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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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Sugita Y, Ohnuma T, Kogure E, Hara T. Factors associated with life-space mobility restriction in home-care older adults receiving home-visit rehabilitation: A cross-sectional multi-center study in Japan. Geriatr Gerontol Int 2023; 23:722-728. [PMID: 37678841 DOI: 10.1111/ggi.14657] [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: 02/13/2023] [Revised: 07/30/2023] [Accepted: 08/16/2023] [Indexed: 09/09/2023]
Abstract
AIM Life-space mobility (LSM) restriction is a serious issue among older adults using home-visit rehabilitation (HR). This study evaluated physical function, transportation, and other factors not comprehensively tested in previous studies and examined factors associated with the restriction of LSM among older adults using HR. METHODS This cross-sectional multi-center study recruited 88 HR users (49 men, 39 women, mean age 79.0 [±7.8] years) living in urban and rural areas from August to October 2020. We administered the Life-Space Assessment (LSA), the Self-Efficacy Scale on Going out among community-dwelling Elderly (SEGE), grip strength, a 30-s chair stand test, Bedside Mobility Scale, Functional Independence Measure, Frenchay Activities Index (FAI), Ikigai-9, and Home and Community Environment (HACE) test. Participants were divided into two groups based on the cut-off value of the LSA scores. In the logistic regression analysis, the dependent variable was LSA scores ≤30, and the independent variables were measured based on objective evaluation items and adjusted for confounding factors (age, sex, and frequency of use of day-care services). RESULTS Restriction of LSM was significantly associated with FAI (odds ratio [OR] = 0.817, 95% confidence interval [CI] = 0.706-0.945), HACE facilitators (OR = 1.558, 95% CI = 1.168-2.079), and living alone (OR = 12.822, 95% CI = 1.202-136.716). CONCLUSION Restriction of LSM is associated with environmental factors, such as assistive devices and household composition, and ability to engage in instrumental activities of daily living. Our findings indicate a great need for focusing on these factors among home-care older adults receiving HR. Geriatr Gerontol Int 2023; 23: 722-728.
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Affiliation(s)
- Yuta Sugita
- Nishinasuno General Home Care Center, Tochigi, Japan
| | - Takeshi Ohnuma
- Rehabilitation Progress Center Incorporated, Tokyo, Japan
| | | | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi, Japan
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Elf M, Rasoal D, Zingmark M, Kylén M. The importance of context-a qualitative study exploring healthcare practitioners' experiences of working with patients at home after a stroke. BMC Health Serv Res 2023; 23:733. [PMID: 37415156 DOI: 10.1186/s12913-023-09735-7] [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: 10/18/2022] [Accepted: 06/22/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Stroke significantly impacts individuals, leading to the need for long-lasting rehabilitation and adaptation to environmental demands. Rehabilitation after stroke is increasingly performed in patients' homes, and it is argued that rehabilitation in this context is more person-centred and positively impacts client outcomes. However, the role of environmental factors in this process is largely unknown. The aim of this study was to explore how multidisciplinary healthcare practitioners working with rehabilitation in the home after stroke consider possibilities and challenges in the environment and how environmental factors are documented in patients' records. METHODS Eight multidisciplinary healthcare practitioners working with home-based rehabilitation after stroke participated in two semistructured focus group sessions. Thematic analysis was used to analyse the transcripts of recorded focus group discussions. Data were also collected from patient history records (N = 14) to identify interventions to increase patients' opportunities to participate in activities inside and outside the home. These records were analysed using life-space mobility as a conceptual framework. RESULTS The analysis generated four overarching themes concerning possibilities and challenges in the environment: (1) the image of rehabilitation conflicts with place, (2) the person in the home reveals individual needs and capabilities, (3) environmental characteristics influence the rehabilitation practice, and (4) the person is integrated within a social context. The patient record analysis showed that most patients were discharged from hospital to home within four days. Assessments at the hospital mainly focused on basic activities of daily living, such as the patient's self-care and walking ability. Also at home, the assessments and actions primarily focused on basic activities with little focus on participation in meaningful activities performed in different life situations outside the home. CONCLUSIONS Our research suggests that one way to improve practice is to include the environment in the rehabilitation and consider the person´s life space. Interventions should focus on supporting out-of-home mobility and activities as part of person-centred stroke rehabilitation. This must be supported by clear documentation in the patient records to strengthen clinical practice as well as the communication between stakeholders.
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Affiliation(s)
- Marie Elf
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Dara Rasoal
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Magnus Zingmark
- Department of Health Sciences, Lund University, Lund, Sweden
- Health and Social Care Administration, Östersund, Sweden
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umåe, Sweden
| | - Maya Kylén
- School of Health and Welfare, Dalarna University, Falun, Sweden.
- Department of Health Sciences, Lund University, Lund, Sweden.
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Kurita S, Doi T, Tsutsumimoto K, Nakakubo S, Kiuchi Y, Nishimoto K, Shimada H. Association between Active Mobility Index and sarcopenia among Japanese community-dwelling older adults. J Cachexia Sarcopenia Muscle 2022; 13:1919-1926. [PMID: 35437935 PMCID: PMC9178158 DOI: 10.1002/jcsm.12994] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/14/2022] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A physically active lifestyle, including physical and social activities, is needed to maintain muscle mass, strength, and physical performance. A large life space characterizes an active lifestyle, but the association between life space with physical and social activities and sarcopenia is unclear. This study aimed to examine the association between life space with physical and social activities, assessed using the Active Mobility Index (AMI), and sarcopenia in community-dwelling Japanese older adults. METHODS This study used a large, cross-sectional cohort dataset from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes (NCGG-SGS). Between 2013 and 2018, community-dwelling Japanese adults aged ≥60 years participated in the NCGG-SGS. Sarcopenia was identified by measuring muscle mass and strength based on the clinical definition. The secondary outcomes were sarcopenia indices, including lower muscle mass, lower muscle strength, and lower gait speed. AMI assessed life space with physical and social activities in each life space (distance from the respondent's home: <1, 1-10, or >10 km) during the past month by noting the frequency, primary purpose, type of transportation, interaction with others, and physical activity. The associations between quartile groups of AMI total, physical, and social scores and sarcopenia were examined using a logistic regression model. RESULTS From all participants, 21 644 participants (age 73.5 ± 5.8 years, 54.7% female) were included in the analysis. The prevalence of sarcopenia was 4.1% (n = 894). For the AMI total score, referred to Q1 group, Q3 and Q4 groups were significantly associated with a reduced odds ratio (OR) of sarcopenia after adjusting for all covariates [adjusted OR (aOR) (95% confidence interval), Q3: 0.71 (0.57-0.89), Q4: 0.69 (0.55-0.87)]. Q3 and Q4 of the AMI physical score groups were also significantly associated with reduced OR of sarcopenia [Q3: 0.71 (0.57-0.89), Q4: 0.67 (0.54-0.84)]. For the AMI social score, only the Q4 group showed reduced OR for sarcopenia [0.79 (0.62-1.01)]. Q3 and Q4 of the AMI total score and physical score were associated with reduced OR of all sarcopenia indices (aOR 0.55-0.82, all P < 0.05), whereas Q4 of AMI social score was associated with all indices (aOR 0.85-0.81, all P < 0.05). CONCLUSIONS The extent of life space with physical activity was associated with sarcopenia in community-dwelling older adults. A longitudinal study is needed to examine whether life space with physical and social activities affect the development of sarcopenia.
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Affiliation(s)
- Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yuto Kiuchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.,Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Kazuhei Nishimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Medical Sciences, Medical Science Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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Puthusseryppady V, Morrissey S, Aung MH, Coughlan G, Patel M, Hornberger M. Using GPS Tracking to Investigate Outdoor Navigation Patterns in Patients With Alzheimer Disease: Cross-sectional Study. JMIR Aging 2022; 5:e28222. [PMID: 35451965 PMCID: PMC9073623 DOI: 10.2196/28222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 12/01/2021] [Accepted: 02/07/2022] [Indexed: 11/29/2022] Open
Abstract
Background Spatial disorientation is one of the earliest and most distressing symptoms seen in patients with Alzheimer disease (AD) and can lead to them getting lost in the community. Although it is a prevalent problem worldwide and is associated with various negative consequences, very little is known about the extent to which outdoor navigation patterns of patients with AD explain why spatial disorientation occurs for them even in familiar surroundings. Objective This study aims to understand the outdoor navigation patterns of patients with AD in different conditions (alone vs accompanied; disoriented vs not disoriented during the study) and investigate whether patients with AD experienced spatial disorientation when navigating through environments with a high outdoor landmark density and complex road network structure (road intersection density, intersection complexity, and orientation entropy). Methods We investigated the outdoor navigation patterns of community-dwelling patients with AD (n=15) and age-matched healthy controls (n=18) over a 2-week period using GPS tracking and trajectory mining analytical techniques. Here, for the patients, the occurrence of any spatial disorientation behavior during this tracking period was recorded. We also used a spatial buffer methodology to capture the outdoor landmark density and features of the road network in the environments that the participants visited during the tracking period. Results The patients with AD had outdoor navigation patterns similar to those of the controls when they were accompanied; however, when they were alone, they had significantly fewer outings per day (total outings: P<.001; day outings: P=.003; night outings: P<.001), lower time spent moving per outing (P=.001), lower total distance covered per outing (P=.009), lower walking distance per outing (P=.02), and lower mean distance from home per outing (P=.004). Our results did not identify any mobility risk factors for spatial disorientation. We also found that the environments visited by patients who experienced disorientation versus those who maintained their orientation during the tracking period did not significantly differ in outdoor landmark density (P=.60) or road network structure (road intersection density: P=.43; intersection complexity: P=.45; orientation entropy: P=.89). Conclusions Our findings suggest that when alone, patients with AD restrict the spatial and temporal extent of their outdoor navigation in the community to successfully reduce their perceived risk of spatial disorientation. Implications of this work highlight the importance for future research to identify which of these individuals may be at an actual high risk for spatial disorientation as well as to explore the implementation of health care measures to help maintain a balance between patients’ right to safety and autonomy when making outings alone in the community.
