation, SMI,
and lower limb muscle strength. In the female model, the direct factors in descending
order of ES were age, fall self-efficacy, mobility, social isolation, and SMI; age was
noted as having an indirect effect on the remaining associated factors. Conclusions: This study clarified the gender differences in factors influencing LSM and the
underlying structure of LSM mediation by these factors. Therefore, gender differences
should be considered when planning interventions aimed at improving the LSM and general
well-being of older people, particularly for community-dwelling individuals.
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Affiliation(s)
- Kensuke Matsuda
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Takashi Ariie
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Ryota Okoba
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Nozomi Hamachi
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Akari Suzuki
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Hideo Kaneko
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Masaharu Morita
- Department of Physical Therapy, School of Health Sciences at Odawara, International University of Health and Welfare, Kanagawa, Japan
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Lima MDCCD, Perracini MR, Guerra RO, Borim FDSA, Yassuda MS, Neri AL. Accuracy of the life-space mobility measure for discriminating frailty and sarcopenia in older people. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2022. [DOI: 10.1590/1981-22562022025.210219.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective To identify the profile of a sample of older people recruited at home based on a measure of life-space mobility and to establish the accuracy of the cut-off points of this instrument for discriminating between levels of frailty, frailty in walking speed and risk of sarcopenia. Method An observational methodological study of 391 participants aged ≥72 (80.4±4.6) years, who answered the Life-Space Assessment (LSA) and underwent frailty and risk of sarcopenia screening using the frailty phenotype and SARC-F measures, respectively, was performed. The cut-off points for frailty and risk of sarcopenia were determined using ROC (Receiver Operating Characteristic) curves and their respective 95% confidence intervals. Results Mean total LSA score was 53.6±21.8. The cut-off points with the best diagnostic accuracy for total LSA were ≤54 points for frailty in walking speed (AUC=0.645 95%; p<0.001) and ≤60 points for risk of sarcopenia (AUC=0.651 95%; p<0.001). Conclusion The ability of older people to move around life-space levels, as assessed by the LSA, proved a promising tool to screen for frailty in walking speed and risk of sarcopenia, thus contributing to the prevention of adverse outcomes.
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Chung J, Boyle J, Wheeler DC. Relationship Between Life-Space Mobility and Health Characteristics in Older Adults Using Global Positioning System Watches. J Appl Gerontol 2021; 41:1186-1195. [PMID: 34719296 DOI: 10.1177/07334648211054834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to examine the feasibility of using global positioning system (GPS) watches to examine relationships between GPS-based life-space mobility (LSM) metrics and self-report LSM and health measures (physical, psychological, and cognitive function) among older adults. Thirty participants wore a Fitbit Surge for 3 days. Eight spatial and temporal LSM measures were derived from GPS data. About 90% of in-home movement speeds were zero, indicating the sedentary lifestyle, but they made some active out-of-home trips as the total distance traveled and size of movement area indicated. There was a significant difference in total distance traveled and 95th percentile of movement speed between mild cognitive and intact cognition groups. GPS-based higher proportion of out-of-home time was significantly associated with greater functional fitness. Greater GPS use hours were significantly associated with higher cognition. These findings suggest the potential of GPS watches to continuously monitor changes in functional health to inform prevention efforts.
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Affiliation(s)
- Jane Chung
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Joseph Boyle
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - David C Wheeler
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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The Effect of Social Cohesion on Interest, Usefulness, and Ease of Use of a Driving Assistance System in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111412. [PMID: 34769929 PMCID: PMC8583404 DOI: 10.3390/ijerph182111412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 11/16/2022]
Abstract
This study examined the relationship between social cohesion and the perceived interest in, the usefulness of, and the ease of use of an instructor-based driver assistance system in a sample of older adults. With the aging of the population, the use of technologies to support the driving skills of the elderly is expected, and it is necessary to clarify the conditions under which the elderly will be interested in these advanced technologies. Traditionally, social cohesion has been focused on as a function of instrumental and practical support in the lives of the elderly. Since social cohesion reflects the intention to help each other, it could be an opportunity to provide information on advanced driving skill techniques to older people who are becoming more difficult to drive. As an initial exploration, this study examined whether social cohesion was associated with the interest in, the usefulness of, and the ease of use of an instructor-based driver assistance system in 150 elderly people. The results showed that a greater social cohesion was significantly associated with these evaluations, and that a comprehension of the system also contributed. The possession of a license was significantly associated with interest in the program. These findings are an essential step toward the understanding of the roles of social cohesion and positive perception of advanced technology in older adults.
