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Röcke C, Luo M, Bereuter P, Katana M, Fillekes M, Gehriger V, Sofios A, Martin M, Weibel R. Charting everyday activities in later life: Study protocol of the mobility, activity, and social interactions study (MOASIS). Front Psychol 2023; 13:1011177. [PMID: 36760916 PMCID: PMC9903074 DOI: 10.3389/fpsyg.2022.1011177] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/15/2022] [Indexed: 01/25/2023] Open
Abstract
Prominent theories of aging emphasize the importance of resource allocation processes as a means to maintain functional ability, well-being and quality of life. Little is known about which activities and what activity patterns actually characterize the daily lives of healthy older adults in key domains of functioning, including the spatial, physical, social, and cognitive domains. This study aims to gain a comprehensive understanding of daily activities of community-dwelling older adults over an extended period of time and across a diverse range of activity domains, and to examine associations between daily activities, health and well-being at the within- and between-person levels. It also aims to examine contextual correlates of the relations between daily activities, health, and well-being. At its core, this ambulatory assessment (AA) study with a sample of 150 community-dwelling older adults aged 65 to 91 years measured spatial, physical, social, and cognitive activities across 30 days using a custom-built mobile sensor ("uTrail"), including GPS, accelerometer, and audio recording. In addition, during the first 15 days, self-reports of daily activities, psychological correlates, contexts, and cognitive performance in an ambulatory working memory task were assessed 7 times per day using smartphones. Surrounding the ambulatory assessment period, participants completed an initial baseline assessment including a telephone survey, web-based questionnaires, and a laboratory-based cognitive and physical testing session. They also participated in an intermediate laboratory session in the laboratory at half-time of the 30-day ambulatory assessment period, and finally returned to the laboratory for a posttest assessment. In sum, this is the first study which combines multi-domain activity sensing and self-report ambulatory assessment methods to observe daily life activities as indicators of functional ability in healthy older adults unfolding over an extended period (i.e., 1 month). It offers a unique opportunity to describe and understand the diverse individual real-life functional ability profiles characterizing later life.
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Affiliation(s)
- Christina Röcke
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland,Center for Gerontology, University of Zurich, Zurich, Switzerland,*Correspondence: Christina Röcke, ✉
| | - Minxia Luo
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland,Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Pia Bereuter
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland,Institute of Geomatics, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
| | - Marko Katana
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland,Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Michelle Fillekes
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland,Department of Geography, University of Zurich, Zurich, Switzerland
| | - Victoria Gehriger
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland,Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Alexandros Sofios
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland,Department of Geography, University of Zurich, Zurich, Switzerland
| | - Mike Martin
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland,Center for Gerontology, University of Zurich, Zurich, Switzerland,Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Robert Weibel
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland,Department of Geography, University of Zurich, Zurich, Switzerland
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Firouraghi N, Kiani B, Jafari HT, Learnihan V, Salinas-Perez JA, Raeesi A, Furst M, Salvador-Carulla L, Bagheri N. The role of geographic information system and global positioning system in dementia care and research: a scoping review. Int J Health Geogr 2022; 21:8. [PMID: 35927728 PMCID: PMC9354285 DOI: 10.1186/s12942-022-00308-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Geographic Information System (GIS) and Global Positioning System (GPS), vital tools for supporting public health research, provide a framework to collect, analyze and visualize the interaction between different levels of the health care system. The extent to which GIS and GPS applications have been used in dementia care and research is not yet investigated. This scoping review aims to elaborate on the role and types of GIS and GPS applications in dementia care and research. Methods A scoping review was conducted based on Arksey and O’Malley’s framework. All published articles in peer-reviewed journals were searched in PubMed, Scopus, and Web of Science, subject to involving at least one GIS/GPS approach focused on dementia. Eligible studies were reviewed, grouped, and synthesized to identify GIS and GPS applications. The PRISMA standard was used to report the study. Results Ninety-two studies met our inclusion criteria, and their data were extracted. Six types of GIS/GPS applications had been reported in dementia literature including mapping and surveillance (n = 59), data preparation (n = 26), dementia care provision (n = 18), basic research (n = 18), contextual and risk factor analysis (n = 4), and planning (n = 1). Thematic mapping and GPS were most frequently used techniques in the dementia field. Conclusions Even though the applications of GIS/GPS methodologies in dementia care and research are growing, there is limited research on GIS/GPS utilization in dementia care, risk factor analysis, and dementia policy planning. GIS and GPS are space-based systems, so they have a strong capacity for developing innovative research based on spatial analysis in the area of dementia. The existing research has been summarized in this review which could help researchers to know the GIS/GPS capabilities in dementia research. Supplementary Information The online version contains supplementary material available at 10.1186/s12942-022-00308-1.
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Affiliation(s)
- Neda Firouraghi
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Behzad Kiani
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. .,École de Santé Publique de L'Université de Montréal (ESPUM), Québec, Montréal, Canada.
| | - Hossein Tabatabaei Jafari
- Visual and Decision Analytics Lab, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
| | - Vincent Learnihan
- Health Research Institute, University of Canberra, Building 23 Office B32, University Drive, Bruce, Canberra, ACT, 2617, Australia
| | - Jose A Salinas-Perez
- Department of Quantitative Methods,, Universidad Loyola Andalucía, Spain Faculty of Medicine, University of Canberra, Canberra, Australia
| | - Ahmad Raeesi
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - MaryAnne Furst
- Health Research Institute, University of Canberra, Building 23 Office B32, University Drive, Bruce, Canberra, ACT, 2617, Australia
| | - Luis Salvador-Carulla
- Mental Health Policy Unit, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia.,Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Nasser Bagheri
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Suri A, VanSwearingen J, Dunlap P, Redfern MS, Rosso AL, Sejdić E. Facilitators and barriers to real-life mobility in community-dwelling older adults: a narrative review of accelerometry- and global positioning system-based studies. Aging Clin Exp Res 2022; 34:1733-1746. [PMID: 35275373 PMCID: PMC8913857 DOI: 10.1007/s40520-022-02096-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/14/2022] [Indexed: 11/01/2022]
Abstract
Real-life mobility, also called "enacted" mobility, characterizes an individual's activity and participation in the community. Real-life mobility may be facilitated or hindered by a variety of factors, such as physical abilities, cognitive function, psychosocial aspects, and external environment characteristics. Advances in technology have allowed for objective quantification of real-life mobility using wearable sensors, specifically, accelerometry and global positioning systems (GPSs). In this review article, first, we summarize the common mobility measures extracted from accelerometry and GPS. Second, we summarize studies assessing the associations of facilitators and barriers influencing mobility of community-dwelling older adults with mobility measures from sensor technology. We found the most used accelerometry measures focus on the duration and intensity of activity in daily life. Gait quality measures, e.g., cadence, variability, and symmetry, are not usually included. GPS has been used to investigate mobility behavior, such as spatial and temporal measures of path traveled, location nodes traversed, and mode of transportation. Factors of note that facilitate/hinder community mobility were cognition and psychosocial influences. Fewer studies have included the influence of external environments, such as sidewalk quality, and socio-economic status in defining enacted mobility. Increasing our understanding of the facilitators and barriers to enacted mobility can inform wearable technology-enabled interventions targeted at delaying mobility-related disability and improving participation of older adults in the community.