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Affiliation(s)
- Vaisakh Puthusseryppady
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom.,Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, United States
| | - Sol Morrissey
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Min Hane Aung
- School of Computing Sciences, University of East Anglia, Norwich, United Kingdom
| | - Gillian Coughlan
- Rotman Research Institute, Baycrest, ON, Canada.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Martyn Patel
- Norfolk and Norwich University Hospitals National Health Service Foundation Trust, Norwich, United Kingdom
| | - Michael Hornberger
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
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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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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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8
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Peterson KF, Adams-Price C. Fear of Dependency and Life-Space Mobility as Predictors of Attitudes Toward Assistive Devices in Older Adults. Int J Aging Hum Dev 2021; 94:273-289. [PMID: 34191644 DOI: 10.1177/00914150211027599] [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] [Indexed: 11/16/2022]
Abstract
Assistive devices can help older adults remain independent; however, they may hesitate to use them due to fears of appearing dependent by embodying aging stereotypes. Reluctance to use assistive devices may lead to decreased life space mobility. The selective optimization with compensation (SOC) model posits that older adults employ strengths to accommodate for age-related functioning declines. The current study examines the predictive power of health perceptions, dependency fears, aging stereotypes, and life space on older adults' views of assistive devices. Results suggest that older adults with greater life space and dependency fears are more likely to view assistive devices positively.
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Douma L, Steverink N, Meijering L. Geographical life-space and subjective wellbeing in later life. Health Place 2021; 70:102608. [PMID: 34157506 DOI: 10.1016/j.healthplace.2021.102608] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 02/15/2021] [Accepted: 06/09/2021] [Indexed: 11/25/2022]
Abstract
Geographical life-space is an important factor to consider when studying subjective wellbeing of older adults. The purpose of this article is twofold: to provide an in-depth understanding of 1) the geographical life-spaces in which the lives of older adults take place and 2) the relation between life-space and experienced levels of subjective wellbeing. Seventy-six older adults (aged 65 and older) participated in our qualitative study. We applied a qualitative research approach, through combining indepth-interviews with visual life-space diagrams. Our findings show that most older adults continue to experience a high level of subjective wellbeing, regardless of the extent of their life-space. We conclude that the possibility to fulfill one's needs, even in a restricted life-space, is more conducive to maintaining subjective wellbeing than the extent of life-space itself.
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Affiliation(s)
- Linden Douma
- Population Research Centre, Urban and Regional Studies Institute (URSI), Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, PO Box 800, 9700 AV, Groningen, the Netherlands.
| | - Nardi Steverink
- Department of Sociology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Rozenstraat 38, 97112, TJ, the Netherlands; Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
| | - Louise Meijering
- Population Research Centre, Urban and Regional Studies Institute (URSI), Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, PO Box 800, 9700 AV, Groningen, the Netherlands.
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Morros-González E, Márquez I, Prada JP, Patino-Hernandez D, Chavarro-Carvaja D, Cano-Gutiérrez C. Life-space assessment and associated clinical factors: SABE Colombia. GERIATRICS, GERONTOLOGY AND AGING 2021. [DOI: 10.53886/gga.e0210043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES: Our aim was to assess whether an association exists between chronic diseases or multimorbidity and limited life space in older adults. METHODS: This is a secondary analysis of the SABE (Salud, Bienestar y Envejecimiento) Colombia Study. We assessed chronic diseases through self-report, and a limited life space was defined as any score ≤ 60 in the Life-Space Assessment scale. Multimorbidity was defined as having two or more coexisting diseases. We performed bivariate analyses and multivariate logistic regressions aiming to obtain odds ratios with 95% confidence intervals. RESULTS: The prevalence of limited life space was 2.95% with a mean score of 76.27 ± 19.34. Statistically significant associations were found between limited life space and mental disease (OR 1.45; 95%CI 1.15 – 1.82) and between limited life space and multimorbidity (OR 1.32; 95%CI 1.06 – 1.63). CONCLUSIONS: Mental disease and multimorbidity are associated with limited life space in older adults. Therefore, preventing, diagnosing, and treating mental illness should be sought in addition to the existing preventive and therapeutic approaches available for noncommunicable diseases.
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Uchida K, Murata S, Kawaharada R, Tsuboi Y, Isa T, Okumura M, Matsuda N, Nakatsuka K, Horibe K, Kogaki M, Ono R. Association Between Kinesiophobia and Life Space Among Community-Dwelling Older People with Chronic Musculoskeletal Pain. PAIN MEDICINE 2020; 21:3360-3365. [PMID: 32935125 DOI: 10.1093/pm/pnaa216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Kinesiophobia (i.e., fear of movement caused by pain) is increasingly acknowledged as a determinant of disuse among patients with chronic musculoskeletal pain. Kinesiophobia may affect life space-a crucial indicator of an active lifestyle among older people. This study aimed to investigate the previously unexamined association between kinesiophobia and life space among community-dwelling older people with chronic musculoskeletal pain. DESIGN Cross-sectional study. SETTING Community. SUBJECTS We analyzed data from 194 community-dwelling older people (age ≥65 years, mean age = 75.7 years, 71.6% women) with chronic musculoskeletal pain. METHODS Kinesiophobia, life space, and pain severity were assessed using the Tampa Scale for Kinesiophobia, Life Space Assessment, and Brief Pain Inventory. Linear regression models were applied to analyze the associations between kinesiophobia and life space, and pain severity and life space. RESULTS In our sample, the prevalence rates for chronic musculoskeletal pain were 10.82% (N = 21) for neck, 55.15% (N = 107) for lower back, 25.26% (N = 49) for shoulder, and 50.00% (N = 97) for knee. The results suggest that higher kinesiophobia is associated with smaller life space (adjusted beta = -0.91, 95% CI = -1.43 to -0.45, P < 0.001), even after adjustment for age, gender, years of education, pain severity, and presence of comorbidity. On the contrary, no significant association between pain severity and life space was observed (adjusted beta = -0.61, 95% CI = -2.92 to 1.72, P = 0.624). CONCLUSIONS Our findings suggest that kinesiophobia plays an important role in the determination of life space among older people with chronic musculoskeletal pain.
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Affiliation(s)
- Kazuaki Uchida
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan
| | - Shunsuke Murata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Rika Kawaharada
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan
| | - Yamato Tsuboi
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan.,Japan Society for the Promotion of Science, Chiyoda, Tokyo, Japan
| | - Tsunenori Isa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan
| | - Maho Okumura
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Naoka Matsuda
- Division of Rehabilitation Medicine, Kobe Mariners Hospital, Kobe, Hyogo, Japan
| | - Kiyomasa Nakatsuka
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan
| | - Kana Horibe
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan
| | - Masahumi Kogaki
- Takumi Day-Care Facility in Children, Nishinomiya, Hyogo, Japan
| | - Rei Ono
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan
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Seinsche J, Zijlstra W, Giannouli E. Motility in Frail Older Adults: Operationalization of a New Framework and First Insights into Its Relationship with Physical Activity and Life-Space Mobility: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8814. [PMID: 33260952 PMCID: PMC7730834 DOI: 10.3390/ijerph17238814] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 01/06/2023]
Abstract
In order to design effective interventions to prevent age-related mobility loss, it is important to identify influencing factors. The concept of "motility" by Kaufmann et al. subdivides such factors into three categories: "access", "skills", and "appropriation". The aim of this study was to assemble appropriate quantitative assessment tools for the assessment of these factors in frail older adults and to get first insights into their relative contribution for life-space and physical activity-related mobility. This is an exploratory cross-sectional study conducted with twenty-eight at least prefrail, retired participants aged 61-94. Life-space mobility was assessed using the "University of Alabama at Birmingham Life-space Assessment" (LSA) and physical activity using the "German Physical Activity Questionnaire" (PAQ50+). Factors from the category "appropriation", followed by factors from the category "skills" showed the strongest associations with the LSA. Factors from the category "access" best explained the variance for PAQ50+. This study's findings indicate the importance of accounting for and examining comprehensive models of mobility. The proposed assessment tools need to be explored in more depth in longitudinal studies with larger sample sizes in order to yield more conclusive results about the appropriateness of the motility concept for such purposes.
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Affiliation(s)
| | | | - Eleftheria Giannouli
- Institute of Movement & Sport Gerontology, German Sport University Cologne, 50933 Cologne, Germany; (J.S.); (W.Z.)
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13
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Tashiro H, Isho T, Takeda T, Nakamura T, Kozuka N, Hoshi F. Life-Space Mobility and Relevant Factors in Community-dwelling Individuals with Stroke in Japan: A Cross-sectional Study. Prog Rehabil Med 2020; 4:20190014. [PMID: 32789261 DOI: 10.2490/prm.20190014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 08/21/2019] [Indexed: 11/09/2022] Open
Abstract
Objective Individuals with stroke frequently experience mobility deficits and limited community reintegration. This study aimed to investigate life-space mobility and relevant factors in community-living individuals with stroke. Methods This was a cross-sectional study of 46 community-dwelling individuals with chronic stroke in Japan (mean age 72.7 ± 7.4 years; mean time post-stroke 63.6 ± 43.3 months; 26 men/20 women). We measured life-space mobility using a Japanese translation of the Life-Space Assessment. The following factors that might affect life-space mobility were assessed: the ability to perform activities of daily living, physical performance, fear of falling, and cognitive function. Results A total of 41 participants (89.1%) had restricted life-space mobility (Life-Space Assessment score <60 points). A multiple linear regression analysis showed that limitations in activities of daily living, walking speed, and Falls Efficacy Scale-International scores were independently related to Life-Space Assessment scores. This model explained 51.3% of the variance in Life-Space Assessment scores. Conclusions Most individuals with stroke had restricted life-space mobility. Life-space mobility was associated with the ability to perform activities of daily living, walking speed, and fear of falling. These findings could contribute to the development of rehabilitation interventions for regaining life-space mobility in individuals with stroke.