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Sloot LH, Malheiros S, Truijen S, Saeys W, Mombaur K, Hallemans A, van Criekinge T. Decline in gait propulsion in older adults over age decades. Gait Posture 2021; 90:475-482. [PMID: 34619614 DOI: 10.1016/j.gaitpost.2021.09.166] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/26/2021] [Accepted: 09/02/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Despite strong evidence that walking speed and forward propulsion decline with increasing age, their relationship is still poorly understood. While changes in the ankle and hip mechanics have been described, few studies have reported the effect of ageing on the whole leg's contribution to propulsion. RESEARCH QUESTION The aim of this study was to investigate age-related changes in the work performed by the leg on the center of mass (COM) push-off power during walking in adults aged 20-86 years. Specifically, we evaluated how deterioration in COM push-off power relates to changes in ankle and hip kinetics as well as age and walking speed. METHODS Motion, ground reaction forces and gastrocnemius muscle activity were recorded in 138 adults during overground walking at self-selected speed. Age-related differences in variables between decades were analyzed with an ANOVA, while the relation between COM push-off power and joint kinetic variables, as well as walking speed and biological age, was evaluated using correlations and multiple regression analysis. RESULTS From the age of 70 years and onwards, COM push-off power was significantly decreased. The decline in COM push-off power was mostly explained by a decline in average ankle push-off power (72 %), and to a lesser extent by peak hip extension moment (3 %). There was no re-distribution of ankle-to-hip push-off power. The decline in COM push-off power seemed more related to walking speed (explaining 54 % of the variance) than biological age (only 4 %). SIGNIFICANCE Findings indicate that age-related decline in COM push-off power in able-bodied adults starts from the age of 70 years, which is before changes have been found in kinematics, but still later than generally presumed. This decrease in push-off power was more related to walking speed than biological age, which emphasizes the need to better understand the reason for speed decline in older adults.
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Affiliation(s)
- Lizeth H Sloot
- ORB Lab, Institute of Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany.
| | - Susanne Malheiros
- ORB Lab, Institute of Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany.
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Belgium.
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Belgium; RevArte Rehabilitation Hospital, Edegem, Antwerp, Belgium.
| | - Katja Mombaur
- ORB Lab, Institute of Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany; Department of Systems Design Engineering & Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Canada.
| | - Ann Hallemans
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Belgium; Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp, Belgium.
| | - Tamaya van Criekinge
- Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp, Belgium; Department of Rehabilitation Sciences, KU Leuven Campus Bruges, Bruges, Belgium.
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Sangrar R, Mun KJ, Griffith LE, Letts L, Vrkljan B. Older Adults' Motivations for Participating in a "Tune-Up" of Their Driving Skills: A Multi-Stakeholder Analysis. J Appl Gerontol 2021; 40:1297-1304. [PMID: 33371754 PMCID: PMC8406366 DOI: 10.1177/0733464820982413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/28/2020] [Accepted: 11/29/2020] [Indexed: 11/15/2022] Open
Abstract
Driver training has the potential to keep older adults safe behind-the-wheel for longer, yet there is limited evidence describing factors that influence their willingness to participate in training. Focus groups with community-dwelling older drivers (n = 23; 70-90 years) and semi-structured interviews with driving instructors (n = 6) and occupational therapists (n = 5) were conducted to identify these factors. Qualitative descriptive analyses highlighted how self-awareness of behind-the-wheel abilities in later life can influence an older adult's motivation to participate in driver training, as well as their willingness to discuss their behaviors. Collision-involvement and near-misses prompted participants to reflect on their driving abilities and their openness to feedback. Participants' preferences for learning contexts that use a strengths-based approach and validate the driving experience of older drivers, while providing feedback on behind-the-wheel performance, were raised. Older driver training initiatives that consider the needs of the aging population in their design can promote road safety and community mobility.
