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Tuomola EM, Keskinen KE, Viljanen A, Rantanen T, Portegijs E. Neighborhood Walkability, Walking Difficulties, and Participation in Leisure Activities Among Older People: A Cross-Sectional Study and 4-Year Follow-Up of a Subsample. J Aging Health 2024; 36:367-378. [PMID: 37482698 PMCID: PMC11025300 DOI: 10.1177/08982643231191444] [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] [Indexed: 07/25/2023]
Abstract
Objectives: To study cross-sectional and longitudinal associations between objectively assessed neighborhood walkability, walking difficulties, and participation in leisure activities among older people. Methods: Self-reported 2 km walking difficulty (intact, modifications, difficulties) at baseline and participating in organized group, outdoor recreation and cultural activities at baseline and follow-up were studied in community-dwelling persons (N = 848) aged 75-90. A walkability index, calculated using a geographic information system, was categorized into tertiles (lowest, middle, highest). Results: Residence in the highest walkability areas was associated with higher participation in cultural activities and lower participation in outdoor recreation, while the latter was most frequently reported by residents in the lowest walkability areas. Those reporting no difficulties were more likely than those reporting difficulties to participate in all studied activities. Residence in the middle or highest walkability areas predicted higher participation in cultural activities at follow-up. Discussion: Older persons activity profiles associate with neighborhood walkability and walking difficulties.
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Affiliation(s)
- Essi-Mari Tuomola
- 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
| | - Anne Viljanen
- 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
| | - Erja Portegijs
- University Medical Center Groningen, Center for Human Movement Sciences, University of Groningen, Groningen, The Netherlands
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Kalu ME, Bello-Haas VD, Griffin M, Boamah S, Harris J, Zaide M, Rayner D, Khattab N, Abrahim S. A Scoping Review of Personal, Financial, and Environmental Determinants of Mobility Among Older Adults. Arch Phys Med Rehabil 2023; 104:2147-2168. [PMID: 37119957 DOI: 10.1016/j.apmr.2023.04.007] [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: 03/27/2022] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To synthesize available evidence of factors comprising the personal, financial, and environmental mobility determinants and their association with older adults' self-reported and performance-based mobility outcomes. DATA SOURCES PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Sociological Abstract, Allied and Complementary Medicine Database, and Cumulative Index to Nursing and Allied Health Literature databases search for articles published from January 2000 to December 2021. STUDY SECTION Using predefined inclusion and exclusion criteria, multiple reviewers independently screened 27,293 retrieved citations from databases, of which 422 articles underwent full-text screening, and 300 articles were extracted. DATA EXTRACTION The 300 articles' information, including study design, sample characteristics including sample size, mean age and sex, factors within each determinant, and their associations with mobility outcomes, were extracted. DATA SYNTHESIS Because of the heterogeneity of the reported associations, we followed Barnett et al's study protocol and reported associations between factors and mobility outcomes by analyses rather than by article to account for multiple associations generated in 1 article. Qualitative data were synthesized using content analysis. A total of 300 articles were included with 269 quantitative, 22 qualitative, and 9 mixed-method articles representing personal (n=80), and financial (n=1), environmental (n=98), more than 1 factor (n=121). The 278 quantitative and mixed-method articles reported 1270 analyses; 596 (46.9%) were positively and 220 (17.3%) were negatively associated with mobility outcomes among older adults. Personal (65.2%), financial (64.6%), and environmental factors (62.9%) were associated with mobility outcomes, mainly in the expected direction with few exceptions in environmental factors. CONCLUSIONS Gaps exist in understanding the effect of some environmental factors (eg, number and type of street connections) and the role of gender on older adults' walking outcomes. We have provided a comprehensive list of factors with each determinant, allowing the creation of core outcome set for a specific context, population, or other forms of mobility, for example, driving.
