Contextual factors associated with life-space mobility in community-dwelling older adults based on International Classification of Functioning, Disability and Health: protocol for a systematic review

Influence of personal mastery on mobility disability among older adults: A systematic review

PURPOSE

Personal mastery is a psychological resource recognized as a domain of quality of life that helps individuals cope with life strains. Despite its relevance, there is a lack surrounding the relationship between mobility disability and personal mastery. This study aimed to investigate the influence of personal mastery on mobility disability among older adults and identify the mechanisms that underlie this influence.

METHODS

A systematic review was conducted by searching four databases (i.e., PubMed, Scopus, ScienceDirect, and the Virtual Health Library of the Latin American and Caribbean Center on Health Sciences Information) using combinations of the following words: mastery, personal mastery, self-control, mobility, disability, older adults, older people, and aging. We summarized and analyzed the findings of cross-sectional and longitudinal/prospective studies.

RESULTS

Twenty-one studies were included. There was high heterogeneity in how the studies had assessed mobility disability. Although a majority of the studies had used the Pearlin's Self-Mastery Scale (PSMS) to assess personal mastery, there were variations in the number of response anchors and scoring strategies that were used. Nevertheless, findings revealed that personal mastery influences mobility disability by acting as a protective resource against adverse outcomes among older adults. The authors of the reviewed articles had provided physiological and behavioral explanations for their findings.

CONCLUSIONS

Higher level of personal mastery can protect older adults from mobility disability, because it confers a sense of personal control, which in turn promotes positive physiological functioning and health behaviors. This knowledge contributes to the maintenance of physical functioning in old age.

Self-Perception of Changes in Routines in Adults and Older Adults Associated to Social Distancing Due to COVID-19-A Study in São Paulo, Brazil

COVID-19 is an acute respiratory illness with higher mortality in older adults. This condition is spread person-to-person through close contact, and among policies employed to decrease transmission are the improvement of hygiene habits and physical distancing. Although social distancing has been recognized as the best way to prevent the transmission, there are concerns that it may promote increased depression symptoms risk and anxiety, mainly in older adults. This cross-sectional study aimed to verify self-concept of social distancing in adults compared to older adults. All participants, over 18 years and residents of São Paulo state (Brazil), were invited to join this research study by a message application and answered an interdisciplinary questionnaire during the period from May 23 to June 23, 2020. The questions were divided into the following aspects: sociodemographic data, financial conditions, routine-related perception, perception of health, physical and emotional state, and eating habits. The younger adult group was composed of 139 participants, with a mean age of 43.15 years (±10.92), and the older adult group was composed of 437 participants with a mean age of 67.59 years (±6.13) of both sex. Changes in routine during the period of social distance were reported by 95% of adults and 96.8% of older adults, but adults indicated more significant alterations in routine. Although there was no difference between groups for several aspects, adults revealed greater alterations in sleep quality, evacuation frequency, and more difficulty to perform daily activities at home. Further studies are necessary to follow up the impacts of social distancing among adults and older adults in different socioeconomic contexts to better understand the long-term alterations and the necessity of interventions.

Cross-sectional study of individual and environmental factors associated with life-space mobility among community-dwelling independent older people

BACKGROUND

Life-space mobility is reflected in comprehensive longevity and health outcomes and is also an important indicator for preventing mortality and decline in well-being among older people. However, a comprehensive framework of life-space mobility and modifiable individual and environmental factors has not been well validated among community-dwelling independent older people, for primary prevention. We examined individual and environmental factors affecting life-space mobility among community-dwelling independent older people.

METHODS

This cross-sectional study included 3500 community-dwelling independent older people randomly selected using the National Basic Resident Registration System in Japan. Life-space mobility was measured using the Japanese version of the Life-Space Assessment (LSA) instrument, which is used to assess an individual's pattern of mobility. Negative multivariate binomial regression analysis was performed in a final sample of 1258 people. Individual factors (including physical, mental, and social characteristics) and environmental factors (including the social and material environment) were measured and analyzed as potential factors.