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Affiliation(s)
- Anisha Suri
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jessie VanSwearingen
- Department of Physical Therapy, School of Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Pamela Dunlap
- Department of Physical Therapy, School of Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mark S Redfern
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrea L Rosso
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ervin Sejdić
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
- The Edward S. Rogers Department of Electrical and Computer Engineering, University of Toronto, Toronto, ON, Canada.
- North York General Hospital, Toronto, ON, Canada.
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Wearable and Portable GPS Solutions for Monitoring Mobility in Dementia: A Systematic Review. SENSORS 2022; 22:s22093336. [PMID: 35591026 PMCID: PMC9104067 DOI: 10.3390/s22093336] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 02/04/2023]
Abstract
Dementia is the most common neurodegenerative disorder globally. Disease progression is marked by declining cognitive function accompanied by changes in mobility. Increased sedentary behaviour and, conversely, wandering and becoming lost are common. Global positioning system (GPS) solutions are increasingly used by caregivers to locate missing people with dementia (PwD) but also offer a non-invasive means of monitoring mobility patterns in PwD. We performed a systematic search across five databases to identify papers published since 2000, where wearable or portable GPS was used to monitor mobility in patients with common dementias or mild cognitive impairment (MCI). Disease and GPS-specific vocabulary were searched singly, and then in combination, identifying 3004 papers. Following deduplication, we screened 1972 papers and retained 17 studies after a full-text review. Only 1/17 studies used a wrist-worn GPS solution, while all others were variously located on the patient. We characterised the studies using a conceptual framework, finding marked heterogeneity in the number and complexity of reported GPS-derived mobility outcomes. Duration was the most frequently reported category of mobility reported (15/17), followed by out of home (14/17), and stop and trajectory (both 10/17). Future research would benefit from greater standardisation and harmonisation of reporting which would enable GPS-derived measures of mobility to be incorporated more robustly into clinical trials.
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5
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Atrsaei A, Hansen C, Elshehabi M, Solbrig S, Berg D, Liepelt-Scarfone I, Maetzler W, Aminian K. Effect of Fear of Falling on Mobility Measured During Lab and Daily Activity Assessments in Parkinson's Disease. Front Aging Neurosci 2021; 13:722830. [PMID: 34916920 PMCID: PMC8669821 DOI: 10.3389/fnagi.2021.722830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/21/2021] [Indexed: 12/24/2022] Open
Abstract
In chronic disorders such as Parkinson’s disease (PD), fear of falling (FOF) is associated with falls and reduced quality of life. With inertial measurement units (IMUs) and dedicated algorithms, different aspects of mobility can be obtained during supervised tests in the lab and also during daily activities. To our best knowledge, the effect of FOF on mobility has not been investigated in both of these settings simultaneously. Our goal was to evaluate the effect of FOF on the mobility of 26 patients with PD during clinical assessments and 14 days of daily activity monitoring. Parameters related to gait, sit-to-stand transitions, and turns were extracted from IMU signals on the lower back. Fear of falling was assessed using the Falls Efficacy Scale-International (FES-I) and the patients were grouped as with (PD-FOF+) and without FOF (PD-FOF−). Mobility parameters between groups were compared using logistic regression as well as the effect size values obtained using the Wilcoxon rank-sum test. The peak angular velocity of the turn-to-sit transition of the timed-up-and-go (TUG) test had the highest discriminative power between PD-FOF+ and PD-FOF− (r-value of effect size = 0.61). Moreover, PD-FOF+ had a tendency toward lower gait speed at home and a lower amount of walking bouts, especially for shorter walking bouts. The combination of lab and daily activity parameters reached a higher discriminative power [area under the curve (AUC) = 0.75] than each setting alone (AUC = 0.68 in the lab, AUC = 0.54 at home). Comparing the gait speed between the two assessments, the PD-FOF+ showed higher gait speeds in the capacity area compared with their TUG test in the lab. The mobility parameters extracted from both lab and home-based assessments contribute to the detection of FOF in PD. This study adds further evidence to the usefulness of mobility assessments that include different environments and assessment strategies. Although this study was limited in the sample size, it still provides a helpful method to consider the daily activity measurement of the patients with PD into clinical evaluation. The obtained results can help the clinicians with a more accurate prevention and treatment strategy.
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Affiliation(s)
- Arash Atrsaei
- Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Clint Hansen
- Department of Neurology, UKSH, Christian-Albrechts-University, Kiel, Germany
| | - Morad Elshehabi
- Department of Neurology, UKSH, Christian-Albrechts-University, Kiel, Germany
| | - Susanne Solbrig
- Department of Neurodegeneration, Center for Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Daniela Berg
- Department of Neurology, UKSH, Christian-Albrechts-University, Kiel, Germany.,Department of Neurodegeneration, Center for Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration, Center for Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany.,IB-Hochschule, Stuttgart, Germany
| | - Walter Maetzler
- Department of Neurology, UKSH, Christian-Albrechts-University, Kiel, Germany
| | - Kamiar Aminian
- Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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Chung J, Boyle J, Wheeler DC. Relationship Between Life-Space Mobility and Health Characteristics in Older Adults Using Global Positioning System Watches. J Appl Gerontol 2021; 41:1186-1195. [PMID: 34719296 DOI: 10.1177/07334648211054834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to examine the feasibility of using global positioning system (GPS) watches to examine relationships between GPS-based life-space mobility (LSM) metrics and self-report LSM and health measures (physical, psychological, and cognitive function) among older adults. Thirty participants wore a Fitbit Surge for 3 days. Eight spatial and temporal LSM measures were derived from GPS data. About 90% of in-home movement speeds were zero, indicating the sedentary lifestyle, but they made some active out-of-home trips as the total distance traveled and size of movement area indicated. There was a significant difference in total distance traveled and 95th percentile of movement speed between mild cognitive and intact cognition groups. GPS-based higher proportion of out-of-home time was significantly associated with greater functional fitness. Greater GPS use hours were significantly associated with higher cognition. These findings suggest the potential of GPS watches to continuously monitor changes in functional health to inform prevention efforts.
