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Niedoba S, Oswald F. Person-Environment Exchange Processes in Transition into Dementia: A Scoping Review. Gerontologist 2024; 64:gnad034. [PMID: 36988643 DOI: 10.1093/geront/gnad034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The important role that the environment plays in the lives of older people is widely acknowledged. To date, little is known about person-environment processes during the early stages of dementia. This scoping review aims to provide an overview of the processes involved during early dementia and the relationship to different dimensions of their life space. RESEARCH DESIGN AND METHODS A scoping review was conducted according to the Johanna Briggs Institute Manual, which involved searching for research on early dementia and the environment across 3 databases. RESULTS A total of 1,358 records were screened, with 284 sources included in the first categorization of the diverse relationships that exist between the environment and the person living with early dementia. Finally, 102 sources were selected that describe person-environment exchange processes of agency, belonging, or stress. People living with dementia actively shape, use, seek out, and avoid their environment as a reaction to both declining abilities and environmental barriers. Specifically, feelings of connectedness and familiarity are important. DISCUSSION AND IMPLICATIONS Taking both an environmental gerontology perspective and a processual, that is, transition perspective broadens the understanding of the experience and behavior of people living with early dementia. They constantly interact with and shape their environment and desire a sense of belonging. This sense of belonging might be threatened by dementia but can be actively reinforced by people living with dementia. These person-environment processes and their dynamics over time should be further investigated. Especially, quantitative data and data on socioeconomic environments are lacking.
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Affiliation(s)
- Simone Niedoba
- Faculty of Educational Sciences, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Frank Oswald
- Interdisciplinary Ageing Research, Faculty of Educational Sciences, Goethe University Frankfurt, Frankfurt am Main, Germany
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Lo AX, Wadley VG, Brown CJ, Long DL, Crowe M, Howard VJ, Kennedy RE. Life-Space Mobility: Normative Values From a National Cohort of U.S. Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glad176. [PMID: 37480583 PMCID: PMC10803118 DOI: 10.1093/gerona/glad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND Life-space mobility, which measures the distance, frequency, and independence achieved as individuals move through their community, is one of the most important contributors to healthy aging. The University of Alabama at Birmingham Life-Space Assessment (LSA) is the most commonly used measure of life-space mobility in older adults, yet U.S. national norms for LSA have not previously been reported. This study reports such norms based on age and sex among community-dwelling older adults. METHODS A cross-sectional analysis using data from the national REasons for Geographic and Racial Disparities in Stroke cohort study. LSA data were available for 10 118 Black and White participants over age 50, which were grouped by age (in 5-year increments) and sex, weighted for the U.S. national population. Correlations were calculated between LSA and measures of functional and cognitive impairment and physical performance. RESULTS The weighted mean LSA ranged from 102.9 for 50-54-year-old males to 69.5 for males aged 85 and older, and from 102.1 for 50-54-year-old females to 60.1 for females aged 85 and older. LSA was strongly correlated with measures of timed walking, activities of daily living, cognition, depressive symptoms, and quality of life (all p < .001). CONCLUSIONS We report U.S. national norms for LSA among community-dwelling Black and White older adults. These norms can serve as a reference tool for determining if clinical and research samples have greater or lesser life-space mobility than typical older adults in the United States for their age and sex.