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Affiliation(s)
- Hideyuki Tashiro
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Hokkaido, Japan.,Graduate School of Health Sciences, Sapporo Medical University, Hokkaido, Japan
| | - Takuya Isho
- Rehabilitation Center, Fujioka General Hospital, Gunma, Japan
| | - Takanori Takeda
- Department of Rehabilitation Technique, Ageo Central General Hospital, Saitama, Japan
| | - Takahito Nakamura
- Department of Rehabilitation, Rehabilitation Amakusa Hospital, Saitama, Japan
| | - Naoki Kozuka
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Hokkaido, Japan
| | - Fumihiko Hoshi
- Department of Physical Therapy, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan
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14
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Vogelsang EM, Raymo JM, Liang J, Kobayashi E, Fukaya T. Population Aging and Health Trajectories at Older Ages. J Gerontol B Psychol Sci Soc Sci 2020; 74:1245-1255. [PMID: 28575472 DOI: 10.1093/geronb/gbx071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE This study examines relationships between municipal age structure and two types of self-rated health: general (SRH) and comparison with similar-aged peers (C-SRH). METHODS Using a national sample of almost 5,000 Japanese older adults over two decades, we employ hierarchical growth curve models to estimate health trajectories. For municipal age structure, we consider both the relative prevalence of elderly adults in the local population and the pace of aging over time. RESULTS Living in the oldest municipalities was generally associated with worse health, particularly between the ages of 70 and 80 years. For SRH, the speed of municipal population aging was also independently associated with worse health. For C-SRH, worse health in older areas was partially explained by less favorable economic conditions in those municipalities. Results also suggest that higher levels of employment and social integration among older adults living in the oldest municipalities operate in the opposite direction. That is, these attributes partially "protect" individuals from other factors that contribute to worse health. DISCUSSION Relative differences in municipal age structure and the pace of population aging are largely unexplored and potentially important correlates of older adult health. This line of research is increasingly salient in a world with substantial and growing regional variation in population aging.
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Affiliation(s)
- Eric M Vogelsang
- Department of Sociology, California State University-San Bernardino
| | - James M Raymo
- Department of Sociology, University of Wisconsin-Madison
| | - Jersey Liang
- School of Public Health, University of Michigan, Ann Arbor
| | - Erika Kobayashi
- Department of Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Japan
| | - Taro Fukaya
- Department of Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Japan
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15
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Yamashita M, Kamiya K, Hamazaki N, Matsuzawa R, Nozaki K, Ichikawa T, Nakamura T, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Prognostic value of instrumental activity of daily living in initial heart failure hospitalization patients aged 65 years or older. Heart Vessels 2020; 35:360-366. [PMID: 31489463 DOI: 10.1007/s00380-019-01490-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/23/2019] [Indexed: 12/24/2022]
Abstract
Although the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) is useful to assess decline of instrumental activities of daily living (IADL) in Japanese individuals, limited data are available in patients with heart failure (HF). This study was performed to investigate the prognostic value of IADL evaluated by TMIG-IC in initial HF hospitalization patients aged ≥ 65 years. We reviewed 297 elderly HF patients with independent basic ADL before hospitalization. Patients with prior HF were excluded. Five TMIG-IC items were investigated as IADL parameters. Patients with full IADL scores were defined as "independent" and others were defined as "dependent". The endpoint was all-cause mortality, and multivariable analysis was performed to identify IADL risk. The median age was 76 years, and 55% of the patients were male. Forty-one deaths occurred over a median follow-up period of 1.01 years. After adjusting for existing risk factors, including Seattle Heart Failure Score, dependent patients had higher mortality risk than independent patients [hazard ratio 3.64, 95% confidence interval (CI) 1.57-8.43], and mortality risk decreased by 16% for each 1-point increase in IADL score (hazard ratio 0.84, 95% CI 0.71-0.99). In conclusion, limited IADL indicated by TMIG-IC was associated with poorer long-term mortality rate in elderly patients with HF. This inexpensive and easily applicable tool will support decision making in cardiac rehabilitation.
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Affiliation(s)
- Masashi Yamashita
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan.
| | - Nobuaki Hamazaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Ryota Matsuzawa
- Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Japan
| | - Kohei Nozaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Takafumi Ichikawa
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Takeshi Nakamura
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Minako Yamaoka-Tojo
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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16
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Chung MH, Leung SF, Välimäki M. Use of tracking technology to examine life-space mobility among people with depression: a systematic review protocol. BMJ Open 2020; 10:e034208. [PMID: 32001494 PMCID: PMC7044916 DOI: 10.1136/bmjopen-2019-034208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/13/2019] [Accepted: 01/03/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION People with depression often experience disabilities that limit their social and physical capacity, daily function, and quality of life. Depressive symptoms and their implications on daily activities are often measured retrospectively using subjective measurement tools. Recently, more objective and accurate electronic data collection methods have been used to describe the daily life of people with depressive disorders. The results, however, have not yet been systematically reviewed. We aim to provide a knowledge basis for the use of tracking technologies in examining life-space mobility among adults with depression and those with anxiety as a comorbidity. METHODS AND ANALYSIS A systematic review with a narrative approach for different types of study design will be conducted. The following databases will be used to gather data from 1994 to the present: MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Embase, Cochrane Library, Scopus, Web of Science, Health Technology Assessment Database and IEEE Xplore. The study selection will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Methodological appraisal of studies will be performed using the Crowe Critical Appraisal Tool as well as the Cochrane Risk-of-Bias Tool for randomised controlled trials. A narrative synthesis of all included studies will be conducted. ETHICS AND DISSEMINATION Because there will be no human involvement in the actual systematic review, no ethical approval will be required. The results will be disseminated in a peer-reviewed journal and in a conference presentation. PROSPERO REGISTRATION NUMBER CRD42019127102.
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Affiliation(s)
- Man Hon Chung
- School of Nursing, Hong Kong Polytechnic University School of Nursing, Kowloon, Hong Kong
| | - Sau Fong Leung
- School of Nursing, Hong Kong Polytechnic University School of Nursing, Kowloon, Hong Kong
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland
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17
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Echizenya Y, Akizuki K, Takayama H, Nishihara K, Hoshi F. Characteristics of balance ability related to life space of older adults in a day care center. COGENT MEDICINE 2020. [DOI: 10.1080/2331205x.2020.1714532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Yuki Echizenya
- Department of Physical Therapy, Saitama Rehabilitation Center Saitama 362-8567 Japan
| | - Kazunori Akizuki
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe International University 9-1-6 Koyouchou, Higasinada-ku, Kobe-shi Hyogo 658-0032 Japan
| | - Haruka Takayama
- Department of Physical Therapy, Urayasu Rehabili Day Station Urayasu Chiba 279-0021 Japan
| | - Ken Nishihara
- Department of Physical Therapy, School of Health and Social Services, Saitama Prefectural University 820 Sannomiya, Koshigaya Saitama 343-8540 Japan
| | - Fumihiko Hoshi
- Department of Physical Therapy, School of Health and Social Services, Saitama Prefectural University 820 Sannomiya, Koshigaya Saitama 343-8540 Japan
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18
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Tseng YC, Gau BS, Lou MF. Validation of the Chinese version of the Life-Space Assessment in community-dwelling older adults. Geriatr Nurs 2019; 41:381-386. [PMID: 31818502 DOI: 10.1016/j.gerinurse.2019.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/23/2019] [Accepted: 11/27/2019] [Indexed: 11/29/2022]
Abstract
The Life-Space Assessment (LSA) is a comprehensive tool for assessing mobility in older adults, but the evidence of its psychometric properties in Chinese older adults is lacking. The aim was to adapt and validate the psychometric properties of the Chinese version of the Life-Space Assessment (LSA-C) in community-dwelling older adults. A cross-sectional study was designed with 225 community-dwelling older adults. The content validity of the LSA-C was satisfactory. The criterion validity was supported by significant correlation between the LSA-C and the Multidimensional Functional Assessment Questionnaire (MFAQ). Additionally, the LSA-C was negatively correlated with the 10-item Center for Epidemiological Studies Depression Scale (CESD-10) and positively correlated with the General Health subscale of the Short-Form-36 Health Survey (GH of the SF-36), implying good construct validity. Finally, the LSA-C showed excellent stability (intraclass correlation coefficient = 0.88). The LSA-C demonstrates adequate psychometric properties, supporting its use in future research in the Chinese context.
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Affiliation(s)
- Ya-Chuan Tseng
- School of Nursing, College of Medicine, National Taiwan University, No.1, Jen-Ai Rd. Sec. 1, Taipei 10051, Taiwan.
| | - Bih-Shya Gau
- School of Nursing, College of Medicine, National Taiwan University, No.1, Jen-Ai Rd. Sec. 1, Taipei 10051, Taiwan.
| | - Meei-Fang Lou
- School of Nursing, College of Medicine, National Taiwan University, No.1, Jen-Ai Rd. Sec. 1, Taipei 10051, Taiwan.
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19
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Giannouli E, Fillekes MP, Mellone S, Weibel R, Bock O, Zijlstra W. Predictors of real-life mobility in community-dwelling older adults: an exploration based on a comprehensive framework for analyzing mobility. Eur Rev Aging Phys Act 2019; 16:19. [PMID: 31700551 PMCID: PMC6825723 DOI: 10.1186/s11556-019-0225-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reduced mobility is associated with a plethora of adverse outcomes. To support older adults in maintaining their independence, it first is important to have deeper knowledge of factors that impact on their mobility. Based on a framework that encompasses demographical, environmental, physical, cognitive, psychological and social domains, this study explores predictors of different aspects of real-life mobility in community-dwelling older adults. METHODS Data were obtained in two study waves with a total sample of n = 154. Real-life mobility (physical activity-based mobility and life-space mobility) was assessed over one week using smartphones. Active and gait time and number of steps were calculated from inertial sensor data, and life-space area, total distance, and action range were calculated from GPS data. Demographic measures included age, gender and education. Physical functioning was assessed based on measures of cardiovascular fitness, leg and handgrip strength, balance and gait function; cognitive functioning was assessed based on measures of attention and executive function. Psychological and social assessments included measures of self-efficacy, depression, rigidity, arousal, and loneliness, sociableness, perceived help availability, perceived ageism and social networks. Maximum temperature was used to assess weather conditions on monitoring days. RESULTS Multiple regression analyses indicated just physical and psychological measures accounted for significant but rather low proportions of variance (5-30%) in real-life mobility. Strength measures were retained in most of the regression models. Cognitive and social measures did not remain as significant predictors in any of the models. CONCLUSIONS In older adults without mobility limitations, real-life mobility was associated primarily with measures of physical functioning. Psychological functioning also seemed to play a role for real-life mobility, though the associations were more pronounced for physical activity-based mobility than life-space mobility. Further factors should be assessed in order to achieve more conclusive results about predictors of real-life mobility in community-dwelling older adults.