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Affiliation(s)
- Jane Chung
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Joseph Boyle
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - David C Wheeler
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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Mobility impact and well-being in later life: A multidisciplinary systematic review. RESEARCH IN TRANSPORTATION ECONOMICS 2021; 86:100975. [PMCID: PMC7547325 DOI: 10.1016/j.retrec.2020.100975] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/19/2020] [Accepted: 10/02/2020] [Indexed: 06/01/2023]
Abstract
In modern societies, the understanding of how active mobility affects the elderly's psycho-physical well-being is crucial to design ageing-friendly transport measures. From a multidisciplinary perspective, this systematic review points out the mobility impact on three elements of the EU Active Ageing Index: health, independence and social connectedness. By scanning four databases (Scopus, Web of Science, PubMed, and TRID), 3727 peer-reviewed papers published in the last decade were found, of which 57 met the inclusion criteria. The screening process was conducted following the PRISMA protocol and registered to the database PROSPERO, while the quality assessment was done using the Mixed Methods Appraisal Tool. More than 80% of the papers showed that an active mobility prevents psycho-physical harms, while only few papers study the relation of mobility with independence and social inclusion, to reduce the need for assistance and the related public expenditures. The findings of this review give important information both to transportation researchers and policymakers and companies, underlining the need for further research as well as investments in targeted age-friendly transport systems. The Covid-19 emergency has further underlined the importance of this issue, being the elderly one of the more disadvantaged and frailer social group.
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8
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Gait speed in clinical and daily living assessments in Parkinson's disease patients: performance versus capacity. NPJ Parkinsons Dis 2021; 7:24. [PMID: 33674597 PMCID: PMC7935857 DOI: 10.1038/s41531-021-00171-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/25/2021] [Indexed: 01/31/2023] Open
Abstract
Gait speed often referred as the sixth vital sign is the most powerful biomarker of mobility. While a clinical setting allows the estimation of gait speed under controlled conditions that present functional capacity, gait speed in real-life conditions provides the actual performance of the patient. The goal of this study was to investigate objectively under what conditions during daily activities, patients perform as well as or better than in the clinic. To this end, we recruited 27 Parkinson's disease (PD) patients and measured their gait speed by inertial measurement units through several walking tests in the clinic as well as their daily activities at home. By fitting a bimodal Gaussian model to their gait speed distribution, we found that on average, patients had similar modes in the clinic and during daily activities. Furthermore, we observed that the number of medication doses taken throughout the day had a moderate correlation with the difference between clinic and home. Performing a cycle-by-cycle analysis on gait speed during the home assessment, overall only about 3% of the strides had equal or greater gait speeds than the patients' capacity in the clinic. These strides were during long walking bouts (>1 min) and happened before noon, around 26 min after medication intake, reaching their maximum occurrence probability 3 h after Levodopa intake. These results open the possibility of better control of medication intake in PD by considering both functional capacity and continuous monitoring of gait speed during real-life conditions.
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Harnessing digital health to objectively assess cognitive impairment in people undergoing hemodialysis process: The Impact of cognitive impairment on mobility performance measured by wearables. PLoS One 2020; 15:e0225358. [PMID: 32310944 PMCID: PMC7170239 DOI: 10.1371/journal.pone.0225358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 04/02/2020] [Indexed: 11/19/2022] Open
Abstract
Cognitive impairment is prevalent but still poorly diagnosed in hemodialysis adults, mainly because of the impracticality of current tools. This study examined whether remotely monitoring mobility performance can help identifying digital measures of cognitive impairment in hemodialysis patients. Sixty-nine diabetes mellitus hemodialysis patients (age = 64.1±8.1years, body mass index = 31.7±7.6kg/m2) were recruited. According to the Mini-Mental State Exam, 44 (64%) were determined as cognitive-intact, and 25 (36%) as cognitive-impaired. Mobility performance, including cumulated posture duration (sitting, lying, standing, and walking), daily walking performance (step and unbroken walking bout), as well as postural-transition (daily number and average duration), were measured using a validated pendant-sensor for a continuous period of 24-hour during a non-dialysis day. Motor capacity was quantified by assessing standing balance and gait performance under single-task and dual-task conditions. No between-group difference was observed for the motor capacity. However, the mobility performance was different between groups. The cognitive-impaired group spent significantly higher percentage of time in sitting and lying (Cohens effect size d = 0.78, p = 0.005) but took significantly less daily steps (d = 0.69, p = 0.015) than the cognitive-intact group. The largest effect of reduction in number of postural-transition was observed in walk-to-sit transition (d = 0.65, p = 0.020). Regression models based on demographics, addition of daily walking performance, and addition of other mobility performance metrics, led to area-under-curves of 0.76, 0.78, and 0.93, respectively, for discriminating cognitive-impaired cases. This study suggests that mobility performance metrics could be served as potential digital biomarkers of cognitive impairment among hemodialysis patients. It also highlights the additional value of measuring cumulated posture duration and postural-transition to improve the detection of cognitive impairment. Future studies need to examine potential benefits of mobility performance metrics for early diagnosis of cognitive impairment/dementia and timely intervention.
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Fillekes MP, Kim EK, Trumpf R, Zijlstra W, Giannouli E, Weibel R. Assessing Older Adults' Daily Mobility: A Comparison of GPS-Derived and Self-Reported Mobility Indicators. SENSORS 2019; 19:s19204551. [PMID: 31635100 PMCID: PMC6833043 DOI: 10.3390/s19204551] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/12/2019] [Accepted: 10/15/2019] [Indexed: 12/24/2022]
Abstract
Interest in global positioning system (GPS)-based mobility assessment for health and aging research is growing, and with it the demand for validated GPS-based mobility indicators. Time out of home (TOH) and number of activity locations (#ALs) are two indicators that are often derived from GPS data, despite lacking consensus regarding thresholds to be used to extract those as well as limited knowledge about their validity. Using 7 days of GPS and diary data of 35 older adults, we make the following three main contributions. First, we perform a sensitivity analysis to investigate how using spatial and temporal thresholds to compute TOH and #ALs affects the agreement between self-reported and GPS-based indicators. Second, we show how daily self-reported and GPS-derived mobility indicators are compared. Third, we explore whether the type and duration of self-reported activity events are related to the degree of correspondence between reported and GPS event. Highest indicator agreement was found for temporal interpolation (Tmax) of up to 5 h for both indicators, a radius (Dmax) to delineate home between 100 and 200 m for TOH, and for #ALs a spatial extent (Dmax) between 125 and 200 m, and temporal extent (Tmin) between 5 and 6 min to define an activity location. High agreement between self-reported and GPS-based indicators is obtained for TOH and moderate agreement for #ALs. While reported event type and duration impact on whether a reported event has a matching GPS event, indoor and outdoor events are detected at equal proportions. This work will help future studies to choose optimal threshold settings and will provide knowledge about the validity of mobility indicators.