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Affiliation(s)
- Alexander X Lo
- Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Virginia G Wadley
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Cynthia J Brown
- Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - D Leann Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Richard E Kennedy
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Motl RW, Foley FW, Picone MA, Lipton ML, Izzetoglu M, Hernandez ME, Holtzer R. Initial validation of the university of Alabama Birmingham study of aging life-space assessment in older adults with multiple sclerosis. Mult Scler Relat Disord 2024; 82:105354. [PMID: 38134603 PMCID: PMC10894523 DOI: 10.1016/j.msard.2023.105354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/21/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Older adults with multiple sclerosis (OAMS) have declines in walking and physical performance that may erode community mobility defined as the spatial extent of mobility in one's daily life and environment. OBJECTIVE This study provided the first application and validation of the University of Alabama Birmingham Study of Aging Life-Space Assessment (UAB LSA) as a measure of community mobility in OAMS. METHODS The sample included 97 OAMS and 108 healthy controls (HCs) who completed baseline assessments as part of an ongoing, longitudinal study. The primary assessments included the UAB LSA and timed 25-foot walk (T25FW), short physical performance battery (SPPB), global health score (GHS), and geriatric depression scale (GDS) in both OAMS and HCs, and patient determined disease steps (PDDS) scale in only OAMS. RESULTS OAMS had significantly lower UAB LSA scores than HCs (p < .001). UAB LSA scores had strong correlations with T25FW(rs = -.641) and SPPB(rs = 0.507) in OAMS, and moderate correlations in HCs (rs = -.300 & rs = 0.384). The correlations between UAB LSA and GHS and GDS scores were significant, but small in OAMS (rs = -.239 & rs = -.231), and not statistically significant in HCs (rs = -.009 & rs = -.166). There was a strong correlation between UAB LSA and PDDS scores in the OAMS sample (rs = -.605). CONCLUSION We provided initial evidence for UAB LSA scores as a measure of community mobility in OAMS.
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Affiliation(s)
- Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States
| | - Frederick W Foley
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States; Multiple Sclerosis Center, Holy Name Medical Center, Teaneck, NJ, United States
| | - Mary Ann Picone
- Multiple Sclerosis Center, Holy Name Medical Center, Teaneck, NJ, United States
| | - Michael L Lipton
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States; Department of Biomedical Engineering, Columbia University, New York, NY, United States
| | - Meltem Izzetoglu
- Villanova University, Electrical and Computer Engineering, Villanova, PA, United States
| | - Manuel E Hernandez
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, United States; Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, Urbana, IL, United States
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States; Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States.
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Paolillo EW, Saloner R, VandeBunte A, Lee S, Bennett DA, Casaletto KB. Multimodal lifestyle engagement patterns support cognitive stability beyond neuropathological burden. Alzheimers Res Ther 2023; 15:221. [PMID: 38111051 PMCID: PMC10726589 DOI: 10.1186/s13195-023-01365-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/03/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Modifiable lifestyle behaviors account for a large proportion of dementia risk. However, the combined contributions of multidomain lifestyle patterns to cognitive aging are poorly understood, as most studies have examined individual lifestyle behaviors in isolation and without neuropathological characterization. This study examined data-driven patterns of lifestyle behaviors across multiple domains among older adults and tested their associations with disease-specific neuropathological burden and cognitive decline. METHODS Participants included 2059 older adults enrolled in the longitudinal Memory and Aging Project (MAP) at the Rush Alzheimer's Disease Center; none of whom had dementia at baseline (73% no cognitive impairment (NCI), 27% mild cognitive impairment [MCI]). All participants completed cognitive testing annually. Lifestyle factors were measured during at least one visit and included (1) actigraphy-measured physical activity, as well as self-reported (2) sleep quality, (3) life space, (4) cognitive activities, (5) social activities, and (6) social network. A subset of participants (n = 791) had autopsy data for which burden of Alzheimer's disease (AD), cerebrovascular disease (CVD), Lewy body disease, and hippocampal sclerosis/TDP-43 was measured. Latent profile analysis across all 2059 participants identified distinct subgroups (i.e., classes) of lifestyle patterns. Linear mixed-effects models examined relationships between lifestyle classes and global cognitive trajectories, with and without covarying for all neuropathologies. Classes were also compared on rates of incident MCI/dementia. RESULTS Five classes were identified: Class 1Low Life Space (lowest lifestyle engagement), Class 2PA (high physical activity), Class 3Low Avg (low to average lifestyle engagement), Class 4Balanced (high average lifestyle engagement), and Class 5Social (large social network). Classes 4Balanced and 5Social had the lowest AD burden, and Class 2PA had the lowest CVD burden. Classes 2-5 had significantly less steep global cognitive decline compared to Class 1Low Life Space, with comparable effect sizes before and after covarying for neuropathological burden. Classes 4Balanced and 5Social exhibited the lowest rates of incident MCI/dementia. CONCLUSIONS Lifestyle behavior patterns among older adults account for differential rates of cognitive decline and clinical progression. Those with at least average engagement across all lifestyle domains exhibit greater cognitive stability after adjustment for neuropathology, highlighting the importance of engagement in multiple healthy lifestyle behaviors for later life cognitive health.