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Affiliation(s)
| | | | | | - Lori Letts
- McMaster University, Hamilton, Ontario, Canada
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Zajac JA, Cavanaugh JT, Baker T, Colón-Semenza C, DeAngelis TR, Duncan RP, Fulford D, LaValley M, Nordahl T, Rawson KS, Saint-Hilaire M, Thomas CA, Earhart GM, Ellis TD. Are Mobile Persons With Parkinson Disease Necessarily More Active? J Neurol Phys Ther 2021; 45:259-265. [PMID: 34091569 PMCID: PMC8460597 DOI: 10.1097/npt.0000000000000362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Walking activity in persons with Parkinson disease (PD) is important for preventing functional decline. The contribution of walking activity to home and community mobility in PD is poorly understood. METHODS Cross-sectional baseline data (N = 69) were analyzed from a randomized controlled PD trial. The Life-Space Assessment (LSA) quantified the extent, frequency, and independence across 5 expanding levels of home and community mobility, producing individual subscores and a total score. Two additional summed scores were used to represent mobility within (Levels 1-3) and beyond (Levels 4-5) neighborhood limits. An accelerometer measured walking activity for 7 days. Regression and correlation analyses evaluated relationships between daily steps and mobility scores. Mann-Whitney U tests secondarily compared differences in mobility scores between the active and sedentary groups. RESULTS Walking activity contributed significantly to the summed Level 1-3 score (β = 0.001, P = 0.004) but not to the summed Level 4-5 (β = 0.001, P = 0.33) or total (β = 0.002, P = 0.07) scores. Walking activity was significantly related to Level 1 (ρ = 0.336, P = 0.005), Level 2 (ρ = 0.307, P = 0.010), and Level 3 (ρ = 0.314, P = 0.009) subscores. Only the summed Level 1-3 score (P = 0.030) was significantly different between the active and sedentary groups. DISCUSSION AND CONCLUSIONS Persons with PD who demonstrated greater mobility beyond the neighborhood were not necessarily more active; walking activity contributed more so to home and neighborhood mobility. Compared with LSA total score, the Level 1-3 summed score may be a more useful participation-level measure for assessing the impact of changes in walking activity.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A349).
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Affiliation(s)
- Jenna A Zajac
- Departments of Physical Therapy and Athletic Training (J.A.Z., T.B., T.R.D., T.N., T.D.E) and Occupational Therapy (D.F.), Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts; Department of Physical Therapy (J.T.C.), University of New England, Portland, Maine; Department of Kinesiology (C.C.-S.), College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, Connecticut; Program in Physical Therapy (R.P.D., K.S.R., G.M.E), Department of Neuroscience (G.M.E), and Department of Neurology (R.P.D., G.M.E), Washington University in St Louis School of Medicine, St Louis, Missouri; School of Public Health (M.L.), Boston University, Boston, Massachusetts; and Department of Neurology (M.S.-H., C.A.T.), Parkinson's Disease and Movement Disorders Center, Boston University, Boston, Massachusetts
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Dunlap PM, Rosso AL, Zhu X, Klatt BN, Brach JS. The Association of Mobility Determinants and Life Space Among Older Adults. J Gerontol A Biol Sci Med Sci 2021; 77:2320-2328. [PMID: 34529773 DOI: 10.1093/gerona/glab268] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is important to understand the factors associated with life space mobility so that mobility disability can be prevented/treated. The purpose of this study was to identify the association between mobility determinants and life space among older adults. METHODS This study was a cross-sectional analysis of 249 community-dwelling older adults (mean age=77.4 years, 65.5% female, 88% white) who were recruited for a randomized, controlled, clinical intervention