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Affiliation(s)
- Michelle Pasquale Fillekes
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland.
| | - Eun-Kyeong Kim
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland.
| | - Rieke Trumpf
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
- Department of Geriatric Psychiatry and Psychotherapy, LVR Hospital Cologne, Wilhelm-Griesinger-Straße 23, 51109 Cologne, Germany.
| | - Wiebren Zijlstra
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
| | - Eleftheria Giannouli
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
| | - Robert Weibel
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
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Fillekes MP, Giannouli E, Kim EK, Zijlstra W, Weibel R. Towards a comprehensive set of GPS-based indicators reflecting the multidimensional nature of daily mobility for applications in health and aging research. Int J Health Geogr 2019; 18:17. [PMID: 31340812 PMCID: PMC6657041 DOI: 10.1186/s12942-019-0181-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 07/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND GPS tracking is increasingly used in health and aging research to objectively and unobtrusively assess individuals' daily-life mobility. However, mobility is a complex concept and its thorough description based on GPS-derived mobility indicators remains challenging. METHODS With the aim of reflecting the breadth of aspects incorporated in daily mobility, we propose a conceptual framework to classify GPS-derived mobility indicators based on their characteristic and analytical properties for application in health and aging research. In order to demonstrate how the classification framework can be applied, existing mobility indicators as used in existing studies are classified according to the proposed framework. Then, we propose and compute a set of selected mobility indicators based on real-life GPS data of 95 older adults that reflects diverse aspects of individuals' daily mobility. To explore latent dimensions that underlie the mobility indicators, we conduct a factor analysis. RESULTS The proposed framework enables a conceptual classification of mobility indicators based on the characteristic and analytical aspects they reflect. Characteristic aspects inform about the content of the mobility indicator and comprise categories related to space, time, movement scope, and attribute. Analytical aspects inform how a mobility indicator is aggregated with respect to temporal scale and statistical property. The proposed categories complement existing studies that often underrepresent mobility indicators involving timing, temporal distributions, and stop-move segmentations of movements. The factor analysis uncovers the following six dimensions required to obtain a comprehensive view of an older adult's daily mobility: extent of life space, quantity of out-of-home activities, time spent in active transport modes, stability of life space, elongation of life space, and timing of mobility. CONCLUSION This research advocates incorporating GPS-based mobility indicators that reflect the multi-dimensional nature of individuals' daily mobility in future health- and aging-related research. This will foster a better understanding of what aspects of mobility are key to healthy aging.
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Affiliation(s)
- Michelle Pasquale Fillekes
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland.
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Andreasstrasse 15, 8050, Zurich, Switzerland.
| | - Eleftheria Giannouli
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Eun-Kyeong Kim
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Andreasstrasse 15, 8050, Zurich, Switzerland
| | - Wiebren Zijlstra
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Robert Weibel
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
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Gough C, Weber H, George S, Maeder A, Lewis L. Location monitoring of physical activity and participation in community dwelling older people: a scoping review. Disabil Rehabil 2019; 43:270-283. [PMID: 31131649 DOI: 10.1080/09638288.2019.1618928] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background: Community participation and physical activity are important for the health of older adults. This review aimed to identify studies which have measured physical activity and community participation in older adults using Global positioning systems.Materials and methods: This scoping review searched key databases using predetermined subject headings and keywords. Two independent reviewers selected studies based on a systematic procedure following current guidelines. Inclusion criteria for studies were: participants aged over 50 years living independently in the community that reported on physical activity and/or participation inclusive of physical and social activity, and including a quantitative measure of location. All searches were limited to English. The primary review question was; "What studies have monitored the location of physical activity in an older population?" with secondary enquiries investigating the types of global positioning system devices, barriers and facilitators for activity and community participation.Results: The search returned 3723 articles (following duplicate removal) and 45 met the inclusion criteria. Studies from 12 countries published over a 12-year period were included. Participants were mainly healthy (n = 23) followed by having a cognitive impairment (n = 10). There were 14 different global positioning system devices used, assessing a variety of outcomes (n = 24). Seventeen studies identified facilitators and barriers to participation and physical activity in an older population. The most common facilitators were safety, weather and access to multi-purpose facilities. The most common barriers were weather, safety, low income/high deprivation areas and use of motor vehicles.Conclusion: This scoping review identified a variety of locational monitoring of older people using global positioning devices. Global positioning systems are a valuable tool to obtain accurate activity locations of older people. There is a need for clear guidelines regarding the use of global positioning system devices and specified outcomes in primary research to enable comparison across studies.Implications for rehabilitationPhysical activity and community participation are vital for healthy ageing.The environment can act as a facilitator or barrier to physical activity and community participation for older adults.Interventions need to target facilitators (weather, safety, facility access and social components) to maximize physical activity and community participation in older people.Interventions should be designed to reduce the barriers (weather, safety, low income and motor vehicle dependency) that prevent older adults from actively participating in their community.
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Affiliation(s)
- Claire Gough
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Heather Weber
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Stacey George
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Anthony Maeder
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Lucy Lewis
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Naidu AS, Vasudev A, Burhan AM, Ionson E, Montero-Odasso M. Does Dual-Task Gait Differ in those with Late-Life Depression versus Mild Cognitive Impairment? Am J Geriatr Psychiatry 2019; 27:62-72. [PMID: 30420282 DOI: 10.1016/j.jagp.2018.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To compare the dual-task gait performance of older adults with Late-Life Depression (LLD) versus Mild Cognitive Impairment (MCI). DESIGN Cross-sectional study with three matched groups: LLD, MCI and non-depressed and cognitively intact (NDCI). SETTING LLD group participants were recruited from geriatric psychiatry clinics in London, Ontario. Matched participants meeting criteria for the MCI or NDCI groups were previously recruited for other research studies from geriatric clinics and the community. PARTICIPANTS Individuals aged 60-85 who met criteria for mild-moderate LLD (N=23) without a diagnosis of a neurocognitive disorder. MEASUREMENTS Participants completed questionnaires regarding mood, cognition and physical activity. Gait speed was recorded using an electronic walkway during simple and dual-task gait (walking while naming animals aloud). Dual-task cost (DTC) is the percentage change in gait speed between simple and dual-task gait. It is a clinically relevant indicator of fall risk and is strongly associated with cognitive decline. For comparison, 23 MCI and 23 NDCI participants, matched with respect to age, sex and comorbidities, were randomly selected from existing research databases. RESULTS Each group had 8 males and 15 females, with mean age of 69.0-69.6 years. The mean (±SD) DTC of the NDCI, LLD and MCI groups were statistically different at 2.4±11.4%, 11.8±9.9% and 22.2±16.7%, respectively. CONCLUSION Older adults with LLD perform worse on dual-task gait than NDCI; however, they are less impaired than those with MCI. The elevated DTC seen in LLD is likely because of underlying executive dysfunction that is less significant than in those with MCI.