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Affiliation(s)
- Emily W Paolillo
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, USA.
| | - Rowan Saloner
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, USA
| | - Anna VandeBunte
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, USA
| | - Shannon Lee
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, USA
| | - David A Bennett
- Department of Neurological Sciences, Rush Medical College, Chicago, IL, USA
| | - Kaitlin B Casaletto
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, USA
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Webber SC, Liu Y, Jiang D, Ripat J, Nowicki S, Tate R, Barclay R. Verification of a comprehensive framework for mobility using data from the Canadian Longitudinal Study on Aging: a structural equation modeling analysis. BMC Geriatr 2023; 23:823. [PMID: 38066452 PMCID: PMC10704626 DOI: 10.1186/s12877-023-04566-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Mobility within and between life spaces is fundamental for health and well-being. Our objective was to verify a comprehensive framework for mobility. METHODS This was a cross-sectional study. We used structural equation modeling to estimate associations between latent factors with data from the Canadian Longitudinal Study on Aging for participants 65-85 years of age (65+, n = 11,667) and for adults with osteoarthritis (OA) aged 45-85 (n = 5,560). Latent factors included life space mobility, and physical, psychosocial, environmental, financial, and cognitive elements. Personal variables (age, sex, education) were covariates. RESULTS The models demonstrated good fit (65+: CFI = 0.90, RMSEA (90% CI) = 0.025 (0.024, 0.026); OA: CFI = 0.90, RMSEA (90% CI) = 0.032 (0.031, 0.033)). In both models, better psychosocial and physical health, and being less afraid to walk after dark (observed environmental variable) were associated with greater life space mobility. Greater financial status was associated with better psychosocial and physical health. Higher education was related to better cognition and finances. Older age was associated with lower financial status, cognition, and physical health. Cognitive health was positively associated with greater mobility only in the 65 + model. Models generated were equivalent for males and females. CONCLUSIONS Associations between determinants described in the mobility framework were verified with adults 65-85 years of age and in an OA group when all factors were considered together using SEM. These results have implications for clinicians and researchers in terms of important outcomes when assessing life space mobility; findings support interdisciplinary analyses that include evaluation of cognition, depression, anxiety, environmental factors, and community engagement, as well as physical and financial health. Public policies that influence older adults and their abilities to access communities beyond their homes need to reflect the complexity of factors that influence life space mobility at both individual and societal levels.
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Affiliation(s)
- Sandra C Webber
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, R106-771 McDermot Ave, Winnipeg, MB, R3E 0T6, Canada.
| | - Yixiu Liu
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Depeng Jiang
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Jacquie Ripat
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Scott Nowicki
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Robert Tate
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Ruth Barclay
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, R106-771 McDermot Ave, Winnipeg, MB, R3E 0T6, Canada
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Wang GM, Teng MY, Yu WJ, Ren H, Cui XS. Life-space mobility among community-dwelling older persons: A scoping review. Geriatr Nurs 2023; 54:108-117. [PMID: 37722235 DOI: 10.1016/j.gerinurse.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/24/2023] [Accepted: 08/24/2023] [Indexed: 09/20/2023]
Abstract
To describe and analyze the current research status of life-space mobility of the older persons in community. The literature in PubMed, Web of Science, Cochrane Library, Embase, EBSCOhost, Scopus, OpenGrey, SinoMed, CNKI, WanFang, and VIP databases was computer searched, and the time frame was build to May 23, 2023. A total of 42 literatures were included, including 35 in English and 7 in Chinese, 30 of which were cross-sectional studies. Theoretical models related to spatial mobility included the "concentric circles" model and the "cone" model. 33 literatures reported the prevalence or level of spatial mobility limitations, and 9 assessment instruments were used, The influencing factors can be divided into four categories. 9 literatures reported on the adverse effects, and 9 literatures reported on the prevention and intervention. The limitation of life-space mobility is a common and under-recognized phenomenon among the older persons in the community,with serious adverse effects, complex and diverse influencing factors.