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Affiliation(s)
- Eleftheria Giannouli
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Michelle Pasquale Fillekes
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - Sabato Mellone
- Department of Electrical, Electronic, and Information Engineering, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
| | - Robert Weibel
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - Otmar Bock
- Institute of Physiology and Anatomy, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Wiebren Zijlstra
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
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20
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Hirosawa T, Morimoto N, Miura K, Tahara T, Murohisa T, Okamura Y, Sato T, Numao N, Imai M, Tano S, Murayama K, Kurata H, Ozawa I, Fukaya Y, Yoshizumi H, Watanabe S, Tsukui M, Takaoka Y, Nomoto H, Isoda N, Yamamoto H. No Regional Disparities in Sofosbuvir Plus Ribavirin Therapy for HCV Genotype 2 Infection in Tochigi Prefecture and Its Vicinity. Intern Med 2019; 58:477-485. [PMID: 30333396 PMCID: PMC6421161 DOI: 10.2169/internalmedicine.1194-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective Regional disparities were observed in the outcomes of interferon (IFN)-based therapy for chronic hepatitis C virus (HCV) infection in a Japanese nationwide study. However, whether or not these regional disparities are observed in the outcomes of direct-acting antiviral drugs, including sofosbuvir (SOF) plus ribavirin (RBV) therapy, remains unclear. Methods We conducted a multicenter study to assess the efficacy of SOF plus RBV therapy for HCV genotype 2 infection in Tochigi Prefecture and its vicinity, in which IFN-based therapy yielded a low sustained virologic response (SVR) rate. In addition, we divided Tochigi Prefecture into six regions to examine regional disparities in the SVR. Patients We enrolled patients with chronic HCV genotype 2 infection. Results Of the 583 patients enrolled, 569 (97.6%) completed the treatment, and 566 (97.1%) also complied with post-treatment follow-up for 12 weeks. The overall SVR12 rate was 96.1% by per protocol and 93.7% by intention-to-treat analyses. No marked differences were observed in the SVR12 between subjects ≥65 and <65 years of age. Although large gaps were observed in the characteristics of patients and accessibility to medical resources, there was no significant difference in the SVR12 rate among the six regions in Tochigi Prefecture. Conclusion SOF plus RBV therapy was effective for HCV genotype 2 infection in an area where IFN-based therapy had previously shown unsatisfactory results. In addition, no regional disparities in the SVR12 were observed in Tochigi Prefecture.
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Affiliation(s)
- Takuya Hirosawa
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Japan
| | - Naoki Morimoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Japan
| | - Kouichi Miura
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Japan
| | - Toshiyuki Tahara
- Department of Gastroenterology, Saiseikai Utsunomiya Hospital, Japan
| | | | | | - Takashi Sato
- Department of Gastroenterology, Nasu Red Cross Hospital, Japan
| | - Norikatsu Numao
- Department of Gastroenterology, Haga Red Cross Hospital, Japan
| | - Masato Imai
- Department of Gastroenterological Surgery, Utsunomiya Memorial Hospital, Japan
| | - Shigeo Tano
- Department of Gastroenterology, Shin-Oyama City Hospital, Japan
| | - Kozue Murayama
- Department of Gastroenterology, Koga Red Cross Hospital, Japan
| | - Hidekazu Kurata
- Department of Gastroenterology, Tochigi Medical Center Shimotsuga, Japan
| | - Iwao Ozawa
- Department of Hepatobiliary Surgery, Tochigi Cancer Center, Japan
| | - Yukimura Fukaya
- Department of Internal Medicine, Nasu Minami Hospital, Japan
| | | | - Shunji Watanabe
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Japan
| | - Mamiko Tsukui
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Japan
| | - Yoshinari Takaoka
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Japan
| | - Hiroaki Nomoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Japan
| | - Norio Isoda
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Japan
| | - Hironori Yamamoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Japan
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21
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Tsuji T, Rantakokko M, Portegijs E, Viljanen A, Rantanen T. The effect of body mass index, lower extremity performance, and use of a private car on incident life-space restriction: a two-year follow-up study. BMC Geriatr 2018; 18:271. [PMID: 30409120 PMCID: PMC6225643 DOI: 10.1186/s12877-018-0956-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 10/18/2018] [Indexed: 12/05/2022] Open
Abstract
Background The purpose of the study was to explore the single and combined contributions of body mass index (BMI) and lower extremity performance as modifiable physical factors, and the influence of use of a private car as an environmental factor on prevalent and incident life-space restriction in community-dwelling older people. Methods Community-dwelling people aged 75–90 years (n = 823) participated in the Life-Space Mobility in Old Age (LISPE) two-year follow-up study. Participants who reported that the largest life-space area they had attained, without aid from any device or another person, was the neighborhood or less were considered to have life-space restriction. Incident life-space restriction was the endpoint of Cox’s proportional hazard model. BMI, lower extremity performance (Short Physical Performance Battery, SPPB), and use of a private car were predictors. Results At baseline, people who had both obesity (BMI ≥30.0) and impaired lower extremity performance (SPPB 0–9) had a higher prevalence of life-space restriction (prevalence ratio 3.6, 95% confidence interval, CI, 2.0–6.3) compared to those with normal weight (BMI 23.0–24.9) and intact physical performance (SPPB 10–12). The 581 people without life-space restriction at the baseline contributed 1033 person-years during the two-year follow-up. Incident life-space restrictions were reported by 28.3% participants. A higher hazard ratio (HR) for incident life-space restriction was observed in subjects having both obesity and impaired lower extremity performance (HR 3.6, 95% CI, 1.7–7.4), impaired lower extremity performance only (HR 1.9, 95% CI 0.9–4.1), and obesity only (HR 1.8, 95% CI, 0.9–3.5) compared to those with normal weight and intact performance. Private car passengers (HR 2.0, 95% CI, 1.3–3.0) compared to car drivers had a higher risk of life-space restriction. All models were adjusted for age, sex, chronic diseases, and education. Conclusions Older people with impaired lower extremity performance have an increased risk of incident life-space restriction especially if combined with obesity. Also, not driving a car renders older people vulnerable to life-space restriction.
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Affiliation(s)
- Taishi Tsuji
- Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo Ward, Chiba City, Chiba, 260-8670, Japan.
| | - Merja Rantakokko
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, FI-40014, Jyväskylä, Finland
| | - Erja Portegijs
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, FI-40014, Jyväskylä, Finland
| | - Anne Viljanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, FI-40014, Jyväskylä, Finland
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, FI-40014, Jyväskylä, Finland
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22
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Lo AX, Rundle AG, Buys D, Kennedy RE, Sawyer P, Allman RM, Brown CJ. Neighborhood Disadvantage and Life-Space Mobility Are Associated with Incident Falls in Community-Dwelling Older Adults. J Am Geriatr Soc 2017; 64:2218-2225. [PMID: 27869994 DOI: 10.1111/jgs.14353] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To determine the relationship between neighborhood-level socioeconomic characteristics, life-space mobility, and incident falls in community-dwelling older adults. DESIGN Prospective, observational cohort study with a baseline in-home assessment and 6-month telephone follow-up. SETTING Central Alabama. PARTICIPANTS Community-dwelling adults aged 65 and older recruited from a random sample of Medicare beneficiaries (N = 1,000). MEASUREMENTS Neighborhood disadvantage was measured using a composite index derived from baseline neighborhood-level residential census tract socioeconomic variables. Data on individual-level socioeconomic characteristics, clinical variables, and life-space collected at baseline were included as covariates in a multivariate model using generalized estimating equations to assess the association with incident falls in the 6 months after baseline. RESULTS Of the 940 participants who completed baseline and follow-up assessments, 126 (13%) reported one or more new falls in the 6 months after baseline. There was an independent nonlinear association between neighborhood disadvantage (according to increasing quartiles of disadvantage) and incident falls after adjusting for confounders: The lowest quartile served as reference; 2nd quartile odds ratio (OR) = 2.4, 95% confidence interval (CI) = 1.2-4.6; 3rd quartile OR = 1.9, 95% CI = 1.0-3.7; 4th quartile OR = 3.2, 95% CI = 1.7-6.0. Each 10-point decrement in life-space (OR = 1.2, 95% CI = 1.0-1.3) was associated with a higher risk of falls. CONCLUSION Greater neighborhood disadvantage was associated with greater risk of falls. Life-space also contributes separately to fall risk. Community-dwelling older adults in disadvantaged neighborhoods, particularly those with limited mobility, may benefit from a more-rigorous assessment of their fall risk by healthcare providers. Neighborhood level socioeconomic characteristics should also be an important consideration when identifying vulnerable populations that may benefit the most from fall prevention programs.
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Affiliation(s)
- Alexander X Lo
- Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, Alabama.,Comprehensive Center for Healthy Aging, University of Alabama at Birmingham, Birmingham, Alabama
| | - Andrew G Rundle
- Department of Epidemiology, Columbia University, New York, New York
| | - David Buys
- Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, Mississippi.,Mississippi Agricultural and Forestry Experiment Station, Mississippi State, Mississippi
| | - Richard E Kennedy
- Comprehensive Center for Healthy Aging, University of Alabama at Birmingham, Birmingham, Alabama.,Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Patricia Sawyer
- Comprehensive Center for Healthy Aging, University of Alabama at Birmingham, Birmingham, Alabama.,Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Richard M Allman
- Geriatrics and Extended Care Services, Office of Patient Care Services, Veterans Health Administration, Washington, District of Columbia
| | - Cynthia J Brown
- Comprehensive Center for Healthy Aging, University of Alabama at Birmingham, Birmingham, Alabama.,Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.,Geriatric Research, Education, and Clinical Center, Birmingham/Atlanta Veterans Affairs, Birmingham, Alabama
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23
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Levasseur M, Généreux M, Desroches J, Carrier A, Lacasse F, Chabot É, Abecia A, Gosselin L, Vanasse A. How to Find Lessons from the Public Health Literature: Example of a Scoping Study Protocol on the Neighborhood Environment. Int J Prev Med 2016; 7:83. [PMID: 27413514 PMCID: PMC4926543 DOI: 10.4103/2008-7802.184311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 04/10/2015] [Indexed: 11/17/2022] Open
Abstract
Background: As key determinants of many favorable health and quality of life outcomes, it is important to identify factors associated with mobility and social participation. Although several investigations have been carried out on mobility, social participation and neighborhood environment, there is no clear integration of these results. This paper presents a scoping study protocol that aims to provide a comprehensive understanding of how the physical and social neighborhood environment is associated with or influences mobility and social participation in older adults. Methods: The rigorous methodological framework for scoping studies is used to synthesize and disseminate current knowledge on the associations or influence of the neighborhood environment on mobility and social participation in aging. Nine databases from public health and other fields are searched with 51 predetermined keywords. Using content analysis, all data are exhaustively analyzed, organized, and synthesized independently by two research assistants. Discussion: A comprehensive synthesis of empirical studies provides decision-makers, clinicians and researchers with current knowledge and best practices regarding neighborhood environments with a view to enhancing mobility and social participation. Such a synthesis represents an original contribution and can ultimately support decisions and development of innovative interventions and clear guidelines for the creation of age-supportive environments. Improvements in public health and clinical interventions might be the new innovation needed to foster health and quality of life for aging population. Finally, the aspects of the associations or influence of the neighborhood environment on mobility and social participation not covered by previous research are identified. Conclusions: Among factors that impact mobility and social participation, the neighborhood environment is important since interventions targeting it may have a greater impact on an individual's mobility and social participation than those targeting individual factors. Although investigations from various domains have been carried out on this topic, no clear integration of these results is available yet.