trial. Associations between cognitive, physical, psychosocial, financial, and environmental mobility determinants and the Life Space Assessment (LSA) at baseline were determined using Spearman's correlation coefficients and one-way analysis of variance. Multivariate analysis was performed using multivariable linear regression models. RESULTS The mean LSA score for the sample was 75.3 (SD=17.8). Personal factors (age, gender, education, comorbidities), cognitive (Trail Making Test A and B), physical (gait speed, lower extremity power, Six Minute Walk Test, Figure of 8 Walk Test, tandem stance, energy cost of walking, and Late Life Function and Disability Function Scale), psychosocial (Modified Gait Efficacy Scale), and financial (neighborhood socio-economic status) domains of mobility were significantly associated with LSA score. In the final regression model, age (β=-0.43), lower extremity power (β=0.03), gait efficacy (β=0.19), and energy cost of walking (β=-57.41) were associated with life space (R 2=0.238). CONCLUSIONS Younger age, greater lower extremity power, more confidence in walking, and lower energy cost of walking were associated with greater life space. Clinicians treating individuals with mobility disability should consider personal, physical, and psychosocial factors assessing barriers to life space mobility.
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Affiliation(s)
- Pamela M Dunlap
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrea L Rosso
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Xiaonan Zhu
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brooke N Klatt
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer S Brach
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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Portegijs E, Saajanaho M, Leppä H, Koivunen K, Eronen J, Rantanen T. Impact of mobility restrictions on active aging; cross-sectional associations and longitudinal changes parallel to COVID-19 restrictions. Arch Gerontol Geriatr 2021; 98:104522. [PMID: 34638047 DOI: 10.1016/j.archger.2021.104522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Meaningful activities can be done in or around home, but opportunities for participation and active aging decrease when moving in smaller areas. Active aging refers to having an active approach to life in line with one's goals, ability and opportunities. In adults over 75 years with different baseline neighborhood mobility levels, we studied active aging scores two years prior to and amid COVID-19, when governments restricted mobility of residents to slow the COVID-19 outbreak. METHODS AGNES cohort data were collected in 2017-2018 and spring 2020. Individuals were queried about their will, ability, and opportunity, and extent of doing 17 activities, and subsequently, item, composite and sub-scores of active aging were computed. Neighborhood mobility was assessed as frequency of moving in or beyond own neighborhood (limited, regular, daily=reference). Associations were studied using Generalized Linear Models (cross-sectionally, n = 1007) and General Estimating Equations (prospectively, n = 774). RESULTS Participants with limited baseline neighborhood mobility had lower active aging scores than those with daily mobility, but the decline over time was similar. Some item scores on opportunity to act and extent of doing, e.g. for making one's day more interesting and advancing matters of faith or worldview, were better retained amid COVID-19 by those with limited mobility, attenuating group differences. CONCLUSIONS Active aging scores were somewhat compromised in individuals with limited neighborhood mobility, but opportunities for and engagement in several activities seemed to be better retained amid COVID-19 than for those with daily mobility. Thus, active aging may be possible despite mobility restriction.
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Affiliation(s)
- Erja Portegijs
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland.