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Affiliation(s)
- Gui-Meng Wang
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China
| | - Meng-Yuan Teng
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China
| | - Wen-Jing Yu
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China
| | - Hui Ren
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China
| | - Xiang-Shu Cui
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China.
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Luo M, Kim EK, Weibel R, Martin M, Röcke C. GPS-Derived Daily Mobility and Daily Well-Being in Community-Dwelling Older Adults. Gerontology 2023; 69:875-887. [PMID: 36657416 DOI: 10.1159/000527827] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 10/26/2022] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Mobility as a multidimensional concept has rarely been examined as a day-to-day varying phenomenon in its within-person association with older adults' daily well-being. This study examined associations between daily mobility and daily well-being in community-dwelling older adults with a set of GPS-derived mobility indicators that were representative of older adults' daily mobility. METHODS Participants wore a custom-built mobile GPS sensor ("uTrail") and completed smartphone-based experience sampling questionnaires on momentary affective states (7 times per day) and daily life satisfaction (in the evening). Analyses included data across 947 days from 109 Swiss older adults aged 65-89 years. RESULTS Multilevel modeling showed that, within persons, a day with a larger life space area, more time spent in passive transport modes, and a higher number of different locations was associated with higher daily life satisfaction but not daily positive or negative affect. Follow-up analysis showed that the daily maximum distance from home was positively associated with daily life satisfaction, providing a first indication that exposure to non-habitual environments might be a possible underlying mechanism to explain the effects of mobility. CONCLUSIONS Traveling a long distance away from home and visiting diverse locations may be a way to improve life satisfaction. Results are discussed in the context of research on healthy aging.
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Affiliation(s)
- Minxia Luo
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland,
- Department of Psychology, University of Zurich, Zurich, Switzerland,
| | - Eun-Kyeong Kim
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
- Department of Geography, University of Zurich, Zurich, Switzerland
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research (LISER), Esch-sur-Alzette, Luxembourg
| | - Robert Weibel
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
- Department of Geography, University of Zurich, Zurich, Switzerland
| | - Mike Martin
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Healthy Longevity Center, University of Zurich, Zurich, Switzerland
| | - Christina Röcke
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
- Healthy Longevity Center, University of Zurich, Zurich, Switzerland
- Center for Gerontology, University of Zurich, Zurich, Switzerland
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Kurita S, Doi T, Tsutsumimoto K, Nakakubo S, Kiuchi Y, Nishimoto K, Shimada H. Associations between Active Mobility Index and objectively measured physical activity among older adults. Aging Clin Exp Res 2023; 35:147-153. [PMID: 36269548 PMCID: PMC9816222 DOI: 10.1007/s40520-022-02256-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/12/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Active mobility index (AMI) is a questionnaire to assess going-out behavior with physical and social activity. The association between AMI scores and objectively measured physical activity (PA) in older adults is unknown. METHODS Community-dwelling older adults aged ≥ 70 years participated in an examination and wore a triaxial accelerometer for seven or more days. The accelerometer measured the time of moderate-to-vigorous intensity PA (MVPA) and light intensity PA (LPA), and step counts. The AMI assessed life space (distance from the respondent's home: < 1, 1-10, or > 10 km) and related activities during the previous month. The AMI total, physical, and social scores were calculated. RESULTS The analyzed data were 2499 participants (mean age: 75.5 ± 4.0 years; 54.4% female). Comparing PA among quartile groups of each AMI score, higher AMI total and physical score groups were associated with higher MVPA, LPA, and step counts (all P < 0.01). The Q4 group of AMI social scores showed significantly higher LPA and step counts than the Q1 and Q2 groups (P < 0.01). The logistic regression model showed higher score groups of AMI total and physical scores associated with increased adjusted odds ratio (aOR) of meeting recommended PA, ≥ 150 min/week of MVPA. CONCLUSIONS Older adults with higher AMI total and physical scores, engaged in more PA. Future studies can use the present findings when estimating PA in older adults from AMI scores and examining the association between AMI scores and health outcomes.