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Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Salma Abrahim
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
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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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Brach M, de Bruin ED, Levin O, Hinrichs T, Zijlstra W, Netz Y. Evidence-based yet still challenging! Research on physical activity in old age. Eur Rev Aging Phys Act 2023; 20:7. [PMID: 36932320 PMCID: PMC10022149 DOI: 10.1186/s11556-023-00318-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Preserving functional health and quality-of-life in old age is a major goal and global challenge in public health. The high rate of sedentary behavior that is characteristic of the older adult population exacerbates impairments of physiological and structural systems that are typically seen in the aging process. Achieving an understanding of the profound influence of physical activity on all aspects of health in old age is the driving force behind the emergence of "physical activity in old age" as a growing area of research. Accumulated evidence implies that being physically active and exercising is far superior to other optimal aging facilitators. Yet this area of research faces numerous constraints and obstacles. This commentary addresses some of these challenges, primarily the heterogeneity of the aging process, which induces both inter- and intra-individual differences among aged individuals, heterogeneity in assessment tools, unjustified inclusion/exclusion criteria and insufficient recruitment strategies, difficulties in implementing research results in real-world conditions, and rudimentary exploitation of innovative technology. We explain the importance of establishing a network of multidisciplinary scientists and stakeholders to propose consensus-based goals and scientifically evidenced wide-ranging plans for dealing with these challenges. In addition, we suggest work directions for this network.
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Affiliation(s)
- Michael Brach
- Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - Eling D. de Bruin
- Department of Health, OST – Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Oron Levin
- Movement Control and Neuroplasticity Research Group, Biomedical Sciences, KU Leuven, Louvain, Belgium
| | - Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Wiebren Zijlstra
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Cologne, Germany
| | - Yael Netz
- Levinsky-Wingate Academic Center, The Academic College at Wingate, Netanya, Israel
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
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5
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Takagi D, Kondo N, Tsuji T, Kondo K. Parks/sports facilities in local communities and the onset of functional disability among older adults in Japan: The J-shaped spatial spillover effects. Health Place 2022; 75:102801. [PMID: 35429762 DOI: 10.1016/j.healthplace.2022.102801] [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: 05/18/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/24/2022]
Abstract
We examined the associations between parks/sports facilities in local communities and the onset of functional disability among Japanese older adults. We further investigated the spatial spillover effects of parks/sports facilities in 1st-, 2nd-, and 3rd-degree neighboring communities. Data on the onset of functional disability, including date of onset, sex, age, and address (school district) of all older adults aged 65 years and older living in Kobe City were obtained from the public long-term care insurance database (163,348 men [190,831 person-year] and 200,443 women [230,464 person-year]). Multilevel proportional hazard regression analyses showed that the number of parks and sports facilities were negatively associated with the onset of functional disability among men. In particular, these associations were stronger for the adjacent district than for individuals' living districts. Our results imply that involving multiple neighboring communities as the intervention unit is effective when utilizing community built environments for long-term care prevention in men.
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Affiliation(s)
- Daisuke Takagi
- Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Naoki Kondo
- Graduate School of Medicine, Kyoto University, Yoshida-konoe-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8315, Japan
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan
| | - Katsunori Kondo
- Center for Preventive Medicine Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba-ken, 260-0856, Japan; Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu-shi, Aichi-ken, 474-8511, Japan
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Portegijs E, Timmermans EJ, Castell MV, Dennison EM, Herbolsheimer F, Limongi F, van der Pas S, Schaap LA, van Schoor N, Deeg DJH. Neighborhood Resources Associated With Active Travel in Older Adults-A Cohort Study in Six European Countries. J Aging Phys Act 2020; 28:920-933. [PMID: 32580163 DOI: 10.1123/japa.2019-0267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 03/18/2020] [Accepted: 04/04/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To study associations between perceived neighborhood resources and time spent by older adults in active travel. METHODS Respondents in six European countries, aged 65-85 years, reported on the perceived presence of neighborhood resources (parks, places to sit, public transportation, and facilities) with response options "a lot," "some," and "not at all." Daily active travel time (total minutes of transport-related walking and cycling) was self-reported at the baseline (n = 2,695) and 12-18 months later (n = 2,189). RESULTS Reporting a lot of any of the separate resources (range B's = 0.19-0.29) and some or a lot for all four resources (B = 0.22, 95% confidence interval [0.09, 0.35]) was associated with longer active travel time than reporting none or fewer resources. Associations remained over the follow-up, but the changes in travel time were similar, regardless of the neighborhood resources. DISCUSSION Perceiving multiple neighborhood resources may support older adults' active travel. Potential interventions, for example, the provision of new resources or increasing awareness of existing resources, require further study.