| | - Milla Saajanaho
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Heidi Leppä
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Kaisa Koivunen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Johanna Eronen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
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Self-report Measures of Hearing and Vision in Older Adults Participating in the Canadian Longitudinal Study of Aging are Explained by Behavioral Sensory Measures, Demographic, and Social Factors. Ear Hear 2021; 42:814-831. [PMID: 33741763 DOI: 10.1097/aud.0000000000000992] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Our objectives were to (1) determine the prevalence of self-reported hearing, vision, and dual sensory (both vision and hearing) difficulties in older Canadian adults; (2) examine the association between self-report and behavioral sensory measures; and (3) controlling for behavioral sensory measures, examine variables that might explain the self-reported sensory difficulty, including age, sex, cultural background, socioeconomic status, nonsensory comorbidities, cognitive function, and social factors. DESIGN We used baseline data collected from the 30,097 participants of the comprehensive cohort of the Canadian Longitudinal Study on Aging. Participants who were 45 to 85 years of age (mean age = 63 years, SD = ± 10.25) were recruited using provincial health registries and random-digit dialing. Analyses were conducted for the sample as a whole or stratified by age. Behavioral sensory data for hearing (pure-tone audiometry) and vision (pinhole-corrected visual acuity) were collected at 11 data collection sites. Self-reported sensory and personal data were obtained through in-person interviews. "Difficulty" was defined as a response of "fair" or "poor" (versus "excellent," "very good" or "good") to questions about hearing ability (using a hearing aid if used) and vision (using glasses or corrective lenses if used). Individuals with both hearing and vision difficulties were defined as having dual sensory difficulties. Variables associated with self-reported sensory difficulties were analyzed with multiple regression models. RESULTS Objective 1. The prevalence of impairments based on behavioral measures was higher than the prevalence of difficulties based on self-report measures. The prevalence based on both types of measures increased with age, but the increase was steeper for behavioral measures. Objective 2. In addition to the expected positive associations between self-report and behavioral measures of hearing [odds ratio (OR) = 2.299)] and vision (OR = 15.247), self-reported sensory difficulty was also explained by other within-modality sensory variables, such as the symmetry of impairment and the use of aids. Objective 3. Controlling for behavioral measures of hearing (better-ear pure-tone average) or vision (better-eye visual acuity), older participants were significantly less likely than younger participants to self-report sensory difficulty. Sensory difficulties were reported more often by males and by those with more comorbid health conditions. Compared to those who did not report vision difficulties, those who did report them were more likely to also report hearing difficulties (OR = 2.921) and vice versa (OR = 2.720). There were modality-specific associations with variables relevant to social participation; for example, independent life space was associated with hearing difficulties, and perceived availability of social support and loneliness with vision difficulties. CONCLUSIONS The low prevalence of self-reported sensory difficulties relative to the behavioral measures of sensory impairments indicates that (a) a simple screening question about sensory ability may not be sufficient to identify older adults who are in the early stages of sensory decline, and (b) self-reported sensory ability is associated with sensory and nonsensory factors. Age, gender, and comorbidities are the most notable nonsensory predictors for both self-reported hearing and vision. These findings shed light on how the self-reported sensory difficulties of older adults may reflect clinical measures of sensory impairment as well as nonsensory factors.
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Ono T, Asakawa Y. Purposes of Going out and Subjective Well-Being in Older Adults with Impairments. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2021.1957068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Takazumi Ono
- Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
- Rehappy Co, Tokyo, Japan
| | - Yasuyoshi Asakawa
- Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
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A Space-Time Analysis of Rural Older People's Outdoor Mobility and Its Impact on Self-Rated Health: Evidence from a Taiwanese Rural Village. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115902. [PMID: 34072884 PMCID: PMC8198793 DOI: 10.3390/ijerph18115902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 11/16/2022]
Abstract
With the aggravation of rural aging, the well-being and self-rated health level of older people in rural communities are significantly lower than those in urban communities. Past studies hold that mobility is essential to the quality of life of the elderly, and well-being depends on their own adaptation strategies in the built environment. Therefore, this study combines three key factors related to active aging: environment, health and mobility, and assumes that the elderly with good health status will have environmental proactivity and a wider range of daily mobility in a poor rural built environment. This study attempts to track daily mobility by using a space-time path method in time geography and then to explore the relationship between outdoor mobility and older people's self-rated health. A 1-week mobility path survey for 20 senior citizens of Xishi Village, a typical rural village in Taiwan, was conducted by wearing a GPS sports watch. A questionnaire survey and in-depth interviews were done to provide more information about the seniors' personal backgrounds and lifestyles. The results show that when the built environment is unfit to the needs of daily activities, half of the participants can make adjustment strategies to go beyond the neighborhoods defined by administrative units. Correlation analysis demonstrated that mental health is associated with daily moving time and distance. In addition, men have higher self-rated health scores than women, and there are significant statistical differences between married and widowed seniors in daily outing time and distance. This exploratory study suggests that in future research on rural health and active aging in rural areas, understanding the daily outdoor mobility of the elderly can help to assess their health status and living demands and quickly find out whether there is a lack of rural living services or environmental planning.