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Affiliation(s)
- Anish S Naidu
- Gait and Brain Lab, Lawson Health Research Institute, London, ON; Parkwood Institute, St. Joseph's Health Care, London, ON; Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Akshya Vasudev
- Gait and Brain Lab, Lawson Health Research Institute, London, ON; Parkwood Institute, St. Joseph's Health Care, London, ON; Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON; Division of Geriatric Psychiatry, Department of Psychiatry, University of Western Ontario, London, ON
| | - Amer M Burhan
- Gait and Brain Lab, Lawson Health Research Institute, London, ON; Parkwood Institute, St. Joseph's Health Care, London, ON; Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON; Division of Geriatric Psychiatry, Department of Psychiatry, University of Western Ontario, London, ON
| | - Emily Ionson
- Gait and Brain Lab, Lawson Health Research Institute, London, ON; Parkwood Institute, St. Joseph's Health Care, London, ON; Division of Geriatric Psychiatry, Department of Psychiatry, University of Western Ontario, London, ON
| | - Manuel Montero-Odasso
- Gait and Brain Lab, Lawson Health Research Institute, London, ON; Parkwood Institute, St. Joseph's Health Care, London, ON; Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON; Division of Geriatric Medicine, Department of Medicine, University of Western Ontario, London, ON.
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14
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Self-reported versus GPS-derived indicators of daily mobility in a sample of healthy older adults. Soc Sci Med 2019; 220:193-202. [DOI: 10.1016/j.socscimed.2018.11.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 10/02/2018] [Accepted: 11/06/2018] [Indexed: 01/18/2023]
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15
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Harada K, Lee S, Lee S, Bae S, Harada K, Shimada H. Changes in objectively measured outdoor time and physical, psychological, and cognitive function among older adults with cognitive impairments. Arch Gerontol Geriatr 2018; 78:190-195. [DOI: 10.1016/j.archger.2018.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 06/06/2018] [Accepted: 06/09/2018] [Indexed: 10/14/2022]
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Harada K, Masumoto K, Katagiri K, Fukuzawa A, Chogahara M, Kondo N, Okada S. Frequency of going outdoors and health-related quality of life among older adults: Examining the moderating role of living alone and employment status. Geriatr Gerontol Int 2017; 18:640-647. [PMID: 29218820 DOI: 10.1111/ggi.13222] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/31/2017] [Accepted: 10/09/2017] [Indexed: 12/01/2022]
Abstract
AIM Going outdoors more frequently is beneficial for maintaining and improving health-related quality of life (HRQOL) among older adults. However, individual differences can alter the effects of going outdoors. The present study aimed to examine whether relationships between going outdoors and HRQOL were moderated by living alone and employment status. METHODS The present study was a secondary analysis of 14-month prospective data (n = 613). Variables used in this study were baseline data on the frequency of going outdoors, HRQOL (physical and mental component summary scores assessed using the Japanese version of the Medical Outcomes study Short Form 8-Item Health Survey), living alone, employment status, potential confounders (sex, age, educational level and instrumental activities of daily living) and follow-up data on HRQOL. RESULTS Mixed models showed that the interaction term of going outdoors and currently living alone on both the physical and mental component summary and that of going outdoors and current employment status on the mental component were significant. Stratified analyses showed that going outdoors more frequently predicted the physical and mental component summary among those who lived with others, and the mental component summary among those who were unemployed. CONCLUSIONS These results show that the influence of going outdoors on HRQOL was moderated by living alone and employment status. Going outdoors more frequently might be important for the maintenance of HRQOL, especially among unemployed older adults living with others. Geriatr Gerontol Int 2018; 18: 640-647.
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Affiliation(s)
- Kazuhiro Harada
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Kouhei Masumoto
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Keiko Katagiri
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Ai Fukuzawa
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Makoto Chogahara
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Narihiko Kondo
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Shuichi Okada
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
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17
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Burholt V, Windle G, Morgan DJ. A Social Model of Loneliness: The Roles of Disability, Social Resources, and Cognitive Impairment. THE GERONTOLOGIST 2017; 57:1020-1030. [PMID: 27831482 PMCID: PMC5881780 DOI: 10.1093/geront/gnw125] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 06/21/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose of the study We consider the points at which cognitive impairment may impact on the pathway to loneliness for older people, through impeding social interaction with family and friends, or by interfering with judgments concerning satisfaction with relationships. Design and methods We conceptualize a mediation model anticipating that social resources (LSNS-6) will mediate the pathway between disability (Townsend Disability Scale) and loneliness (De Jong Gierveld 6-item scale) and a moderated-mediation model in which we hypothesize that cognitive impairment (MMSE) will moderate the association between disability and social resources and between social resources and loneliness. To validate the hypothesized pathways, we draw on the CFAS Wales data set (N = 3,593) which is a nationally representative study of community-dwelling people aged 65 and older in Wales. Results Disability had a significant indirect effect on loneliness through the mediating variable social resources. Cognitive impairment was significantly associated with social resources, but did not moderate the relationship between disability and social resources. Cognitive impairment had a significant impact on loneliness, and moderated the effect of social resources on loneliness. Implications Social structures can (dis)empower people with cognitive impairment and lead to exclusion from social resources or impact on the social construction of aging, cognitive impairment, and dementia. The sense of self for an older person with cognitive impairment may be influenced by social norms and stereotypes, or through a temporal social comparison with an "earlier" sense of self. We conclude that loneliness interventions should be theoretically informed to identify key areas for modification.
