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Harada K, Masumoto K, Okada S. Walking trail access, exercise behavior, and going out-of-home among older adults: Examining longitudinal associations and mediators. Arch Gerontol Geriatr 2024; 126:105534. [PMID: 38905815 DOI: 10.1016/j.archger.2024.105534] [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: 04/18/2024] [Revised: 05/19/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
AIM Although the presence of a walking trail within a neighborhood would be an important environmental determinant of health behaviors, such as exercise and going out-of-home, their longitudinal associations and mediators are still unconfirmed. This study examined the longitudinal associations of walking trail access with exercise behavior and going out-of-home and mediating roles of awareness and use of walking trails on their associations among older adults. METHODS A four-wave questionnaire-based longitudinal survey was conducted among Japanese older adults (Wave 1: baseline; Wave 2: after one year; Wave 3: after three years; and Wave 4: after five years). Each survey measured weekly exercise time and frequency of going out-of-home. Wave 4 survey also measured awareness and use of walking trails. This study calculated distance to nearest walking trail using geographic information systems. This study analyzed the data from all waves (n = 834) for longitudinal associations and the data from Wave 4 (n = 567) for mediated associations. RESULTS Latent growth modeling showed insignificant longitudinal associations of walking trail access with weekly exercise time and frequency of going out-of-home. The path analyses showed that a shorter distance to the walking trail was indirectly and significantly associated with longer weekly exercise time (standardized indirect effect=-0.03, p<.001) and a higher weekly frequency of going out-of-home (standardized indirect effect=-0.03, p<.001), mediated by awareness and use of walking trails. CONCLUSIONS These findings indicate that the influence of walking trail access on exercise behavior and going out-of-home would be attenuated by awareness and use of walking trails among older adults.
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Affiliation(s)
- Kazuhiro Harada
- Graduate School of Human Development and Environment, Kobe University, Japan; Advanced Research Center for Well-being, Kobe University, Japan; Institute for Advanced Research, Kobe University, Japan.
| | - Kouhei Masumoto
- Graduate School of Human Development and Environment, Kobe University, Japan; Advanced Research Center for Well-being, Kobe University, Japan
| | - Shuichi Okada
- Graduate School of Human Development and Environment, Kobe University, Japan; Hyogo Study Center, The Open University of Japan, Japan
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Liang W, Wang X, Cheng S, Jiao J, Zhu X, Duan Y. Effects of High-Intensity Interval Training on the Parameters Related to Physical Fitness and Health of Older Adults: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2024; 10:98. [PMID: 39266933 PMCID: PMC11393274 DOI: 10.1186/s40798-024-00767-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 08/27/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND As a novel and time-efficient exercise form, high-intensity interval training (HIIT) has shown great potential in improving health-related physical fitness among diverse populations. However, empirical evidence on its efficacy among the elderly has not been well summarized. This systematic review and meta-analysis aimed to determine the effect of HIIT interventions on the parameters related to physical fitness and health of older adults, including resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiorespiratory fitness (CRF), body mass index (BMI), body fat percent (BF%), waist circumference (WC), muscular endurance (ME), muscular strength (MS), muscular power (MP), balance and flexibility, compared to non-exercise and other-exercise (e.g., moderate-intensity continuous training, resistance training) conditions. METHODS Literature published from January 2000 to May 2023 was collected through extensive searches across eight databases and relevant review papers. Randomized controlled trials (RCTs) featuring a minimum 2-week exercise intervention for older adults (≥ 60 years) were included. The pooled effect size of Hedges'g was estimated using random-effects models in R. Meta-regression was performed for both categorical (health status, duration of training programme, and frequency) and continuous moderators (mean age, male rate, and attrition rate). RESULTS Forty-four eligible RCTs with 1863 participants (52.1% female; 60.5-81.2 years) were included in the quantitative analysis. Compared to non-exercise condition, HIIT significantly improved resting HR (g = -0.36, 95%CI = [-0.67, -0.05], P = 0.032), SBP (g = -0.29, 95%CI = [-0.54, -0.03], P = 0.008), CRF (g = 0.77, 95%CI = [0.51, 1.04], P < 0.001), BF% (g = -0.26, 95%CI = [-0.41, -0.11], P = 0.006), MS (g = 0.47, 95%CI = [0.23, 0.71], P = 0.004), ME (g = 0.65, 95%CI = [0.10, 1.19], P = 0.036), and balance (e.g., timed-up-and-go) (g = -0.79, 95%CI = [-1.19, -0.40], P = 0.035). Compared to other-exercise condition, HIIT significantly improved resting HR (g = -0.11, 95%CI = [-0.21, -0.01], P = 0.029), SBP (g = -0.14, 95%CI = [-0.28, -0.01], P = 0.038), and CRF (g = 0.23, 95%CI = [0.07, 0.38], P = 0.008). No significant difference was found between HIIT and non-exercise condition for DBP, BMI and WC, as well as between HIIT and other-exercise condition for DBP, BMI, BF%, WC, ME, and balance (all P > 0.05). Meta-regression indicated that mean age moderated the HIIT effect on resting HR (b = -0.02, P = 0.014; HIIT vs. other-exercise condition) and SBP (b = 0.03, P = 0.048; HIIT vs. non-exercise), and attrition rate moderated the effect on CRF (b = 0.03, P = 0.007; HIIT vs. non-exercise). CONCLUSION This study supports the efficacy of HIIT in improving resting HR, SBP, CRF, BF%, MS, ME and balance among older adults. More empirical evidence is needed to determine the efficacy of HIIT for MP and flexibility in this population. TRIAL REGISTRATION PROSPERO CRD42022316246.