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Choukou MA, Mbabaali S, East R. Healthcare Professionals' Perspective on Implementing a Detector of Behavioural Disturbances in Long-Term Care Homes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2720. [PMID: 33800257 PMCID: PMC7967440 DOI: 10.3390/ijerph18052720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 11/25/2022]
Abstract
The number of Canadians with dementia is expected to rise to 674,000 in the years to come. Finding ways to monitor behavioural disturbance in patients with dementia (PwDs) is crucial. PwDs can unintentionally behave in ways that are harmful to them and the people around them, such as other residents or care providers. Current practice does not involve technology to monitor PwD behaviours. Events are reported randomly by nonstaff members or when a staff member notices the absence of a PwD from a scheduled event. This study aims to explore the potential of implementing a novel detector of behavioural disturbances (DBD) in long-term care homes by mapping the perceptions of healthcare professionals and family members about this technology. Qualitative information was gathered from a focus group involving eight healthcare professionals working in a tertiary care facility and a partner of a resident admitted in the same facility. Thematic analysis resulted in three themes: (A) the ability of the DBD to detect relevant dementia-related behavioural disturbances that are typical of PwD; (B) the characteristics of the DBD and clinical needs and preferences; (C) the integration of the DBD into daily routines. The results tend to confirm the adequacy of the DBD to the day-to-day needs for the detection of behavioural disturbances and hazardous behaviours. The DBD was considered to be useful and easy to use in the tertiary care facility examined in this study. The participants intend to use the DBD in the future, which means that it has a high degree of acceptance.
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Affiliation(s)
- Mohamed-Amine Choukou
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada; (S.M.); (R.E.)
- Riverview Health Centre, Winnipeg, MB R3L 2P4, Canada
- Centre on Aging, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Sophia Mbabaali
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada; (S.M.); (R.E.)
| | - Ryan East
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada; (S.M.); (R.E.)
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Rantanen T, Eronen J, Kauppinen M, Kokko K, Sanaslahti S, Kajan N, Portegijs E. Life-Space Mobility and Active Aging as Factors Underlying Quality of Life Among Older People Before and During COVID-19 Lockdown in Finland-A Longitudinal Study. J Gerontol A Biol Sci Med Sci 2021; 76:e60-e67. [PMID: 33125043 PMCID: PMC7665359 DOI: 10.1093/gerona/glaa274] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Indexed: 12/19/2022] Open
Abstract
Background Social distancing, i.e. avoiding places with other people and staying at home, was recommended to prevent viral transmission during the COVID-19 pandemic. Potentially, reduced out-of-home mobility and lower activity levels among older people may lower their quality of life (QOL). We studied cross-sectional and longitudinal associations of and changes in life-space mobility, active ageing and QOL during COVID-19 social distancing compared to two years before. Methods Altogether 809 community-living participants initially aged 75, 80 or 85 years of our active aging study (AGNES) conducted in 2017-2018 took part in the current AGNES-COVID-19 survey in May and June 2020. Outdoor mobility was assessed with the Life-Space Assessment (range 0-120). Active approach to life was assessed with the University of Jyväskylä Active Aging Scale (range 0–272), and QOL with the shortened Older People’s Quality of Life Questionnaire (range13-65; higher scores better for all). Data were analyzed with General Estimating Equations, General Linear Models, and Oneway-ANOVA. Results Life-space mobility (B -10.8, SE 0.75, p<0.001), the active ageing score (B -24.1, SE 0.88, p<0.001) and the QOL score (B -1.65, SE 0.21, p<0.001) were lower during COVID-19 social distancing vs. two years before. Concurrent life-space mobility and active ageing scores, age and sex explained 48% of QOL at the baseline and 42% during social distancing. Longitudinally, steeper declines in all three variables coincided. Conclusions The observed declines indicate compliance with social distancing recommendation, but underline the importance of participation in meaningful life situations as a factor underlying good QOL also during COVID-19 pandemic.