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Affiliation(s)
- Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-choAichi, Obu, 474-8511 Japan
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-choAichi, Obu, 474-8511 Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-choAichi, Obu, 474-8511 Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-choAichi, Obu, 474-8511 Japan
| | - Yuto Kiuchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-choAichi, Obu, 474-8511 Japan ,Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Kazuhei Nishimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-choAichi, Obu, 474-8511 Japan ,Department of Medical Sciences, Medical Science Division, Graduate School of Medicine, Science and Technology, Shinshu University, Nagano, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-choAichi, Obu, 474-8511 Japan
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Kato K, Yoshimi T, Aimoto K, Sato K, Itoh N, Kondo I. A rise-assisting robot extends life space and improves facial expressions of nursing home residents. BMC Health Serv Res 2022; 22:1588. [PMID: 36575420 PMCID: PMC9794109 DOI: 10.1186/s12913-022-08952-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 12/12/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The introduction of nursing care-support devices using robotic technology is expected to reduce the task burden in long-term care facilities. OBJECTIVE To investigate the use of the rise-assisting robot, Resyone, in extending and improving the life space of nursing home residents with severe care needs. METHODS We performed a feasibility study in which Resyone was used to facilitate visits to additional sites in and around the nursing home as part of the care package of three residents. Two weeks before and four weeks after implementation of the new arrangements, the 30 caregivers involved were asked to record transfer times and destinations, while also checking the residents' facial expressions. RESULTS Before implementation, participants had limited life spaces, but afterwards they regularly visited additional destinations including the garden, home entrance and corridors, which previously they had not visited frequently. The residents' facial expressions became more positive and less negative. This study demonstrates that Resyone can enrich care activities in severely disabled individuals. CONCLUSION These findings suggest that the sustainable use of Resyone would improve the quality of care at care facilities. Moreover, the extension of otherwise limited life space has the potential to improve care receivers' quality of life. TRIAL REGISTRATION UMIN Clinical Trials Registry No. UMIN000039204 (20/01/2020); retrospectively registered; interventional study; parallel, non-randomized, single blinded. URL of trial registry records: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000044709 .