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Affiliation(s)
- Wei Liang
- School of Physical Education, Shenzhen University, Shenzhen, China
| | - Xiang Wang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.
| | - Shishi Cheng
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Jiao Jiao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Xiangui Zhu
- School of Physical Education, Hebei Normal University, Shijiazhuang, China
| | - Yanping Duan
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.
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Dunlap PM, Crane BM, Perera S, Moored KD, Carlson MC, Brach JS, Klatt BN, Rosso AL. Effects of a Physical Therapist Intervention on GPS Indicators of Community Mobility in Older Adults: A Secondary Analysis of a Randomized Controlled Trial. Phys Ther 2023; 103:pzad071. [PMID: 37364044 PMCID: PMC10471202 DOI: 10.1093/ptj/pzad071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/22/2022] [Accepted: 05/04/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE The authors compared the effects of a standard strength and endurance intervention with a standard plus timing and coordination training intervention on community mobility measured using global positioning systems (GPS) among community-dwelling older adults in this secondary analysis of a randomized controlled trial. METHODS Participants were randomized to a standard or a standard plus timing and coordination training program. Community mobility was measured using the Life Space Assessment (LSA) and GPS indicators of community mobility at baseline, as well as at 12 (immediately after the intervention), 24, and 36 weeks. Linear mixed models were used for analysis. RESULTS There were 166 participants with GPS data at baseline, including 81 in the standard plus group and 85 in the standard group. The groups did not differ in participant characteristics or GPS measures at baseline. There were no significant within-group changes in GPS indicators of community mobility or LSA score over time, nor between-group differences of the same. CONCLUSION There were no significant changes in community mobility with either intervention or between-intervention differences. These findings suggest that interventions targeting physical function alone may not be sufficient to improve community mobility or participation in older adults. Future research should focus on the development of multifaceted interventions targeted to improve real-world participation. IMPACT The studied interventions did not significantly change community mobility measured using GPS-derived community mobility measures or self-report measures in older adults, suggesting that more comprehensive interventions may be needed to target improvements in community mobility.
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Affiliation(s)
- Pamela M Dunlap
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Breanna M Crane
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Subashan Perera
- Division of Geriatric Medicine and Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kyle D Moored
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Jennifer S Brach
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brooke N Klatt
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrea L Rosso
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Crane B, Moored K, Rosso A, Carlson M. Using GPS Technologies to Examine Community Mobility in Older Adults. J Gerontol A Biol Sci Med Sci 2023; 78:811-820. [PMID: 36073676 PMCID: PMC10172976 DOI: 10.1093/gerona/glac185] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Objective measures of community mobility are advantageous for capturing movement outside the home. Compared with subjective, self-reported techniques, global positioning system (GPS) technologies leverage passive, real-time location data to reduce recall bias and increase measurement precision. We developed methods to quantify community mobility among community-dwelling older adults and assessed how GPS-derived indicators relate to clinical measures of physical and cognitive performance. METHODS Participants (n = 149; M ± standard deviation [SD] = 77.1 ± 6.5 years) from the program to improve mobility in aging (PRIMA) study, a physical therapy intervention to improve walking ability, carried a GPS device for 7 days. Community mobility was characterized by assessing activity space, shape, duration, and distance. Associations between GPS-derived indicators and cognition and physical function were evaluated using Spearman correlations. RESULTS In adjusted models, a larger activity space, greater duration (eg, time out-of-home), and greater distance traveled from home were correlated with better 6-Minute Walk Test performance (ρ = 0.17-0.23, p's < .05). A more circular activity shape was related to poorer performance on the Trail Making Test, Part A (ρ = 0.18, p < .05). More time out-of-home and a larger activity space were correlated with faster times on the Trail Making Test, Part B (ρ = -0.18 to -0.24, p's < .05). Community mobility measures were not associated with global cognition, skilled walking, or usual gait speed. CONCLUSION GPS-derived community mobility indicators capture real-world activity among older adults and were correlated with clinical measures of executive function and walking endurance. These findings will guide the design of future interventions to promote community mobility.