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Affiliation(s)
- Mélanie Levasseur
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, J1H 5N4, Canada; Research Centre on Aging, Eastern Townships Integrated University Centre for Health and Social Services - Sherbrooke Hospital University Centre (CIUSSS de l'Estrie - CHUS), Sherbrooke, Quebec, J1H 4C4, Canada
| | - Mélissa Généreux
- Department Public Health, CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, J1J 1B1, Canada
| | - Josiane Desroches
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, J1H 5N4, Canada; Research Centre on Aging, Eastern Townships Integrated University Centre for Health and Social Services - Sherbrooke Hospital University Centre (CIUSSS de l'Estrie - CHUS), Sherbrooke, Quebec, J1H 4C4, Canada
| | - Annie Carrier
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, J1H 5N4, Canada; Research Centre on Aging, Eastern Townships Integrated University Centre for Health and Social Services - Sherbrooke Hospital University Centre (CIUSSS de l'Estrie - CHUS), Sherbrooke, Quebec, J1H 4C4, Canada
| | - Francis Lacasse
- CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, J1H 4C4, Canada
| | - Éric Chabot
- Réseau de transport de Longueuil, Longueuil, Quebec, J4G 2M4, Canada
| | - Ana Abecia
- Centre d'études de l'Asie de l'est, Faculté des Arts et des Sciences, Université de Montréal, Pavillon 3744, rue Jean-Brillant, Montreal, Quebec, H3C 3J7, Canada
| | - Louise Gosselin
- Sherbrooke Healthy City Inc., Sherbrooke, Quebec, J1H 5H9, Canada
| | - Alain Vanasse
- Etienne-LeBel Clinical Research Centre, CHUS, Sherbrooke, Quebec, J1H 5N4, Canada; Department of Emergency and Family Medicine, Université de Sherbrooke, PRIMUS Research Group, Sherbrooke, Quebec, J1H 5N4, Canada
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24
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Viljanen A, Mikkola TM, Rantakokko M, Portegijs E, Rantanen T. The Association Between Transportation and Life-Space Mobility in Community-Dwelling Older People With or Without Walking Difficulties. J Aging Health 2016; 28:1038-54. [DOI: 10.1177/0898264315618919] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The aim of this study is to examine whether a persons’ most frequently used mode of transportation is associated with life-space mobility and whether the association differs between persons with or without walking difficulties. Method: Life-space mobility was measured with the Life-Space Assessment in 848 community-dwelling men and women aged 75 to 90 years. Six separate mobility groups were formed according to the most frequently used mode of transportation (car driver, car passenger, public transportation) combined with the presence or absence of difficulties walking 2 km. Results: Car drivers without walking difficulties had the highest life-space mobility scores, and car passengers with walking difficulties had the lowest scores. Mode of transportation influenced the odds for restricted life space differently depending on whether or not the person had walking difficulties. Discussion: To support community mobility among older persons, it would be important to improve different transportation options to meet older persons’ individual wishes, needs, and resources.
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Kestens Y, Chaix B, Gerber P, Desprès M, Gauvin L, Klein O, Klein S, Köppen B, Lord S, Naud A, Payette H, Richard L, Rondier P, Shareck M, Sueur C, Thierry B, Vallée J, Wasfi R. Understanding the role of contrasting urban contexts in healthy aging: an international cohort study using wearable sensor devices (the CURHA study protocol). BMC Geriatr 2016; 16:96. [PMID: 27151297 PMCID: PMC4858908 DOI: 10.1186/s12877-016-0273-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 04/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Given the challenges of aging populations, calls have been issued for more sustainable urban re-development and implementation of local solutions to address global environmental and healthy aging issues. However, few studies have considered older adults' daily mobility to better understand how local built and social environments may contribute to healthy aging. Meanwhile, wearable sensors and interactive map-based applications offer novel means for gathering information on people's mobility, levels of physical activity, or social network structure. Combining such data with classical questionnaires on well-being, physical activity, perceived environments and qualitative assessment of experience of places opens new opportunities to assess the complex interplay between individuals and environments. In line with current gaps and novel analytical capabilities, this research proposes an international research agenda to collect and analyse detailed data on daily mobility, social networks and health outcomes among older adults using interactive web-based questionnaires and wearable sensors. METHODS/DESIGN Our study resorts to a battery of innovative data collection methods including use of a novel multisensor device for collection of location and physical activity, interactive map-based questionnaires on regular destinations and social networks, and qualitative assessment of experience of places. This rich data will allow advanced quantitative and qualitative analyses in the aim to disentangle the complex people-environment interactions linking urban local contexts to healthy aging, with a focus on active living, social networks and participation, and well-being. DISCUSSION This project will generate evidence about what characteristics of urban environments relate to active mobility, social participation, and well-being, three important dimensions of healthy aging. It also sets the basis for an international research agenda on built environment and healthy aging based on a shared and comprehensive data collection protocol.
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Affiliation(s)
- Yan Kestens
- Montreal University Research Center (CRCHUM), 850, rue St-Denis, Montréal, QC, H2X 0A9, Canada. .,École de Santé Publique de l'Université de Montréal (ESPUM), 7101, rue du Parc, Montréal, QC, H3N 1X9, Canada.
| | - Basile Chaix
- Inserm, UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Faculté de médecine Saint-Antoine, 27 rue Chaligny, cedex 12, Paris, 75571, France
| | - Philippe Gerber
- Luxembourg Institute of Socio-Economic Research, 11, Porte des Sciences, Esch-sur-Alzette, L-4366, Luxembourg
| | - Michel Desprès
- École d'urbanisme et d'architecture de paysage, Université de Montréal, 2940, chemin de la Côte-Sainte-Catherine, Montréal, QC, H3C 3 J7, Canada
| | - Lise Gauvin
- Montreal University Research Center (CRCHUM), 850, rue St-Denis, Montréal, QC, H2X 0A9, Canada.,École de Santé Publique de l'Université de Montréal (ESPUM), 7101, rue du Parc, Montréal, QC, H3N 1X9, Canada
| | - Olivier Klein
- Luxembourg Institute of Socio-Economic Research, 11, Porte des Sciences, Esch-sur-Alzette, L-4366, Luxembourg
| | - Sylvain Klein
- Luxembourg Institute of Socio-Economic Research, 11, Porte des Sciences, Esch-sur-Alzette, L-4366, Luxembourg
| | - Bernhard Köppen
- Luxembourg Institute of Socio-Economic Research, 11, Porte des Sciences, Esch-sur-Alzette, L-4366, Luxembourg
| | - Sébastien Lord
- École d'urbanisme et d'architecture de paysage, Université de Montréal, 2940, chemin de la Côte-Sainte-Catherine, Montréal, QC, H3C 3 J7, Canada
| | - Alexandre Naud
- Montreal University Research Center (CRCHUM), 850, rue St-Denis, Montréal, QC, H2X 0A9, Canada.,École de Santé Publique de l'Université de Montréal (ESPUM), 7101, rue du Parc, Montréal, QC, H3N 1X9, Canada
| | - Hélène Payette
- Canada Research Center on Aging, CIUSSS de l'Estrie-CHUS, Faculty of Medicine & Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Lucie Richard
- Faculty of Nursing, Université de Montréal, Montreal, QC, H3C 3 J7, Canada
| | - Pierre Rondier
- Montreal University Research Center (CRCHUM), 850, rue St-Denis, Montréal, QC, H2X 0A9, Canada
| | | | - Cédric Sueur
- UMR Géographie-Cités, 13 rue du Four, Paris, 75006, France
| | - Benoit Thierry
- Montreal University Research Center (CRCHUM), 850, rue St-Denis, Montréal, QC, H2X 0A9, Canada
| | - Julie Vallée
- Département d'Ecologie, Physiologie et Ethologie; Institut Pluridisciplinaire Hubert Curien, 23, rue Becquerel, Strasbourg, 67087, France
| | - Rania Wasfi
- Montreal University Research Center (CRCHUM), 850, rue St-Denis, Montréal, QC, H2X 0A9, Canada.,École de Santé Publique de l'Université de Montréal (ESPUM), 7101, rue du Parc, Montréal, QC, H3N 1X9, Canada
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26
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Tsai LT, Rantakokko M, Rantanen T, Viljanen A, Kauppinen M, Portegijs E. Objectively Measured Physical Activity and Changes in Life-Space Mobility Among Older People. J Gerontol A Biol Sci Med Sci 2016; 71:1466-1471. [PMID: 26975981 DOI: 10.1093/gerona/glw042] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 02/19/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Our aim was to study the relationship between objectively measured physical activity and subsequent changes in life-space mobility over 2 years among older people. Life-space mobility refers to the area a person moves through in daily life, taking into account frequency, and need of assistance. Life-space mobility and physical activity correlate, but whether different intensities of objectively assessed physical activity predicts decline in life-space mobility is not known. METHODS Prospective cohort study of the "Life-space Mobility in Old Age" (LISPE) project accelerometer substudy. Participants were community-dwelling older people aged 75-90 (n = 164). Life-space mobility was measured with the Life-Space Assessment at baseline face-to-face home interview and telephone follow-up interviews 1 and 2 years after baseline. Physical activity (step count and time spent in moderate activity, low activity, and sedentary behavior) was measured by a tri-axial accelerometer (Hookie "AM20 Activity Meter") for 7 days at baseline. Generalized estimating equations (GEE models) were used to compare changes in life-space mobility between participants categorized according to the baseline physical activity measures. RESULTS Median age of the participants was 79.5 (IQR 6.7) and 64% were women. Over the 2 years, life-space mobility declined significantly among those with lower step counts and less time spent in moderate activity measured at baseline. Time spent in low activity and sedentary behavior did not predict changes in life-space mobility. CONCLUSIONS In old age, more time spent walking outdoors and accumulation of moderate-intensity physical activity may help to maintain higher life-space mobility, a correlate of good quality of life.