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Affiliation(s)
- Vanessa Burholt
- Centre for Innovative Ageing, College of Human and Health Science, Swansea University, UK
| | - Gill Windle
- Dementia Services Development Centre, Bangor Institute of Health & Medical Research, Bangor University, UK
| | - Deborah J Morgan
- Centre for Innovative Ageing, College of Human and Health Science, Swansea University, UK
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18
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Maria GG, Juan GG. Negative Bias in the Perception and Memory of Emotional Information in Alzheimer Disease. J Geriatr Psychiatry Neurol 2017; 30:131-139. [PMID: 28421897 DOI: 10.1177/0891988716686833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is some controversy about the ability of patients with Alzheimer disease (AD) to experience and remember emotional stimuli. This study aims to assess the emotional experience of patients with AD and the existence of emotional enhancement of memory. We also investigated the influence of affective state on these processes. METHODS Sixty pictures from the International Affective Picture System were administered to 106 participants (72 patients with AD and 54 controls). Participants performed immediate free recall and recognition tasks. Positive and Negative Affect Schedule was used to assess the participants' current affect. RESULTS Patients identified the valence of unpleasant pictures better than of others pictures and experienced them as more arousing. Patients and controls recalled and recognized higher number of emotional pictures than of neutral ones. Patients discriminated better the unpleasant pictures. A mood congruent effect was observed on emotional experience but not on memory. Positive affect was associated with better immediate recall and with a more liberal response bias. CONCLUSION Patients with AD can identify the emotional content of the stimuli, especially of the unpleasant ones, and the emotional enhancement of memory is preserved. Affective state does not explain the differences in the processing and memory of emotional items between patients and controls.
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Affiliation(s)
- Gomez-Gallego Maria
- 1 Faculty of Health Sciences, Department of Neuroscience, Catholic University of Murcia, Murcia, Spain
| | - Gomez-Garcia Juan
- 2 Faculty of Economics, Department of Quantitative Methods, University of Murcia, Murcia, Spain
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19
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Cabrita M, Lousberg R, Tabak M, Hermens HJ, Vollenbroek-Hutten MMR. An exploratory study on the impact of daily activities on the pleasure and physical activity of older adults. Eur Rev Aging Phys Act 2017; 14:1. [PMID: 28074110 PMCID: PMC5216572 DOI: 10.1186/s11556-016-0170-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 12/13/2016] [Indexed: 11/23/2022] Open
Abstract
Background Pleasure is one determinant of intrinsic motivation and yet a dimension often forgotten when promoting physical activity among the older population. In this study we investigate the relation between daily activities and physical activity, experience of pleasure, and the interaction between pleasure and physical activity in the daily lives of community-dwelling older adults. Methods Participants carried a hip-worn accelerometer during 30 consecutive days resulting in a total of 320 days of data collection. Current activity, location, companion and experience of pleasure during each activity were assessed through experience sampling on a smartphone every 1–2 h. Between- and within-individual differences were analysed with multi-level models and 10xN = 1 regression analysis. Results Outdoor activities were associated with higher physical activity than indoor activities (p < 0.001). Performing leisure activities, outdoors and not alone significantly predicted pleasure in daily life (all p’s < 0.05). Being more active while performing leisure activities resulted in higher experiences of pleasure (p < 0.001). However, when performing basic activities of daily living (e.g. commuting or households) this relation was inverted. Results provide meaningful indication for individual variance. The 30 days of data collected from each participant allow for identification of individual differences. Conclusions Daily activities and their contexts do influence the experience of pleasure and physical activity of older adults in daily life of older adults, although similar research with larger population is recommended. Results are in accordance with the literature, indicating that the method adopted (accelerometry combined with experience sampling) provides reliable representation of daily life. Identification of individual differences can eventually be automatically performed through data mining techniques. Further research could look at innovative approaches to promote Active Ageing using mobile technology in the daily life, by promoting physical activity through recommendation of pleasurable activities, and thus likely to increase the intrinsic motivation to become physically active.
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Affiliation(s)
- Miriam Cabrita
- Telemedicine group, Roessingh Research and Development, P.O. Box 310, Enschede, 7522 AH The Netherlands ; Telemedicine group, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, P.O. Box 217, Enschede, 7500 AE The Netherlands
| | - Richel Lousberg
- Department of Psychiatry & Psychology, Maastricht University, Maastricht, The Netherlands
| | - Monique Tabak
- Telemedicine group, Roessingh Research and Development, P.O. Box 310, Enschede, 7522 AH The Netherlands ; Telemedicine group, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, P.O. Box 217, Enschede, 7500 AE The Netherlands
| | - Hermie J Hermens
- Telemedicine group, Roessingh Research and Development, P.O. Box 310, Enschede, 7522 AH The Netherlands ; Telemedicine group, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, P.O. Box 217, Enschede, 7500 AE The Netherlands
| | - Miriam M R Vollenbroek-Hutten
- Telemedicine group, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, P.O. Box 217, Enschede, 7500 AE The Netherlands
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20
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Harada K, Lee S, Lee S, Bae S, Harada K, Suzuki T, Shimada H. Objectively-measured outdoor time and physical and psychological function among older adults. Geriatr Gerontol Int 2016; 17:1455-1462. [DOI: 10.1111/ggi.12895] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 07/09/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Kazuhiro Harada
- Graduate School of Human Development and Environment; Kobe University; Kobe Hyogo Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology; National Center for Geriatrics and Gerontology; Obu Aichi Japan
| | - Sungchul Lee
- Department of Preventive Gerontology; National Center for Geriatrics and Gerontology; Obu Aichi Japan
| | - Seongryu Bae
- Department of Preventive Gerontology; National Center for Geriatrics and Gerontology; Obu Aichi Japan
| | - Kenji Harada
- School of Health and Sport Sciences; Chukyo University; Toyota Aichi Japan
| | - Takao Suzuki
- Institute for Gerontology; J. F. Oberlin University; Machida Tokyo Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology; National Center for Geriatrics and Gerontology; Obu Aichi Japan
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21
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Austin J, Dodge HH, Riley T, Jacobs PG, Thielke S, Kaye J. A Smart-Home System to Unobtrusively and Continuously Assess Loneliness in Older Adults. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2016; 4:2800311. [PMID: 27574577 PMCID: PMC4993148 DOI: 10.1109/jtehm.2016.2579638] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/15/2016] [Accepted: 05/20/2016] [Indexed: 01/29/2023]
Abstract