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Affiliation(s)
- Breanna M Crane
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,USA
| | - Kyle D Moored
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania,USA
| | - Andrea L Rosso
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania,USA
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,USA
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Gignac F, Righi V, Toran R, Paz Errandonea L, Ortiz R, Mijling B, Naranjo A, Nieuwenhuijsen M, Creus J, Basagaña X. Short-term NO 2 exposure and cognitive and mental health: A panel study based on a citizen science project in Barcelona, Spain. ENVIRONMENT INTERNATIONAL 2022; 164:107284. [PMID: 35576732 DOI: 10.1016/j.envint.2022.107284] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The association between short-term exposure to air pollution and cognitive and mental health has not been thoroughly investigated so far. OBJECTIVES We conducted a panel study co-designed with citizens to assess whether air pollution can affect attention, perceived stress, mood and sleep quality. METHODS From September 2020 to March 2021, we followed 288 adults (mean age = 37.9 years; standard deviation = 12.1 years) for 14 days in Barcelona, Spain. Two tasks were self-administered daily through a mobile application: the Stroop color-word test to assess attention performance and a set of 0-to-10 rating scale questions to evaluate perceived stress, well-being, energy and sleep quality. From the Stroop test, three outcomes related to selective attention were calculated and z-score-transformed: response time, cognitive throughput and inhibitory control. Air pollution was assessed using the mean nitrogen dioxide (NO2) concentrations (mean of all Barcelona monitoring stations or using location data) 12 and 24 h before the tasks were completed. We applied linear regression with random effects by participant to estimate intra-individual associations, controlling for day of the week and time-varying factors such as alcohol consumption and physical activity. RESULTS Based on 2,457 repeated attention test performances, an increase of 30 μg/m3 exposure to NO2 12 h was associated with lower cognitive throughput (beta = -0.08, 95% CI: -0.15, -0.01) and higher response time (beta = 0.07, 95% CI: 0.01, 0.14) (increase inattentiveness). Moreover, an increase of 30 μg/m3 exposure to NO2 12 h was associated with higher self-perceived stress (beta = 0.44, 95% CI: 0.13, 0.77). We did not find statistically significant associations with inhibitory control and subjective well-being. CONCLUSIONS Our findings suggest that short-term exposure to air pollution could have adverse effects on attention performance and perceived stress in adults.
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Affiliation(s)
- Florence Gignac
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Raül Toran
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Rodney Ortiz
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Bas Mijling
- Royal Netherlands Meteorological Institute (KNMI), De Bilt, the Netherlands
| | | | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Xavier Basagaña
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
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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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Lai FHY, Yan EWH, Tsui WS, Yu KKY. A randomized control trial of activity scheduling for caring for older adults with dementia and its impact on their spouse care-givers. Arch Gerontol Geriatr 2020; 90:104167. [DOI: 10.1016/j.archger.2020.104167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/14/2020] [Accepted: 06/28/2020] [Indexed: 01/05/2023]
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Chung J, Lee J, Elswick RK. Life-space mobility in dementia patients and family caregivers: A dyadic approach. Int J Older People Nurs 2020; 15:e12341. [PMID: 32798303 DOI: 10.1111/opn.12341] [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] [Received: 02/24/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Given that most dementia care is provided at home by family caregivers, caregivers' health and outdoor activities may influence persons with dementia (PWDs)' mobility. At the same time, PWDs' functional deterioration and mobility changes might affect mobility behaviours in their caregivers. The aims of this pilot study were to examine the relationship of PWD's life-space mobility (LSM) with their caregiver's LSM and to investigate the role of caregiver and PWD characteristics in determining the level of LSM in both PWDs and caregivers. DESIGN AND METHOD A cross-sectional survey was conducted with 26 caregivers providing dementia care at home. Caregivers were used as proxy for assessing sociodemographic, clinical and physical function in PWDs. Caregivers' sociodemographic characteristics, LSM, social support, depressive symptoms, caregiving burden and preparedness for caregiving were measured. RESULTS The level of LSM in caregivers was correlated with the PWD's LSM level. Caregivers who perceived high levels of social support and readiness for caregiving tended to report high levels of LSM. PWDs' age and independence in instrumental activities of daily living were correlated with caregivers' LSM. CONCLUSIONS The study findings suggest that the caregiver's LSM influenced and was affected by the PWD's LSM. This underscores the need for additional research that examines the role of caregivers' psychosocial and physical health on PWDs' mobility and the context of dementia care and its influences on how dementia care dyads decide and participate in mobility behaviours. IMPLICATIONS FOR PRACTICE The findings of this pilot study will be helpful in identifying a target for interventions designed to delay the onset of mobility disability and maintain and improve social participation in PWDs. To minimise the effects of mobility limitations in PWDs, it is critical to examine their mobility issues from multilevel perspectives, including their caregiver's LSM levels and characteristics that have implications for both research and clinical practice.