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Affiliation(s)
- Li-Tang Tsai
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland.
| | - Merja Rantakokko
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland
| | - Taina Rantanen
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland
| | - Anne Viljanen
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland
| | - Markku Kauppinen
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland
| | - Erja Portegijs
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland
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27
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Mobility in Old Age: Capacity Is Not Performance. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3261567. [PMID: 27034932 PMCID: PMC4789440 DOI: 10.1155/2016/3261567] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 01/11/2016] [Accepted: 02/09/2016] [Indexed: 11/18/2022]
Abstract
Background. Outcomes of laboratory-based tests for mobility are often used to infer about older adults' performance in real life; however, it is unclear whether such association exists. We hypothesized that mobility capacity, as measured in the laboratory, and mobility performance, as measured in real life, would be poorly linked. Methods. The sample consisted of 84 older adults (72.5 ± 5.9 years). Capacity was assessed via the iTUG and standard gait parameters (stride length, stride velocity, and cadence). Performance was assessed in real life over a period of 6.95 ± 1.99 days using smartphone technology to calculate following parameters: active and gait time, number of steps, life-space, mean action-range, and maximum action-range. Correlation analyses and stepwise multiple regression analyses were applied. Results. All laboratory measures demonstrated significant associations with the real-life measures (between r = .229 and r = .461). The multiple regression analyses indicated that the laboratory measures accounted for a significant but very low proportion of variance (between 5% and 21%) in real-life measures. Conclusion. In older adults without mobility impairments, capacity-related measures of mobility bear little significance for predicting real-life performance. Hence, other factors play a role in how older people manage their daily-life mobility. This should be considered for diagnosis and treatment of mobility deficits in older people.
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28
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Pilot study on the Chinese version of the Life Space Assessment among community-dwelling elderly. Arch Gerontol Geriatr 2015; 61:301-6. [DOI: 10.1016/j.archger.2015.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 06/15/2015] [Accepted: 06/18/2015] [Indexed: 11/20/2022]
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29
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Byles JE, Leigh L, Vo K, Forder P, Curryer C. Life space and mental health: a study of older community-dwelling persons in Australia. Aging Ment Health 2015; 19:98-106. [PMID: 24903196 DOI: 10.1080/13607863.2014.917607] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The ability of older people to mobilise within and outside their community is dependent on a number of factors. This study explored the relationship between spatial mobility and psychological health among older adults living in Australia. METHODS The survey sample consisted of 260 community-dwelling men and women aged 75-80 years, who returned a postal survey measuring spatial mobility (using the Life Space Questionnaire) and psychological health (using the SF36 Health Related Quality of Life Profile). From the Life Space Questionnaire, participants were given a life-space score and multinomial regression was used to explore the potential effect of mental health on life-space score. RESULTS The study found a significant association between mental health and life space. However, gender, physical functioning, and ability to drive were most strongly associated with the extent of life space and spatial mobility. Compared to men, older women are more likely to experience less spatial mobility and restricted life space, and hence are more vulnerable to social isolation. CONCLUSION Mental health and life space were associated for the older people in this study. These findings have important implications for health policy and highlight the need to support older persons to maintain independence and social networks, and to successfully age in place within their community. This study also highlights the utility of the Life Space Questionnaire in terms of identifying older persons at risk of poorer mental health.
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Affiliation(s)
- Julie E Byles
- a Research Centre for Gender, Health and Ageing , Faculty of Health and Medicine , The University of Newcastle , Callaghan , Australia
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30
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Ogawa M, Izawa KP, Kitamura A, Ono R, Satomi-Kobayashi S, Sakai Y, Okita Y. Preoperative physical activity in relation to postoperative delirium in elective cardiac surgery patients. Int J Cardiol 2015; 201:154-6. [PMID: 26298363 DOI: 10.1016/j.ijcard.2015.06.154] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 06/27/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Masato Ogawa
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan; Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Kazuhiro P Izawa
- Kobe University Graduate School of Health Sciences, Kobe, Japan.
| | - Aki Kitamura
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Rei Ono
- Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Seimi Satomi-Kobayashi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yutaka Okita
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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31
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Levasseur M, Généreux M, Bruneau JF, Vanasse A, Chabot É, Beaulac C, Bédard MM. Importance of proximity to resources, social support, transportation and neighborhood security for mobility and social participation in older adults: results from a scoping study. BMC Public Health 2015; 15:503. [PMID: 26002342 PMCID: PMC4460861 DOI: 10.1186/s12889-015-1824-0] [Citation(s) in RCA: 177] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 05/06/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Since mobility and social participation are key determinants of health and quality of life, it is important to identify factors associated with them. Although several investigations have been conducted on the neighborhood environment, mobility and social participation, there is no clear integration of the results. This study aimed to provide a comprehensive understanding regarding how the neighborhood environment is associated with mobility and social participation in older adults. METHODS A rigorous methodological scoping study framework was used to search nine databases from different fields with fifty-one keywords. Data were exhaustively analyzed, organized and synthesized according to the International Classification of Functioning, Disability and Health (ICF) by two research assistants following PRISMA guidelines, and results were validated with knowledge users. RESULTS The majority of the 50 selected articles report results of cross-sectional studies (29; 58%), mainly conducted in the US (24; 48%) or Canada (15; 30%). Studies mostly focused on neighborhood environment associations with mobility (39; 78%), social participation (19; 38%), and occasionally both (11; 22%). Neighborhood attributes considered were mainly 'Pro ducts and technology' (43; 86) and 'Services, systems and policies' (37; 74%), but also 'Natural and human-made changes' (27; 54%) and 'Support and relationships' (21; 42%). Mobility and social participation were both positively associated with Proximity to resources and recreational facilities, Social support, Having a car or driver's license, Public transportation and Neighborhood security, and negatively associated with Poor user-friendliness of the walking environment and Neighborhood insecurity. Attributes of the neighborhood environment not covered by previous research on mobility and social participation mainly concerned 'Attitudes', and 'Services, systems and policies'. CONCLUSION Results from this comprehensive synthesis of empirical studies on associations of the neighborhood environment with mobility and social participation will ultimately support best practices, decisions and the development of innovative inclusive public health interventions including clear guidelines for the creation of age-supportive environments. To foster mobility and social participation, these interventions must consider Proximity to resources and to recreational facilities, Social support, Transportation, Neighborhood security and User-friendliness of the walking environment. Future studies should include both mobility and social participation, and investigate how they are associated with 'Attitudes', and 'Services, systems and policies' in older adults, including disadvantaged older adults.
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Affiliation(s)
- Mélanie Levasseur
- University of Sherbrooke, 2500 University Blvd., J1K 2R1, Sherbrooke, QC, Canada.
- Research Centre on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke, 1036 Belvedere South, J1H 4C4, Sherbrooke, QC, Canada.
| | - Mélissa Généreux
- University of Sherbrooke, 2500 University Blvd., J1K 2R1, Sherbrooke, QC, Canada.
- Research Centre on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke, 1036 Belvedere South, J1H 4C4, Sherbrooke, QC, Canada.
- Public Health Department, Health and Social Services Agency, 300 King East, Suite 300, J1J 1B1, Sherbrooke, QC, Canada.
| | - Jean-François Bruneau
- University of Sherbrooke, 2500 University Blvd., J1K 2R1, Sherbrooke, QC, Canada.
- Montreal Polytechnique, Downtown Station, P.O. Box 6079, H3C 3A7, Montreal, QC, Canada.
| | - Alain Vanasse
- University of Sherbrooke, 2500 University Blvd., J1K 2R1, Sherbrooke, QC, Canada.
- Research Centre, CHUS, 3001 12th Avenue North, J1H 5N4, Sherbrooke, QC, Canada.
| | - Éric Chabot
- Ordre des urbanistes du Québec, H2Y 3V4, Montreal, QC, Canada.
| | - Claude Beaulac
- Ordre des urbanistes du Québec, H2Y 3V4, Montreal, QC, Canada.
| | - Marie-Michèle Bédard
- University of Sherbrooke, 2500 University Blvd., J1K 2R1, Sherbrooke, QC, Canada.
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32
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The will to mobility: life-space satisfaction and distress in people with dementia who live alone. AGEING & SOCIETY 2014. [DOI: 10.1017/s0144686x14000683] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTIncreasing numbers of people with dementia reside in single-person households, yet little is known of their experiences and priorities. This exploratory Australian study elicited perceptions of seven people with dementia living alone, regarding their domestic environment and its surroundings. The general aim was to identify unmet service needs in this vulnerable population. Drawing upon the theoretical concepts of ‘the will to mobility’ and ‘life-space’, we identified four factors of particular salience to our respondents. These were access to public space, social distance and proximity, changing meanings of space and objects, and imaginative co-presence. Participants provided useful insights into a soon-to-be-common scenario in which increased numbers of people with dementia will be living without a resident carer. The findings have implications for the development of more personalised and targeted dementia care in the domestic setting, more inclusive public planning and more extensive public education programmes.
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Ohnuma T, Hashidate H, Yoshimatsu T, Abe T. Clinical usefulness of indoor life-space assessment in community-dwelling older adults certified as needing support or care. Nihon Ronen Igakkai Zasshi 2014; 51:151-60. [PMID: 24858119 DOI: 10.3143/geriatrics.51.151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE This study aimed to develop a questionnaire to evaluate indoor life-space mobility and assess its validity in community-dwelling older adults certified as needing support or care. METHODS The participants included 37 community-dwelling older adults undergoing home-visit rehabilitation (mean age: 78.5±7.0 years). We developed a questionnaire to assess the degree of indoor life-space mobility (home-based life-space assessment (Hb-LSA)), evaluating the functional status (life-space assessment (LSA), time spent away from bed, functional independence measure (FIM), bedside mobility scale (BMS)), physical function (hand grip power (HGP), 30-second chair stand (CS-30), one-leg standing (OLS)) and cognitive status (mental status questionnaire (MSQ)). RESULTS The average Hb-LSA score was 56.3±24.3 (minimum 4 to maximum 102.5). The test-retest reliability was high (intraclass correlation coefficients: (1, 1)=0.986, (1, 2)=0.993). The Hb-LSA scores were significantly associated with the LSA (r=0.897), time spent away from bed (r=0.497), FIM (r=0.786), BMS (r=0.720), HGP (r=0.388), CS-30 (r=0.541) and OLS (r=0.455). There were no significant associations between the Hb-LSA scores and the FIM cognitive subscores (r=0.180) or MSQ scores (r=-0.240). The Hb-LSA scores were significantly higher among the participants able to move independently indoors (75.8±18.8 points) than in those who required help to move (45.7±20.2 points). CONCLUSIONS The Hb-LSA is a useful, reliable and valid tool for assessing the degree of indoor physical mobility in the life-space. The Hb-LSA score is related to the degree of independence of indoor mobility.