Loneliness is a common condition in older adults and is associated with increased morbidity and mortality, decreased sleep quality, and increased risk of cognitive decline. Assessing loneliness in older adults is challenging due to the negative desirability biases associated with being lonely. Thus, it is necessary to develop more objective techniques to assess loneliness in older adults. In this paper, we describe a system to measure loneliness by assessing in-home behavior using wireless motion and contact sensors, phone monitors, and computer software as well as algorithms developed to assess key behaviors of interest. We then present results showing the accuracy of the system in detecting loneliness in a longitudinal study of 16 older adults who agreed to have the sensor platform installed in their own homes for up to 8 months. We show that loneliness is significantly associated with both time out-of-home (\documentclass[12pt]{minimal}
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Affiliation(s)
- Johanna Austin
- Oregon Center for Aging and Technology Department of Neurology Oregon Health & Science University Portland OR 97239 USA
| | - Hiroko H Dodge
- Oregon Center for Aging and Technology Department of Neurology Oregon Health & Science University Portland OR 97239 USA
| | - Thomas Riley
- Oregon Center for Aging and Technology Department of Neurology Oregon Health & Science University Portland OR 97239 USA
| | - Peter G Jacobs
- Department of Biomedical Engineering Oregon Health & Science University Portland OR 97239 USA
| | - Stephen Thielke
- Department of Psychiatry and Behavioral SciencesUniversity of WashingtonSeattleWA98102USA; Geriatric Research, Education, and Clinical CenterSeattle VA Medical CenterSeattleWA98108USA
| | - Jeffrey Kaye
- Oregon Center for Aging and Technology Department of Neurology Oregon Health & Science University Portland OR 97239 USA
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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: 62] [Impact Index Per Article: 7.8] [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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23
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Brown LJE, Adlam T, Hwang F, Khadra H, Maclean LM, Rudd B, Smith T, Timon C, Williams EA, Astell AJ. Computerized Self-Administered Measures of Mood and Appetite for Older Adults: The Novel Assessment of Nutrition and Ageing Toolkit. J Appl Gerontol 2016; 37:157-176. [PMID: 26912736 DOI: 10.1177/0733464816630636] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The "Novel Assessment of Nutrition and Ageing" (NANA) toolkit is a computerized system for collecting longitudinal information about older adults' health and behavior. Here, we describe the validation of six items for measuring older adults' self-reported mood and appetite as part of the NANA system. In Study 1, 48 community-living older adults (aged 65-89 years) completed NANA measures of their current mood and appetite alongside standard paper measures, on three occasions, in a laboratory setting. In Study 2, 40 community-living older adults (aged 64-88 years) completed daily NANA measures of momentary mood and appetite in their own homes, unsupervised, alongside additional measures of health and behavior, over three 7-day periods. The NANA measures were significantly correlated with standard measures of mood and appetite, and showed stability over time. They show utility for tracking mood and appetite longitudinally, and for better understanding links with other aspects of health and behavior.
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Affiliation(s)
| | | | | | | | | | | | - Tom Smith
- 7 Generic Robotics Ltd., Reading, UK
| | | | | | - Arlene J Astell
- 9 University of Sheffield, UK.,10 Ontario Shores Centre for Mental Health Sciences, Canada
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Ishiki A, Okinaga S, Tomita N, Kawahara R, Tsuji I, Nagatomi R, Taki Y, Takahashi T, Kuzuya M, Morimoto S, Iijima K, Koseki T, Arai H, Furukawa K. Changes in Cognitive Functions in the Elderly Living in Temporary Housing after the Great East Japan Earthquake. PLoS One 2016; 11:e0147025. [PMID: 26760971 PMCID: PMC4720119 DOI: 10.1371/journal.pone.0147025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 12/28/2015] [Indexed: 11/18/2022] Open
Abstract
On March 11, 2011, Japan experienced an earthquake of magnitude 9.0 and subsequent enormous tsunamis. This disaster destroyed many coastal cities and caused nearly 20,000 casualties. In the aftermath of the disaster, many tsunami survivors who lost their homes were forced to live in small temporary apartments. Although all tsunami survivors were at risk of deteriorating health, the elderly people were particularly at a great risk with regard to not only their physical health but also their mental health. In the present study, we performed a longitudinal cohort study to investigate and analyze health conditions and cognitive functions at 28, 32, and 42 months after the disaster in the elderly people who were forced to reside in temporary apartments in Kesennuma, a city severely damaged by the tsunamis. The ratio of people considered to be cognitively impaired significantly increased during the research period. On the other hand, the mean scores of the Kessler Psychological Distress Scale-6 and Athens Insomnia Scale improved based on the comparison between the data at 24 and 42 months. The multiple logistic regression analysis revealed that frequency of "out-of-home activities" and "walking duration" were independently associated with an increase in the ratio of people with cognitive impairment. We concluded that the elderly people living in temporary apartments were at a high risk of cognitive impairment and "out-of-home activities" and "walking" could possibly maintain the stability of cognitive functions.
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Affiliation(s)
- Aiko Ishiki
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Shoji Okinaga
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Naoki Tomita
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Reiko Kawahara
- Department of Gerontological Nursing, Tohoku University School of Medicine, Sendai, Japan
| | - Ichiro Tsuji
- Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryoichi Nagatomi
- Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Yasuyuki Taki
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Takashi Takahashi
- Department of Infection Control and Immunology and Graduate School of Infection Control Sciences, Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigeto Morimoto
- Department of Geriatric Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Katsuya Iijima
- Institute of Gerontology, University of Tokyo, Tokyo, Japan
| | - Takeyoshi Koseki
- Department of Oral Health and Development Sciences, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Hiroyuki Arai
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Katsutoshi Furukawa
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- * E-mail:
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Tackling Societal Challenges Related to Ageing and Transport Transition: An Introduction to Philosophical Principles of Causation Adapted to the Biopsychosocial Model. Geriatrics (Basel) 2015; 1:geriatrics1010003. [PMID: 31022799 PMCID: PMC6371111 DOI: 10.3390/geriatrics1010003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 12/14/2015] [Accepted: 12/17/2015] [Indexed: 11/17/2022] Open
Abstract
In geriatrics, driving cessation is addressed within the biopsychosocial model. This has broadened the scope of practitioners, not only in terms of assessing fitness to drive, but also by helping to maintain social engagements and provide support for transport transition. Causes can be addressed at different levels by adapting medication, improving physical health, modifying behaviour, adapting lifestyle, or bringing changes to the environment. This transdisciplinary approach requires an understanding of how different disciplines are linked to each other. This article reviews the philosophical principles of causality between fields and provides a framework for understanding causality within the biopsychosocial model. Understanding interlevel constraints should help practitioners overcome their differences, and favor transversal approaches to driving cessation.