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Hinrichs T, Zanda A, Fillekes MP, Bereuter P, Portegijs E, Rantanen T, Schmidt-Trucksäss A, Zeller AW, Weibel R. Map-based assessment of older adults' life space: validity and reliability. Eur Rev Aging Phys Act 2020; 17:21. [PMID: 33292160 PMCID: PMC7700712 DOI: 10.1186/s11556-020-00253-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background Map-based tools have recently found their way into health-related research. They can potentially be used to quantify older adults’ life-space. This study aimed to evaluate the validity (vs. GPS) and the test-retest reliability of a map-based life-space assessment (MBA). Methods Life-space of one full week was assessed by GPS and by MBA. MBA was repeated after approximately 3 weeks. Distance-related (mean and maximum distance from home) and area-related (convex hull, standard deviational ellipse) life-space indicators were calculated. Intraclass correlations (MBA vs. GPS and test-retest) were calculated in addition to Bland-Altman analyses (MBA vs. GPS). Results Fifty-eight older adults (mean age 74, standard deviation 5.5 years; 39.7% women) participated in the study. Bland-Altman analyses showed the highest agreement between methods for the maximum distance from home. Intraclass correlation coefficients ranged between 0.19 (95% confidence interval 0 to 0.47) for convex hull and 0.72 (95% confidence interval 0.52 to 0.84) for maximum distance from home. Intraclass correlation coefficients for test-retest reliability ranged between 0.04 (95% confidence interval 0 to 0.30) for convex hull and 0.43 (95% confidence interval 0.19 to 0.62) for mean distance from home. Conclusions While acceptable validity and reliability were found for the distance-related life-space parameters, MBA cannot be recommended for the assessment of area-related life-space parameters.
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Affiliation(s)
- Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052, Basel, Switzerland.
| | - Adriana Zanda
- Department of Geography, University of Zurich, Zurich, Switzerland
| | - Michelle P Fillekes
- Department of Geography, University of Zurich, Zurich, Switzerland.,University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland
| | - Pia Bereuter
- Institute of Geomatics Engineering, University of Applied Sciences and Arts, Northwestern Switzerland, Muttenz, Switzerland
| | - Erja Portegijs
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyvaskyla, Finland
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyvaskyla, Finland
| | - Arno Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052, Basel, Switzerland
| | - Andreas W Zeller
- Centre for Primary Health Care, University of Basel, Basel, Switzerland
| | - Robert Weibel
- Department of Geography, University of Zurich, Zurich, Switzerland.,University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland
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Recovery of mobility function and life-space mobility after ischemic stroke: the MOBITEC-Stroke study protocol. BMC Neurol 2020; 20:348. [PMID: 32938425 PMCID: PMC7493846 DOI: 10.1186/s12883-020-01920-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/07/2020] [Indexed: 11/10/2022] Open
Abstract
Background Stroke is a major cause of disability and stroke incidence increases with age. Stroke frequently results in permanent limitations of mobility, and, consequently, the need for the help of others in activities of daily living. In order to optimize rehabilitative efforts and their functional outcomes, detailed knowledge of the functional recovery process, regarding mobility, is needed. Objectives of the MOBITEC-Stroke study are: 1.) To characterize mobility, including lower extremity physical function (LEPF) and life space (the geospatial extent of all of a person’s movements), and changes in mobility within the first year after stroke. 2.) To identify and characterize subgroups with different mobility trajectories. 3.) To evaluate whether changes in LEPF are associated with changes in life-space. 4.) To evaluate participants’ reasons for going outdoors, transportation use, and assistance needed for outdoor movement. Methods Patients with incident first stroke who live in their own homes (target N = 59, based on sample size calculation) will be included in this cohort study. At 3, 6, 9, and 12 months after stroke a battery of mobility tests will be performed at the study centre, including laboratory-based tests of balance and strength, and quantitative gait analysis. Life-space assessment (including 1-week GPS measurements) will be performed in participants’ real life. Semantic information on visited locations (reasons for going outdoors, transportation use, assistance needed) will be collected by using interactive digital maps. Linear mixed effects models will be used to model the trajectories of mobility measures for the total sample and for predefined subgroups. As an exploratory analysis, growth mixture models (GMMs) will be used to identify relevant subgroups with different trajectories. Linear mixed effect models will be used to test whether changes in LEPF parameters are associated with changes in life-space. Participants’ motivation for going outdoors, transportation use, and assistance needed for outdoor mobility will be analysed descriptively. Discussion A comprehensive and detailed knowledge of recovery patterns will enable the planning of targeted and adaptively tailored rehabilitation measures. Information about patients’ reasons for outdoor mobility will provide the opportunity to define individualized and patient-oriented rehabilitation goals. Trial registration ISRCTN85999967 (on 13 August 2020; retrospectively).