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Oh-Park M, Hung C, Chen P, Barrett AM. Severity of spatial neglect during acute inpatient rehabilitation predicts community mobility after stroke. PM R 2014; 6:716-22. [PMID: 24412266 DOI: 10.1016/j.pmrj.2014.01.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 12/25/2013] [Accepted: 01/06/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine whether stroke survivors with more severe spatial neglect during their acute inpatient rehabilitation had poorer mobility after returning to their communities. DESIGN A prospective observational study. SETTING Acute inpatient rehabilitation and follow-up in the community. PARTICIPANTS Thirty-one consecutive stroke survivors with right-brain damage (women, n = 15 [48.4%]), with the mean (standard deviation) age of 60 ± 11.5 years, were included in the study if they demonstrated spatial neglect within 2 months after stroke. METHODS Spatial neglect was assessed with the Behavioral Inattention Test (BIT) (range, 0-146 [a lower score indicates more severity]) and the Catherine Bergego Scale (range, 0-30 [a higher score indicates more severity]). A score of the Behavioral Inattention Test <129 or of the Catherine Bergego Scale >0 defined the presence of spatial neglect. MAIN OUTCOME MEASUREMENTS The outcome measure is community mobility, defined by the extent and frequency of traveling within the home and in the community, and is assessed with the University of Alabama at Birmingham Study of Aging Life-Space Assessment (range, 0-120 [a lower score indicates less mobile]). This measure was assessed after participants returned home ≥6 months after stroke. The covariates were age, gender, functional independence at baseline; follow-up interval; and depressed mood, which may affect the relationship between spatial neglect and community mobility. RESULTS A lower Behavioral Inattention Test score was a significant predictor of a lower Life-Space Assessment score after controlling for all the covariates (β = 0.009 [95% confidence interval, 0.008-0.017]); P = .020). The proportion of participants unable to travel independently beyond their homes was 0%, 27.3%, and 72.7% for those with mild, moderate, and severe acute neglect, respectively (Catherine Bergego Scale range, 1-10, 11-20, and 21-30, respectively). CONCLUSIONS Our result indicates that acute spatial neglect has a negative impact on regaining of functional mobility in the community. Specific screening and treatment of spatial neglect during acute stroke care may be necessary to improve long-term mobility recovery.
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Affiliation(s)
- Mooyeon Oh-Park
- Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ; Kessler Institute for Rehabilitation, West Orange, NJ; Stroke Rehabilitation Research Laboratory, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ 07052(∗).
| | - Cynthia Hung
- Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ(†)
| | - Peii Chen
- Stroke Rehabilitation Research Laboratory, Kessler Foundation, West Orange, NJ; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ(‡)
| | - A M Barrett
- Stroke Rehabilitation Research Laboratory, Kessler Foundation, West Orange, NJ; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ; Kessler Institute for Rehabilitation, West Orange, NJ(§)
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Wettstein M, Wahl HW, Shoval N, Auslander G, Oswald F, Heinik J. Identifying Mobility Types in Cognitively Heterogeneous Older Adults Based on GPS-Tracking: What Discriminates Best? J Appl Gerontol 2013; 34:1001-27. [PMID: 24652916 DOI: 10.1177/0733464813512897] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 10/20/2013] [Indexed: 11/16/2022] Open
Abstract
Heterogeneity in older adults' mobility and its correlates have rarely been investigated based on objective mobility data and in samples including cognitively impaired individuals. We analyzed mobility profiles within a cognitively heterogeneous sample of N = 257 older adults from Israel and Germany based on GPS tracking technology. Participants were aged between 59 and 91 years (M = 72.9; SD = 6.4) and were either cognitively healthy (CH, n = 146), mildly cognitively impaired (MCI, n = 76), or diagnosed with an early-stage dementia of the Alzheimer's type (DAT, n = 35). Based on cluster analysis, we identified three mobility types ("Mobility restricted," "Outdoor oriented," "Walkers"), which could be predicted based on socio-demographic indicators, activity, health, and cognitive impairment status using discriminant analysis. Particularly demented individuals and persons with worse health exhibited restrictions in mobility. Our findings contribute to a better understanding of heterogeneity in mobility in old age.
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Hashidate H, Shimada H, Shiomi T, Shibata M, Sawada K, Sasamoto N. Measuring indoor life-space mobility at home in older adults with difficulty to perform outdoor activities. J Geriatr Phys Ther 2013; 36:109-14. [PMID: 22976813 DOI: 10.1519/jpt.0b013e31826e7d33] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Measurement of indoor physical activity at home in older adults who have difficulty performing outdoor activities is a key to documenting baseline physical activity levels to guide physical activity interventions aimed at reducing the rate of decline in mobility. PURPOSE The purpose of this study was to describe indoor life-space mobility at home (LSH) and examine the association between LSH and mobility-related physical functions in older adults who have difficulty performing outdoor activities. METHODS The participants were 20 community-dwelling older adults (mean age [SD], 76.6 [5.1] years) receiving home-care rehabilitation. Participants were assessed for LSH and physical function related to mobility. Assessments included isometric knee extensor strength, the Timed Up and Go (TUG) Test, functional status (a 13-item Motor subscale of Functional Independence Measure, the Tokyo Metropolitan Institute of Gerontology Index of Competence, and outdoor life-space mobility (life-space assessment [LSA]). Life-space mobility at home documented how far and how often participants moved from a bedroom to 4 destinations (entrance, dining room, bathroom, and toilet) at home with or without assistance during the week prior to the assessment. RESULTS Reliability of LSH was high (intraclass correlation coefficient [ICC] (1,1) = 0.80, ICC (1,2) = 0.89). Simple bivariate correlations showed a significant relationship between LSH and isometric knee extensor strength (rs = 0.59, P = .01) and TUG Test (rs = -0.74 P = .01). Life-space mobility at home showed moderate correlations with the Functional Independence Measure (rs = 0.58, P = .01) and Tokyo Metropolitan Institute of Gerontology Index of Competence (rs = 0.49, P = .03), but no significant correlation with the LSA (rs = 0.33, P = .17). DISCUSSION Regarding intrarater reliability, the ICCs for measuring the LSH indicated high reproducibility. The results suggest that the LSA mainly reflects outdoor life-space mobility and activity rather than indoor life-space whereas the LSH reflects indoor life-space mobility and is considered an indicator of a major decline in indoor activities and physical abilities. CONCLUSIONS The LSH concept can measure with high reliability and concurrent or discriminant validity, and it is a different concept from outdoor life-space mobility. Life-space mobility at home may be an important factor associated with physical functions related to mobility and functional status, and measuring LSH may be useful to assess current indoor life-space activity in older adults who have difficulty performing outdoor activities.
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Affiliation(s)
- Hiroyuki Hashidate
- Department of Physical Therapy, School of Health Sciences, Kyorin University, Tokyo 192-8508, Japan.
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Wettstein M, Wahl HW, Diehl MK. A multidimensional view of out-of-home behaviors in cognitively unimpaired older adults: examining differential effects of socio-demographic, cognitive, and health-related predictors. Eur J Ageing 2013; 11:141-153. [PMID: 28804322 DOI: 10.1007/s10433-013-0292-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Previous studies on predictors of out-of-home behavior (OOHB) have often neglected the multidimensional nature of this construct. The present study distinguished between two levels of analyzing OOHB: out-of-home mobility seen as single behavioral units (e.g., number of places visited, action range, and walking) versus OOHBs seen as engagement in integrated, larger activity units (e.g., cognitively and physically demanding activities). We examined whether a differential relationship between these levels of OOHBs with established predictors of OOHBs, i.e., socio-demographic variables, cognitive abilities, physical functioning, and depression, exists. A sample of 100 cognitively healthy, community-dwelling adults with a mean age of 70.8 years underwent a multi-method OOHB assessment using GPS- (out-of-home mobility) and questionnaire-based (out-of-home activity engagement) measures. Predictors were assessed based on internationally implemented procedures. Regression analyses showed that walking-based mobility and engagement in physical activities could be predicted by physical functioning, whereas most effects of socio-demographic variables, such as age and gender, and of depression on OOHBs were negligible. At the bivariate level, episodic memory was related to action range, global mobility, and to cognitively demanding activity engagement, but not to walking, whereas executive function was related with physically demanding activity engagement only. However, some of these connections became weaker in the full predictor model. Findings support the notion that it is necessary to assess OOHB as a multiple-indicator construct.
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Affiliation(s)
- Markus Wettstein
- Department of Psychological Ageing Research, Heidelberg University, Heidelberg, Germany
| | - Hans-Werner Wahl
- Department of Psychological Ageing Research, Heidelberg University, Heidelberg, Germany
| | - Manfred K Diehl
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO USA
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Wettstein M, Wahl HW, Shoval N, Oswald F, Voss E, Seidl U, Frölich L, Auslander G, Heinik J, Landau R. Out-of-home behavior and cognitive impairment in older adults: findings of the SenTra Project. J Appl Gerontol 2012; 34:3-25. [PMID: 25548086 DOI: 10.1177/0733464812459373] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study explores differences in the out-of-home behavior of community-dwelling older adults with different cognitive impairment. Three levels of complexity of out-of-home behavior were distinguished: (a) mostly automatized walking behavior (low complexity), (b) global out-of-home mobility (medium complexity), and (c) defined units of concrete out-of-home activities, particularly cognitively demanding activities (high complexity). A sample of 257 older adults aged 59 to 91 years (M = 72.9 years, SD = 6.4 years) included 35 persons with early-stage Alzheimer's disease (AD), 76 persons with mild cognitive impairment (MCI), and 146 cognitively healthy persons (CH). Mobility data were gathered by using a GPS tracking device as well as by questionnaire. Predicting cognitive impairment status by out-of-home behavior and a range of confounders by means of multinomial logistic regression revealed that only cognitively demanding activities showed at least a marginally significant difference between MCI and CH and were highly significant between AD and CH.