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Petersen J, Austin D, Mattek N, Kaye J. Time Out-of-Home and Cognitive, Physical, and Emotional Wellbeing of Older Adults: A Longitudinal Mixed Effects Model. PLoS One 2015; 10:e0139643. [PMID: 26437228 PMCID: PMC4593630 DOI: 10.1371/journal.pone.0139643] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 09/14/2015] [Indexed: 01/19/2023] Open
Abstract
Background Time out-of-home has been linked with numerous health outcomes, including cognitive decline, poor physical ability and low emotional state. Comprehensive characterization of this important health metric would potentially enable objective monitoring of key health outcomes. The objective of this study is to determine the relationship between time out-of-home and cognitive status, physical ability and emotional state. Methods and Findings Participants included 85 independent older adults, age 65–96 years (M = 86.36; SD = 6.79) who lived alone, from the Intelligent Systems for Assessing Aging Changes (ISAAC) and the ORCATECH Life Laboratory cohorts. Factors hypothesized to affect time out-of-home were assessed on three different temporal levels: yearly (cognitive status, loneliness, clinical walking speed), weekly (pain and mood) or daily (time out-of-home, in-home walking speed, weather, and season). Subject characteristics including age, race, and gender were assessed at baseline. Total daily time out-of-home in hours was assessed objectively and unobtrusively for up to one year using an in-home activity sensor platform. A longitudinal tobit mixed effects regression model was used to relate daily time out-of-home to cognitive status, physical ability and emotional state. More hours spend outside the home was associated with better cognitive function as assessed using the Clinical Dementia Rating (CDR) Scale, where higher scores indicate lower cognitive function (βCDR = -1.69, p<0.001). More hours outside the home was also associated with superior physical ability (βPain = -0.123, p<0.001) and improved emotional state (βLonely = -0.046, p<0.001; βLow mood = -0.520, p<0.001). Weather, season, and weekday also affected the daily time out-of-home. Conclusions These results suggest that objective longitudinal monitoring of time out-of-home may enable unobtrusive assessment of cognitive, physical and emotional state. In addition, these results indicate that the factors affecting out-of-home behavior are complex, with factors such as living environment, weather and season significantly affecting time out-of-home. Studies investigating the relationship between time out-of-home and health outcomes may be optimized by taking into account the environment and life factors presented here.
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Affiliation(s)
- Johanna Petersen
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, United States of America
- * E-mail:
| | - Daniel Austin
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States of America
| | - Nora Mattek
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States of America
| | - Jeffrey Kaye
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States of America
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Fang ML, Coatta K, Badger M, Wu S, Easton M, Nygård L, Astell A, Sixsmith A. Informing Understandings of Mild Cognitive Impairment for Older Adults: Implications From a Scoping Review. J Appl Gerontol 2015; 36:808-839. [PMID: 26092574 DOI: 10.1177/0733464815589987] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The development of effective interventions for mild cognitive impairment (MCI) in older adults has been limited by extensive variability in the conceptualization and definition of MCI, its subtypes, and relevant diagnostic criteria within the neurocultural, pharmaceutical, and gerontological communities. A scoping review was conducted to explore the conceptual development of MCI and identify the resulting ethical, political, and technological implications for the care of older adults with MCI. A comprehensive search was conducted between January and April 2013 to identify English-language peer-reviewed articles published between 1999 and 2013. Our analysis revealed that the MCI conceptual debate remains unresolved, the response to ethical issues is contentious, the policy response is limited, and one-dimensional and technological interventions are scarce. Reflections on the conceptual, ethical, and policy responses in conjunction with the identification of the needs of older adults diagnosed with MCI highlight significant opportunities for technological interventions to effectively reposition MCI in the aging care discourse.
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Affiliation(s)
- Mei Lan Fang
- 1 Simon Fraser University, Vancouver, British Columbia, Canada
| | | | - Melissa Badger
- 1 Simon Fraser University, Vancouver, British Columbia, Canada
| | - Sarah Wu
- 1 Simon Fraser University, Vancouver, British Columbia, Canada
| | - Margaret Easton
- 1 Simon Fraser University, Vancouver, British Columbia, Canada
| | | | | | - Andrew Sixsmith
- 1 Simon Fraser University, Vancouver, British Columbia, Canada
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Fernández-Carro C, Módenes JA, Spijker J. Living conditions as predictor of elderly residential satisfaction. A cross-European view by poverty status. Eur J Ageing 2015; 12:187-202. [PMID: 28804354 DOI: 10.1007/s10433-015-0338-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Although there is an extensive body of literature on the use of residential satisfaction to measure the impact of housing conditions on well-being in later life, less is known about differences and similarities between sub-populations and national contexts. By means of a cross-European analysis (EU15), this study aims to examine how objective and subjective factors of living conditions shape the perceptions of older Europeans about the adequacy of their residential environment. Two patterns of housing quality are explored: (1) international heterogeneity of the EU15 countries, and (2) intra-national heterogeneity, where we distinguish between households at risk of poverty and those not at risk in the elderly population of these countries. Data were drawn from the 2007 wave of the European Union Statistics on Income and Living Conditions survey, providing a sample of more than 58,000 individuals aged 65 years and older. The housing characteristics surveyed were reduced using tetrachoric correlations in a principal component analysis. The resulting predictors, as well as control variables (including gender, age, health status and tenure), are assessed using multiple linear regression analysis to explore their association with a high or low level of residential satisfaction. Despite a generally positive assessment by older Europeans of their living space, major geographic and household income differences existed in the factors that explained residential satisfaction. Identifying factors associated with residential satisfaction in different household income groups and national contexts may facilitate the development of EU policies that attempt to make 'ageing in place' a viable and suitable option for older Europeans.
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Affiliation(s)
| | | | - Jeroen Spijker
- Centre d'Estudis Demogràfics, Bellaterra, Barcelona, Spain
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Hirsch JA, Winters M, Clarke P, McKay H. Generating GPS activity spaces that shed light upon the mobility habits of older adults: a descriptive analysis. Int J Health Geogr 2014; 13:51. [PMID: 25495710 PMCID: PMC4326206 DOI: 10.1186/1476-072x-13-51] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 11/30/2014] [Indexed: 02/07/2023] Open
Abstract
Background Measuring mobility is critical for understanding neighborhood influences on older adults’ health and functioning. Global Positioning Systems (GPS) may represent an important opportunity to measure, describe, and compare mobility patterns in older adults. Methods We generated three types of activity spaces (Standard Deviation Ellipse, Minimum Convex Polygon, Daily Path Area) using GPS data from 95 older adults in Vancouver, Canada. Calculated activity space areas and compactness were compared across sociodemographic and resource characteristics. Results Area measures derived from the three different approaches to developing activity spaces were highly correlated. Participants who were younger, lived in less walkable neighborhoods, had a valid driver’s license, had access to a vehicle, or had physical support to go outside of their homes had larger activity spaces. Mobility space compactness measures also differed by sociodemographic and resource characteristics. Conclusions This research extends the literature by demonstrating that GPS tracking can be used as a valuable tool to better understand the geographic mobility patterns of older adults. This study informs potential ways to maintain older adult independence by identifying factors that influence geographic mobility. Electronic supplementary material The online version of this article (doi:10.1186/1476-072X-13-51) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia V5A 1S6, Canada.
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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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