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Affiliation(s)
- Jane Chung
- Virginia Commonwealth University School of Nursing, Richmond, Virginia, USA
| | - Jongwon Lee
- University of New Mexico College of Nursing, Albuquerque, New Mexico, USA
| | - Ronald K Elswick
- Virginia Commonwealth University School of Nursing, Richmond, Virginia, USA
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The Effect of a Multicomponent Dual-Task Exercise on Cortical Thickness in Older Adults with Cognitive Decline: A Randomized Controlled Trial. J Clin Med 2020; 9:jcm9051312. [PMID: 32370159 PMCID: PMC7290566 DOI: 10.3390/jcm9051312] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 04/24/2020] [Accepted: 04/26/2020] [Indexed: 02/03/2023] Open
Abstract
The aim of this study was to examine cortical thickness changes associated with a multicomponent exercise intervention combining physical exercise and cognitive training in older adults with cognitive decline. This study involved a secondary analysis of neuroimaging data from a randomized controlled trial with 280 older adults having cognitive decline who were randomly assigned to either a multicomponent exercise group (n = 140) that attended weekly 90-minute exercise and cognitive training sessions or a health education control group (n = 140). The cortical thickness and cognitive performance were assessed at the baseline and at trial completion (10 months). The cortical thickness in the frontal and temporal regions was determined using FreeSurfer software. Cognitive performance was evaluated using the Gerontology-Functional Assessment Tool (NCGG-FAT). The cortical thickness significantly increased in the middle temporal (p < 0.001) and temporal pole (p < 0.001) in the multicomponent exercise group compared with the control group. Cortical thickness changes were significantly associated with change in trail making test (TMT)-A, TMT-B, and story memory after a 10-month multicomponent exercise intervention. This study suggests that multicomponent exercise programs combining physical exercise and cognitive training have important implications for brain health, especially in providing protection from age-related cortical thinning.
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Fillekes MP, Kim EK, Trumpf R, Zijlstra W, Giannouli E, Weibel R. Assessing Older Adults' Daily Mobility: A Comparison of GPS-Derived and Self-Reported Mobility Indicators. SENSORS 2019; 19:s19204551. [PMID: 31635100 PMCID: PMC6833043 DOI: 10.3390/s19204551] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/12/2019] [Accepted: 10/15/2019] [Indexed: 12/24/2022]
Abstract
Interest in global positioning system (GPS)-based mobility assessment for health and aging research is growing, and with it the demand for validated GPS-based mobility indicators. Time out of home (TOH) and number of activity locations (#ALs) are two indicators that are often derived from GPS data, despite lacking consensus regarding thresholds to be used to extract those as well as limited knowledge about their validity. Using 7 days of GPS and diary data of 35 older adults, we make the following three main contributions. First, we perform a sensitivity analysis to investigate how using spatial and temporal thresholds to compute TOH and #ALs affects the agreement between self-reported and GPS-based indicators. Second, we show how daily self-reported and GPS-derived mobility indicators are compared. Third, we explore whether the type and duration of self-reported activity events are related to the degree of correspondence between reported and GPS event. Highest indicator agreement was found for temporal interpolation (Tmax) of up to 5 h for both indicators, a radius (Dmax) to delineate home between 100 and 200 m for TOH, and for #ALs a spatial extent (Dmax) between 125 and 200 m, and temporal extent (Tmin) between 5 and 6 min to define an activity location. High agreement between self-reported and GPS-based indicators is obtained for TOH and moderate agreement for #ALs. While reported event type and duration impact on whether a reported event has a matching GPS event, indoor and outdoor events are detected at equal proportions. This work will help future studies to choose optimal threshold settings and will provide knowledge about the validity of mobility indicators.