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Freiberger E, Sieber CC, Kob R. Mobility in Older Community-Dwelling Persons: A Narrative Review. Front Physiol 2020; 11:881. [PMID: 33041836 PMCID: PMC7522521 DOI: 10.3389/fphys.2020.00881] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 06/29/2020] [Indexed: 12/21/2022] Open
Abstract
Due to the demographic changes and the increasing awareness of the role of physical function, mobility in older age is becoming an important topic. Mobility limitations have been reported as increasingly prevalent in older persons affecting about 35% of persons aged 70 and the majority of persons over 85 years. Mobility limitations have been associated with increased fall risk, hospitalization, a decreased quality of life, and even mortality. As concepts of mobility are multifactorial and complex, in this narrative review, definitions, physical factors, and their age-related changes associated with mobility will be presented. Also, areas of cognitive decline and their impact on mobility, as well as neuromuscular factors related to mobility will be addressed. Another section will relate psychological factors such as Fall-related psychological concerns and sedentary behavior to mobility. Assessment of mobility as well as effective exercise interventions are only shortly addressed. In the last part, gaps and future work on mobility in older persons are discussed.
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Affiliation(s)
- Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | - Cornel Christian Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | - Robert Kob
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
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Portegijs E, Keskinen KE, Eronen J, Saajanaho M, Rantakokko M, Rantanen T. Older Adults' Physical Activity and the Relevance of Distances to Neighborhood Destinations and Barriers to Outdoor Mobility. Front Public Health 2020; 8:335. [PMID: 32850580 PMCID: PMC7426456 DOI: 10.3389/fpubh.2020.00335] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/16/2020] [Indexed: 12/30/2022] Open
Abstract
Aim: To determine the relevance of features located close to home and further away, our aim was to study associations between older adults' physical activity and self-reported neighborhood destinations and barriers to outdoor mobility categorized by presence and maximal distance from home. Methods: Cross-sectional analyses comprising men and women 79-94 years old (57%) living independently in Central Finland (n = 185). Self-reported physical activity was categorized into lower (≤3 h moderate activity a week) and higher (≥4 h moderate or intense activity a week) activity. Assisted by interviewers, participants located on an interactive map destinations perceived to facilitate and barriers perceived to hinder outdoor mobility in their neighborhood. Participants' home addresses were geolocated. Euclidean distances between home and reported locations were computed, and the maximal distance from home to neighborhood destinations and barriers, respectively, was categorized based using four common buffer distances, i.e., 250 m, 500 m, 750 m, and 1 km. Participants reporting destinations or barriers within and beyond the respective distance were compared with those reporting none. Results: About 80% of participants reported neighborhood destinations and 55% neighborhood barriers to outdoor mobility. Barriers were generally located closer to home than destinations [median 166 m (range 25 m-6.10 km) vs. 492 m (5 m-2.7 km)]. Logistic regression analyses adjusted for age, sex, and physical performance showed that neighborhood destinations increased the odds for higher physical activity when located beyond 500 m from home [OR 2.95, 95% confidence interval (CI) 1.02-8.54], but not when located solely within 500 m (OR 1.70, 95% CI 0.30-9.61), in comparison with when reporting no destinations. In contrast, neighborhood barriers decreased the odds for higher physical activity when solely located within 500 m (OR 0.31, 95% CI 0.14-0.72), but not when any barrier was located beyond 500 m (OR 0.96, 95% CI 0.23-3.99), compared with when reporting no barriers. Associations were similar for 250-m buffer distances, but not robust for 750-m and 1,000-m buffers because of lower prevalence. Conclusion: Neighborhood barriers to outdoor mobility located close to home were associated with lower physical activity of older adults, whereas barriers further away were not. Attractive destinations for outdoor mobility located further away from home correlated with higher physical activity, potentially by motivating one to go out and be physically active. Temporal relationships warrant further study.
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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
| | - Johanna Eronen
- 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
| | - Merja Rantakokko
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
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