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Affiliation(s)
- Taina Rantanen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyvaskyla, Finland
| | - Johanna Eronen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyvaskyla, Finland
| | - Markku Kauppinen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyvaskyla, Finland
| | - Katja Kokko
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyvaskyla, Finland
| | - Sini Sanaslahti
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyvaskyla, Finland
| | - Niina Kajan
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyvaskyla, Finland
| | - Erja Portegijs
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyvaskyla, Finland
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Portegijs E, Keskinen KE, Tuomola EM, Hinrichs T, Saajanaho M, Rantanen T. Older adults' activity destinations before and during COVID-19 restrictions: From a variety of activities to mostly physical exercise close to home. Health Place 2021; 68:102533. [PMID: 33647634 PMCID: PMC9185126 DOI: 10.1016/j.healthplace.2021.102533] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/25/2022]
Abstract
The aim was to study various types of older adult's activity destinations (counts, frequency of visitation, and distance from home) in the pre-COVID-19 era, and to study prospectively how COVID-19-related regulations limiting mobility affected these. Using a map-based questionnaire, 75-85-year-old participants reported activity destinations, that is, any destinations for physical exercise, destinations facilitating one's outdoor mobility, and destinations for other activities, which they had visited several times during the past month. At baseline, a variety of activity destinations was reported, but during COVID-19, destinations reported markedly declined in number, they were reported predominantly for physical exercise, and they were located closer to home.
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Affiliation(s)
- Erja Portegijs
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland.
| | - Kirsi E Keskinen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Essi-Mari Tuomola
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Milla Saajanaho
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
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Todo E, Higuchi Y, Ueda T, Murakami T, Kozuki W. A 3-month multicomponent home-based rehabilitation program for older people with restricted life-space mobility: a pilot study. J Phys Ther Sci 2021; 33:158-163. [PMID: 33642692 PMCID: PMC7897524 DOI: 10.1589/jpts.33.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/25/2020] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to verify the effects of a 3-month multicomponent home-based rehabilitation program developed on the basis of the reevaluation of older people with restricted life-space mobility. [Participants and Methods] The participants were residents in Japan aged ≥65 years who had Life-Space Assessment scores ≤52.3. Multicomponent home-based rehabilitation was conducted by physical and occupational therapists. Each visit included 40-60 min of combined exercise, practicing activities of daily living, improving the home environment, and caregiver support. The programs were developed in accordance with a flow diagram. The primary outcome was life-space mobility evaluated using the Life-Space Assessment score. [Results] Overall, 30 participants completed the intervention. The mean age of the participants was 82.4 ± 7.5 years. Three months after the intervention initiation, the Life-Space Assessment scores significantly improved from 12.0 to 30.5. The proportion of participants at maximal life-space level 5 (unlimited mobility) doubled from 16.7% at baseline to 33.3%. The functional independent measure score, fall efficacy scale score, and lower limb strength associated with standing up also significantly improved. We found no significant changes in the geriatric depression scale 5 and self-rated good health scores. [Conclusion] Multicomponent home-based rehabilitation can improve life-space mobility in older people with restricted life-space mobility.