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Affiliation(s)
| | | | | | | | - Elke Voss
- Central Institute of Mental Health, Mannheim, Germany
| | - Ulrich Seidl
- Klinikum Stuttgart, Department of Psychiatry, Stuttgart, Germany
| | - Lutz Frölich
- Central Institute of Mental Health, Mannheim, Germany
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Uemura K, Shimada H, Makizako H, Yoshida D, Doi T, Yamada M, Suzuki T. Factors associated with life-space in older adults with amnestic mild cognitive impairment. Geriatr Gerontol Int 2012; 13:161-6. [PMID: 22680286 DOI: 10.1111/j.1447-0594.2012.00878.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM Restriction of life-space is associated with physical performance and functional decline in older adults. Little is known about the factors associated with life-space in older adults with amnestic mild cognitive impairment (aMCI). The purpose of this study was to identify factors associated with life-space in older adults with aMCI. METHODS The study participants were 69 older adults (mean age 74.5 years, males 56.5%) who were identified with aMCI. Life-space mobility was measured using a Japanese translation of the life-space assessment (LSA). Age, sex, cognitive function (general function, executive function and processing speed), physical performance, instrumental activities of daily living status (IADL) and fear of falling (FoF) were measured as potential relevant factors. RESULTS Univariate analysis showed that the LSA was associated with FoF, sex, physical performance, processing speed and IADL. In the stepwise regression analysis, FoF, processing speed and IADL maintained a significant association with the LSA scores, although sex and physical performance did not reach significance. CONCLUSION The results suggest that the restrictions of life-space in older adults with aMCI were more affected by the FoF, slower processing speed and restricted IADL than sex or physical performance.
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Affiliation(s)
- Kazuki Uemura
- Section for Health Promotion, Department of Health and Medical Care, National Center for Geriatrics and Gerontology, Obu, Japan.
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Yamamoto T, Kondo K, Misawa J, Hirai H, Nakade M, Aida J, Kondo N, Kawachi I, Hirata Y. Dental status and incident falls among older Japanese: a prospective cohort study. BMJ Open 2012; 2:bmjopen-2012-001262. [PMID: 22855628 PMCID: PMC4400665 DOI: 10.1136/bmjopen-2012-001262] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To examine if self-reported number of teeth, denture use and chewing ability are associated with incident falls. DESIGN Longitudinal cohort study (the Aichi Gerontological Evaluation Study). SETTING 5 Japanese municipalities. PARTICIPANTS 1763 community-dwelling individuals aged 65 years and older without experience of falls within the previous year at baseline. MAIN OUTCOME MEASURES Self-reported history of multiple falls during the past year at the follow-up survey about 3 years later. Baseline data on the number of teeth present and/or denture use and chewing ability were collected using self-administered questionnaires. Logistic regression analyses controlled for sex, age, functional disability during follow-up period, depression, self-rated health and educational attainment. RESULTS 86 (4.9%) subjects reported falls at the follow-up survey. Logistic regression models fully adjusted for all covariates showed that subjects having 19 or fewer teeth but not using dentures had a significantly increased risk for incident falls (OR 2.50, 95% CI 1.21 to 5.17, p=0.013) compared with those having 20 or more teeth. Among subjects with 19 or fewer teeth, their risk of falls was not significantly elevated so long as they wore dentures (OR 1.36, 95% CI 0.76 to 2.45, p=0.299). No significant association was observed between chewing ability and incident falls in the fully adjusted model. CONCLUSIONS Having 19 or fewer teeth but not using dentures was associated with higher risk for the incident falls in older Japanese even after adjustment for multiple covariates. Dental care to prevent tooth loss and denture treatment for older people might prevent falls, although the authors cannot exclude the possibility that the association is due to residual confounding.
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Affiliation(s)
- Tatsuo Yamamoto
- Division of Sociological Approach in Dentistry, Department of Dental
Sociology, Kanagawa Dental College, Yokosuka-shi, Kanagawa, Japan
| | - Katsunori Kondo
- Center for Well-being and Society, Nihon Fukushi University, Nagoya-shi,
Aichi, Japan
| | - Jimpei Misawa
- Center for Well-being and Society, Nihon Fukushi University, Nagoya-shi,
Aichi, Japan
| | - Hiroshi Hirai
- Department of Civil and Environmental Engineering, Faculty of
Engineering, Iwate University, Morioka-shi, Iwate, Japan
| | - Miyo Nakade
- Department of Nutrition, Faculty of Health and Nutrition, Tokaigakuen
University, Nagoya-shi, Aichi, Japan
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University
Graduate School of Dentistry, Sendai-shi, Miyagi, Japan
| | - Naoki Kondo
- Department of Health Sciences, Interdisciplinary Graduate School of
Medicine and Engineering, University of Yamanashi, Chuo-shi, Yamanashi, Japan
| | - Ichiro Kawachi
- Department of Society, Human Development and Health, Harvard School of
Public Health, Boston, Massachusetts, USA
| | - Yukio Hirata
- Division of Sociological Approach in Dentistry, Department of Dental
Sociology, Kanagawa Dental College, Yokosuka-shi, Kanagawa, Japan
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Abstract
OBJECTIVE To test the hypothesis that a constricted life space, the extent of movement through the environment covered during daily functioning, is associated with increased risk of incident Alzheimer disease (AD), increased risk of mild cognitive impairment (MCI), and more rapid cognitive decline in older adults. DESIGN Two prospective cohort studies. SETTING Retirement communities, community-based organizations, churches, and senior subsidized housing facilities across the Chicago metropolitan area. PARTICIPANTS A total of 1,294 community-dwelling elders without baseline clinical dementia. MAIN OUTCOME MEASURES Detailed annual clinical evaluation to diagnose incident AD and MCI, and document change in cognitive function. RESULTS During a mean (SD) follow-up of 4.4 (1.7) years, 180 persons developed AD. In a proportional hazards model controlling for age, sex, race, and education, a more constricted life space was associated with an increased risk of AD (hazard ratio = 1.21, confidence interval: 1.08-1.36). A person with a life space constricted to their home was almost twice as likely to develop AD than a person with the largest life space (out of town). The association did not vary along demographic lines and persisted after the addition of terms for performance-based physical function, disability, depressive symptoms, social network size, vascular disease burden, and vascular risk factors. The association remained consistent after excluding persons with MCI at baseline and who developed AD in the first 2 years of observation. A constricted life space was also associated with an increased risk of MCI (hazard ratio = 1.17, confidence interval: 1.06-1.28), and a more rapid rate of global cognitive decline (estimate: -0.012, standard error: 0.003, t[5033] = -3.58, p <0.001). CONCLUSIONS A constricted life space is associated with increased risk of AD, MCI, and cognitive decline among older persons.
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Boyle PA, Buchman AS, Barnes LL, James BD, Bennett DA. Association between life space and risk of mortality in advanced age. J Am Geriatr Soc 2010; 58:1925-30. [PMID: 20831722 DOI: 10.1111/j.1532-5415.2010.03058.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To examine the association between life space, a measure of functional status that describes the range of movement through the environment covered during daily functioning, and the risk of mortality in older community-based persons. DESIGN Two ongoing, prospective observational cohort studies of aging. SETTING Greater metropolitan Chicago area. PARTICIPANTS One thousand four hundred forty-five community-based older persons without dementia. MEASUREMENTS Life space was measured at baseline using a series of questions designed to measure the extent of participants' movement throughout their environment, ranging from the bedroom to out of town. The association between life space and mortality was examined using proportional hazards models adjusted for age, sex, race, and education. RESULTS Over up to 8 years of follow-up (mean 4.1 years), 329 of 1,445 (22.8%) participants died. In a proportional hazards model adjusted for age, sex, race, and education, a more-constricted life space was associated with a greater risk of death (hazard ratio=1.18, 95% confidence interval=1.09-1.27, P<.001), such that people with life spaces constricted to their immediate home environment (score=3) were approximately 1.6 times as likely to die as those whose life spaces included trips out of town (score=0). This association persisted after the addition of terms for several potential confounders, including physical activity, performance-based physical function, disability, depressive symptoms, social networks, body mass index, and number of chronic medical conditions. CONCLUSION Constricted life space is associated with greater risk of death in older community-based persons.
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Auger C, Demers L, Gélinas I, Miller WC, Jutai JW, Noreau L. Life-Space Mobility of Middle-Aged and Older Adults at Various Stages of Usage of Power Mobility Devices. Arch Phys Med Rehabil 2010; 91:765-73. [DOI: 10.1016/j.apmr.2010.01.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 01/18/2010] [Accepted: 01/24/2010] [Indexed: 11/25/2022]
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Aberg AC. Care recipients' perceptions of activity-related life space and life satisfaction during and after geriatric rehabilitation. Qual Life Res 2008; 17:509-20. [PMID: 18415707 DOI: 10.1007/s11136-008-9337-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Accepted: 03/27/2008] [Indexed: 11/30/2022]
Abstract
The debate concerning older people's life spaces should be based on subjective priorities of the elderly themselves. The purpose of this study was therefore to improve the understanding of preferences of elderly care recipients regarding activity-related life space (ARLS) and life satisfaction. A mainly qualitative design was used. Fifteen persons aged 80-94 years, undergoing geriatric rehabilitation, were interviewed during hospital stay and on two follow-up occasions after discharge. Transcribed interviews were analyzed in line with the thematic framework approach. The results point to three approaches related to preferences of ARLS: hierarchical limitations, changing continuity, and boundary breaking. Adaptive approaches were employed when physical incapacity was considered a hindrance to activity, adaptations which as a rule resulted in limitations of ARLS preferences. Activity related to the area 'close to one's own body' emerged as one of three identified key activities with importance for life satisfaction, the others being socializing and going out of doors. Continuity of activity in a familiar life space was expressed as a common ideal. If the aim of geriatric rehabilitation is to improve care recipients' life satisfaction, attention needs to be paid to the subjective dimensions of the ARLS in the goal setting.
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Affiliation(s)
- Anna Cristina Aberg
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden.
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