RESULTS

Negative multivariable binomial regression analysis, adjusted for demographics, showed that LSA score was associated with locomotive syndrome (β = - 0.48, 95% confidence interval [CI] = - 0.24 to - 0.73), depression (β = - 0.29, 95% CI = - 0.03 to - 0.55), health literacy (β = 0.20, 95% CI = 0.39-0.01), and participation in community activities (β = 0.23, 95% CI = 0.03-0.43) among individual factors, and receipt of social support (β = - 0.19, 95% CI = 0.00 to - 0.38) and social network (β = 0.29, 95% CI = 0.48-0.10) among environmental factors.

CONCLUSIONS

Our findings suggest that modifiable individual factors and environmental factors are related to life-space mobility among community-dwelling older people.

Assessing timewise changes over 15 months in life-space mobility among community-dwelling elderly persons

BACKGROUND

The purpose of this study was to examine the differences of timewise changes in life-space mobility between elderly people living alone and those living with others among community-dwelling elderly people from a day care facility with a rehabilitation service for seniors.

METHODS

The present study used a longitudinal design with repeated measures every 3 months. In conformity with our inclusion criteria, this study included 233 community-dwelling elderly users of a day care facility with rehabilitation services for seniors in Japan. We analyzed the life-space assessment (LSA) scores collected at five time points (baseline, 3 months, 6 months, 9 months, and 12 months) using mixed-effects models with random intercepts and slopes over time. In the present study, the explanatory variables of interest were time, and living situation (living alone or with others). As possible confounders, we considered the following: (a) age, (b) sex, (c) social frailty, (d) physical frailty, (e) mild cognitive impairment (MCI), (f) depression, and (g) economic satisfaction.

RESULTS

The mean age of participants was 78.9 years (SD = 7.7), their mean LSA score was 60.1 points (SD = 25.7), and 42.9% of the participants were men. After adjusting for age, gender, frailty, depression, MCI, and economic satisfaction, the mean LSA score of older adults who lived with others was significantly lower (7.42 points, 95%CI = - 18.30 to - 0.15, p = 0.048) than that older adults who lived alone.

DISCUSSION

Community-dwelling older adults who used a day care center with rehabilitation services and lived with others had a smaller life-space at baseline than those who lived alone. This suggests that there is a need to pay more attention to social frailty among both older adults who live alone and those who live with others.

CONCLUSIONS

According to a multilevel analysis growth model, elderly persons who lived with others had significantly lower life-space mobility than those who lived alone.

GPS mobility as a digital biomarker of negative symptoms in schizophrenia: a case control study

Mobility is an important correlate of physical, cognitive, and mental health in chronic illness, and can be measured passively with mobile phone global positional satellite (GPS) sensors. To date, GPS data have been reported in a few studies of schizophrenia, yet it is unclear whether these data correlate with concurrent momentary reports of location, vary by people with schizophrenia and healthy comparison subjects, or associate with symptom clusters in schizophrenia. A total of 142 participants with schizophrenia (n = 86) or healthy comparison subjects (n = 56) completed 7 days of ecological momentary assessment (EMA) reports of location and behavior, and simultaneous GPS locations were tracked every five minutes. We found that GPS-derived indicators of average distance travelled overall and distance from home, as well as percent of GPS samples at home were highly correlated with EMA reports of location at the day- and week-averaged level. GPS-based mobility indicators were lower in schizophrenia with medium to large effect sizes. Less GPS mobility was related to greater negative symptom severity, particularly diminished motivation, whereas greater GPS mobility was weakly associated with more community functioning. Neurocognition, depression, and positive symptoms were not associated with mobility indicators. Therefore, passive GPS sensing could provide a low-burden proxy measure of important outcomes in schizophrenia, including negative symptoms and possibly of functioning. As such, passive GPS sensing could be used for monitoring and timely interventions for negative symptoms in young persons at high risk for schizophrenia.