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Affiliation(s)
- Michelle Pasquale Fillekes
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland.
| | - Eun-Kyeong Kim
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland.
| | - Rieke Trumpf
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
- Department of Geriatric Psychiatry and Psychotherapy, LVR Hospital Cologne, Wilhelm-Griesinger-Straße 23, 51109 Cologne, Germany.
| | - Wiebren Zijlstra
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
| | - Eleftheria Giannouli
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
| | - Robert Weibel
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
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Fillekes MP, Giannouli E, Kim EK, Zijlstra W, Weibel R. Towards a comprehensive set of GPS-based indicators reflecting the multidimensional nature of daily mobility for applications in health and aging research. Int J Health Geogr 2019; 18:17. [PMID: 31340812 PMCID: PMC6657041 DOI: 10.1186/s12942-019-0181-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 07/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND GPS tracking is increasingly used in health and aging research to objectively and unobtrusively assess individuals' daily-life mobility. However, mobility is a complex concept and its thorough description based on GPS-derived mobility indicators remains challenging. METHODS With the aim of reflecting the breadth of aspects incorporated in daily mobility, we propose a conceptual framework to classify GPS-derived mobility indicators based on their characteristic and analytical properties for application in health and aging research. In order to demonstrate how the classification framework can be applied, existing mobility indicators as used in existing studies are classified according to the proposed framework. Then, we propose and compute a set of selected mobility indicators based on real-life GPS data of 95 older adults that reflects diverse aspects of individuals' daily mobility. To explore latent dimensions that underlie the mobility indicators, we conduct a factor analysis. RESULTS The proposed framework enables a conceptual classification of mobility indicators based on the characteristic and analytical aspects they reflect. Characteristic aspects inform about the content of the mobility indicator and comprise categories related to space, time, movement scope, and attribute. Analytical aspects inform how a mobility indicator is aggregated with respect to temporal scale and statistical property. The proposed categories complement existing studies that often underrepresent mobility indicators involving timing, temporal distributions, and stop-move segmentations of movements. The factor analysis uncovers the following six dimensions required to obtain a comprehensive view of an older adult's daily mobility: extent of life space, quantity of out-of-home activities, time spent in active transport modes, stability of life space, elongation of life space, and timing of mobility. CONCLUSION This research advocates incorporating GPS-based mobility indicators that reflect the multi-dimensional nature of individuals' daily mobility in future health- and aging-related research. This will foster a better understanding of what aspects of mobility are key to healthy aging.
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Affiliation(s)
- Michelle Pasquale Fillekes
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland.
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Andreasstrasse 15, 8050, Zurich, Switzerland.
| | - Eleftheria Giannouli
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Eun-Kyeong Kim
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Andreasstrasse 15, 8050, Zurich, Switzerland
| | - Wiebren Zijlstra
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Robert Weibel
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
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Environmental predictors of objectively measured out-of-home time among older adults with cognitive decline. Arch Gerontol Geriatr 2019; 82:259-265. [PMID: 30878823 DOI: 10.1016/j.archger.2019.01.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/07/2019] [Accepted: 01/26/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Older adults with cognitive decline are vulnerable to various health problems. Going out of home for longer time could be beneficial for their health. Identifying modifiable predictors is essential for developing effective strategies that would increase time spent out-of-home by older adults. This study examined social and physical environmental predictors of objectively measured out-of-home time spent among older adults with cognitive decline. METHODS This study was a secondary analysis of a randomized controlled trial (n = 147). Out-of-home time per day was measured by a Global Positioning System at baseline and 1-year follow-up. Baseline data of social environment (living alone, social network [Japanese version of the Lubben Social Network Scale]), objective physical environment (road network distance from each home address to nearest supermarket store, convenience store, and public transportation), and demographic factors (gender, age, education, driving status, fear of falling) were examined as potential predictors. RESULTS After adjusting main effects of allocation group, time of measures, and their interactive effect, a mixed model showed that younger age (p = 0.044), current driving status (p = 0.039), and stronger social network (p = 0.003) were predictors of out-of-home time. However, none of the physical environmental factors significantly predicted outdoor time. CONCLUSIONS The present study found that social network was a predictor of objectively measured out-of-home time among older adults with global cognitive decline. A sufficient social network might help increase out-of-home time among them. However, the influence of physical environment on out-of-home time might be small.
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