A path analysis of the interdependent relationships between life space assessment scores and relevant factors in an elderly Japanese community

Determinants of subjective outdoor thermal comfort in an urban historic and cultural heritage landscape in Xi'an, China

In this study, we investigated factors related to subjective outdoor thermal comfort in the Ancient Ming Dynasty Walled City in Xi'an, China. Environmental data were collected from study sites by microclimate monitoring. Survey locations, demographics, psychological characteristics, thermal sensation vote (TSV), and thermal comfort vote (TCV) data were collected from 639 individuals in a questionnaire survey. Generalized linear regression analysis and path analysis were used to understand the associations between the TSV, environmental and psychological factors, and TCV. We found that green space locations, higher age, and greater subjective well-being and environmental satisfaction were associated with increased TCV. The universal thermal climate index was associated with TCV, and this association could have been affected by the individual's psychological state. Our findings suggest that environmental factors and psychological factors had non-negligible effects on the subjective thermal comfort of individuals located in an open urban area with historical and cultural significance.

The level of life space mobility among community-dwelling elderly: A systematic review and meta-analysis

BACKGROUND

Multiple countries have conducted surveys on the level of life space mobility for community-dwelling elderly through the Life-Space Assessment, the results vary greatly, from 41.7 to 88.6. However, there is no meta-analysis on the current situation of community-dwelling elderly life space mobility.

OBJECTIVE

To systematically assess the global level of life space mobility for community-dwelling elderly, to identify potential covariates such as geographical regions, survey years, gender, and age that contribute to the heterogeneity between the studies, and to identify the dynamic trend based on survey years.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Two reviewers searched the following 8 electronic bibliographic databases from inception until May 28, 2023: PubMed, The Cochrane Library, Web of Science, Embase, Chinese Biomedical Database, China Knowledge Resource Integrated Database, WanFang, and Weipu Database.

REVIEW METHODS

This review was conducted using the Stata 14.1 and R 4.3.1. The Cochrane's Q statistical and I2 index were used to test for heterogenicity and assess the degree of heterogenicity, respectively. Studies were appraised using the Agency for Healthcare Research and Quality tool, the Newcastle-Ottawa Scale for the quality of cross-sectional studies, cohort studies, respectively.

RESULTS

A total of 29 studies were selected from databases and reference lists. The pooled score of Life-Space Assessment was 66.84 (95% CI: 63.30-70.39) and the prevalence of restricted life space was 42% (95% CI: 0.27-0.57). The geographical regions, survey years, gender were found to be a significant covariate of the pooled score of life space mobility estimate in the subgroup analysis. The mean score of Life-Space Assessment gradually achieved stability after 2017.

CONCLUSIONS

The life space mobility of community-dwelling elderly in the global is at a moderate level, with 42% of them experiencing restricted life space. South America, females and earlier survey years have a lower level of life space mobility. In the future, the government should identify vulnerable groups for targeted intervention to promote the level of LSM in the community-dwelling elderly.

REGISTRATION

PROSPERO [CRD42023443054].

Life-space mobility among community-dwelling older persons: A scoping review

To describe and analyze the current research status of life-space mobility of the older persons in community. The literature in PubMed, Web of Science, Cochrane Library, Embase, EBSCOhost, Scopus, OpenGrey, SinoMed, CNKI, WanFang, and VIP databases was computer searched, and the time frame was build to May 23, 2023. A total of 42 literatures were included, including 35 in English and 7 in Chinese, 30 of which were cross-sectional studies. Theoretical models related to spatial mobility included the "concentric circles" model and the "cone" model. 33 literatures reported the prevalence or level of spatial mobility limitations, and 9 assessment instruments were used, The influencing factors can be divided into four categories. 9 literatures reported on the adverse effects, and 9 literatures reported on the prevention and intervention. The limitation of life-space mobility is a common and under-recognized phenomenon among the older persons in the community,with serious adverse effects, complex and diverse influencing factors.

Gender Differences in Life-space Mobility-associated Factors and Structures in Community-dwelling Older People

Objectives:

This cross-sectional study sought to examine gender dissimilarities in factors and structures associated with life-space mobility (LSM) in community-dwelling older people.

Methods:

This study included a total of 294 older people living in Okawa, Fukuoka Prefecture, Japan. The subjects’ body mass index (BMI) and skeletal muscle mass index (SMI) were evaluated. Furthermore, the age, gender, and LSM of the participants were assessed. LSM was assessed using a framework based on social isolation, fall self-efficacy, mobility, cognitive function, and lower limb muscle strength. Path analysis was performed to assess LSM-associated factors and their respective effect sizes (ESs), and male and female LSM models were established.

Results:

Path analysis identified SMI and social isolation as direct factors and cognitive function as an indirect factor associated with LSM in both men and women. In the male LSM model, the direct factors in descending order of ES were BMI, social isolation, SMI, and lower limb muscle strength. In the female model, the direct factors in descending order of ES were age, fall self-efficacy, mobility, social isolation, and SMI; age was noted as having an indirect effect on the remaining associated factors.

Conclusions:

This study clarified the gender differences in factors influencing LSM and the underlying structure of LSM mediation by these factors. Therefore, gender differences should be considered when planning interventions aimed at improving the LSM and general well-being of older people, particularly for community-dwelling individuals.

Short physical performance battery score and driving a car are independent factors associated with life-space activities in older adults with cardiovascular disease

AIM

Decreased use of life spaces, as reflected in decreased Life-Space Assessment (LSA) scores, is associated with poor prognosis in older adults. The purpose of this study was to examine factors affecting the extent of life-space activities in older adults with cardiovascular disease.

METHODS

We carried out a prospective observational study in 98 older adults (minimum age 65 years; mean age 79.5 ± 7.4 years) who were admitted to our hospital due to cardiovascular disease. Once their medical condition was stable, they underwent cardiopulmonary exercise testing, echocardiography and physical evaluation, and completed questionnaires.

RESULTS

The LSA score was significantly associated with the ability to drive a car (driving 95.1 ± 21.1 points, not driving 60.4 ± 30.3 points, P < 0.001). In addition, LSA was significantly correlated with age; peak VO₂ ; brain natriuretic peptide; and Short Physical Performance Battery, Geriatric Depression Scale and Mini-Mental State Examination scores. In a multiple regression analysis, Short Physical Performance Battery and driving a car were significantly associated with LSA (β = 0.28, β = 0.37, respectively).

CONCLUSION

Assessment of motor function and social factors in addition to clinical cardiac function might be important to understand the complete context of life-space activity in older adults with cardiovascular disease. Geriatr Gerontol Int 2021; ••: ••-••.

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.