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Affiliation(s)
- Emiko Todo
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University: 3-7-30 Habikino, Habikino-shi, Osaka 583-8555, Japan.,Home-visit Nursing Station, Tatsumi Clinic & Hospital, Japan
| | - Yumi Higuchi
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University: 3-7-30 Habikino, Habikino-shi, Osaka 583-8555, Japan
| | - Tetsuya Ueda
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University: 3-7-30 Habikino, Habikino-shi, Osaka 583-8555, Japan
| | - Tatsunori Murakami
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University: 3-7-30 Habikino, Habikino-shi, Osaka 583-8555, Japan
| | - Wataru Kozuki
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University: 3-7-30 Habikino, Habikino-shi, Osaka 583-8555, Japan
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Miyashita T, Tadaka E, Arimoto A. Cross-sectional study of individual and environmental factors associated with life-space mobility among community-dwelling independent older people. Environ Health Prev Med 2021; 26:9. [PMID: 33461488 PMCID: PMC7814432 DOI: 10.1186/s12199-021-00936-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 01/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Life-space mobility is reflected in comprehensive longevity and health outcomes and is also an important indicator for preventing mortality and decline in well-being among older people. However, a comprehensive framework of life-space mobility and modifiable individual and environmental factors has not been well validated among community-dwelling independent older people, for primary prevention. We examined individual and environmental factors affecting life-space mobility among community-dwelling independent older people. METHODS This cross-sectional study included 3500 community-dwelling independent older people randomly selected using the National Basic Resident Registration System in Japan. Life-space mobility was measured using the Japanese version of the Life-Space Assessment (LSA) instrument, which is used to assess an individual's pattern of mobility. Negative multivariate binomial regression analysis was performed in a final sample of 1258 people. Individual factors (including physical, mental, and social characteristics) and environmental factors (including the social and material environment) were measured and analyzed as potential factors. RESULTS Negative multivariable binomial regression analysis, adjusted for demographics, showed that LSA score was associated with locomotive syndrome (β = - 0.48, 95% confidence interval [CI] = - 0.24 to - 0.73), depression (β = - 0.29, 95% CI = - 0.03 to - 0.55), health literacy (β = 0.20, 95% CI = 0.39-0.01), and participation in community activities (β = 0.23, 95% CI = 0.03-0.43) among individual factors, and receipt of social support (β = - 0.19, 95% CI = 0.00 to - 0.38) and social network (β = 0.29, 95% CI = 0.48-0.10) among environmental factors. CONCLUSIONS Our findings suggest that modifiable individual factors and environmental factors are related to life-space mobility among community-dwelling older people.
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Affiliation(s)
- Tomoha Miyashita
- Health and Welfare Center, Totsuka Ward Office, 16-17 Totsukacho, Totsuka-ku, Yokohama, 244-0003, Japan.
| | - Etsuko Tadaka
- Department of Community Health Nursing, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Azusa Arimoto
- Department of Community Health Nursing, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
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Validation of the Life-Space Assessment (LSA-CI) in multi-morbid, older persons without cognitive impairment. Eur Geriatr Med 2021; 12:657-662. [PMID: 33428172 DOI: 10.1007/s41999-020-00441-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The "Life-Space Assessment in Persons with Cognitive Impairment" (LSA-CI) to assess mobility within the environment including frequency and independence in 1 week has been developed for and successfully validated in older persons with mild to moderate cognitive impairment. However, its psychometric properties in persons without cognitive impairment are unknown. This study aims to validate the LSA-CI in older persons without cognitive impairment. METHODS Comprehensive validation with construct validity, test-retest reliability and sensitivity to change of the LSA-CI including the main composite score and three sub-scores in community-dwelling older persons recruited during geriatric rehabilitation. RESULTS Excellent feasibility with 100% completion rate and an average assessment duration of 4 min in 65 older, multimorbid persons (mean age: 81.4 ± 5.9 years; 72.3% female; average number of diagnoses: 11.1 ± 4.4). The LSA-CI composite score stood out with moderate to high construct validity (Spearman correlation coefficients |0.26|-|0.60|), excellent test-retest reliability (intraclass correlation coefficient 0.890) and moderate sensitivity to change (adjusted standardized response mean 0.70). Analysis of sub-scores confirmed most of the composite score results. CONCLUSIONS The LSA-CI represents a valid, reliable, responsive, and highly feasible assessment method in multi-morbid, older persons without cognitive impairment, supporting the use of the LSA-CI in clinical practice and research.
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