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Affiliation(s)
- Kenji Kato
- grid.419257.c0000 0004 1791 9005Laboratory for Clinical Evaluation with Robotics, Assistive Robot Center, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi 474-8511 Japan
| | - Tatsuya Yoshimi
- grid.419257.c0000 0004 1791 9005Laboratory for Clinical Evaluation with Robotics, Assistive Robot Center, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi 474-8511 Japan
| | - Keita Aimoto
- grid.419257.c0000 0004 1791 9005Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi 474-8511 Japan
| | - Kenji Sato
- grid.419257.c0000 0004 1791 9005Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi 474-8511 Japan
| | - Naoki Itoh
- grid.419257.c0000 0004 1791 9005Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi 474-8511 Japan
| | - Izumi Kondo
- grid.419257.c0000 0004 1791 9005Assistive Robot Center, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi 474-8511 Japan
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Tomida K, Lee S, Bae S, Makino K, Chiba I, Harada K, Katayama O, Morikawa M, Shimada H. Association of dual sensory impairment with changes in life space: A longitudinal study with two-year follow-up. Maturitas 2022; 165:78-84. [PMID: 35940025 DOI: 10.1016/j.maturitas.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/19/2022] [Accepted: 07/28/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Dual sensory impairment (DSI) of hearing and vision in older adults may limit lifestyle activities of daily living and contribute to a reduced life space. This study aimed to investigate how DSI is associated with specific lifestyle activities and predicts changes in mobility in life space. STUDY DESIGN Participants comprised 4214 older adults (52.3 % female, mean age 75.8 years) who met the study's inclusion criteria. The participants were divided into three groups according to the number of sensory impairments: (1) no sensory impairment (NSI), (2) single sensory impairment (SSI), and (3) DSI. MAIN OUTCOME MEASURE We investigated the association between DSI and specific lifestyle activities at baseline. The Active Mobility Index (AMI) was used to assess life-space. Two years later, the association between DSI and life-space mobility was verified using multinomial logistic regression analysis. RESULTS DSI was more likely to have limited people's instrumental activities of daily living and cognitive, social, and productive activities at baseline (P < 0.05). In the adjusted model with potential covariates, people with DSI had a lower life-space score at 2 years than people with NSI (odds ratio [OR] = 1.40, 95 % confidence interval [CI]: 1.01-1.95), but the difference was not significant for SSI (OR = 0.98, 95 % CI: 0.78-1.24). CONCLUSIONS This study suggested that DSI was a factor that limited various activities and narrowed the life-space mobility of older adults. Prevention of DSI may be important for community-dwelling older adults to maintain a more active lifestyle.
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Affiliation(s)
- Kouki Tomida
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Seongryu Bae
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Ippei Chiba
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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11
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Kurita S, Doi T, Tsutsumimoto K, Nakakubo S, Kiuchi Y, Nishimoto K, Shimada H. Association between Active Mobility Index and sarcopenia among Japanese community-dwelling older adults. J Cachexia Sarcopenia Muscle 2022; 13:1919-1926. [PMID: 35437935 PMCID: PMC9178158 DOI: 10.1002/jcsm.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/14/2022] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A physically active lifestyle, including physical and social activities, is needed to maintain muscle mass, strength, and physical performance. A large life space characterizes an active lifestyle, but the association between life space with physical and social activities and sarcopenia is unclear. This study aimed to examine the association between life space with physical and social activities, assessed using the Active Mobility Index (AMI), and sarcopenia in community-dwelling Japanese older adults. METHODS This study used a large, cross-sectional cohort dataset from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes (NCGG-SGS). Between 2013 and 2018, community-dwelling Japanese adults aged ≥60 years participated in the NCGG-SGS. Sarcopenia was identified by measuring muscle mass and strength based on the clinical definition. The secondary outcomes were sarcopenia indices, including lower muscle mass, lower muscle strength, and lower gait speed. AMI assessed life space with physical and social activities in each life space (distance from the respondent's home: <1, 1-10, or >10 km) during the past month by noting the frequency, primary purpose, type of transportation, interaction with others, and physical activity. The associations between quartile groups of AMI total, physical, and social scores and sarcopenia were examined using a logistic regression model. RESULTS From all participants, 21 644 participants (age 73.5 ± 5.8 years, 54.7% female) were included in the analysis. The prevalence of sarcopenia was 4.1% (n = 894). For the AMI total score, referred to Q1 group, Q3 and Q4 groups were significantly associated with a reduced odds ratio (OR) of sarcopenia after adjusting for all covariates [adjusted OR (aOR) (95% confidence interval), Q3: 0.71 (0.57-0.89), Q4: 0.69 (0.55-0.87)]. Q3 and Q4 of the AMI physical score groups were also significantly associated with reduced OR of sarcopenia [Q3: 0.71 (0.57-0.89), Q4: 0.67 (0.54-0.84)]. For the AMI social score, only the Q4 group showed reduced OR for sarcopenia [0.79 (0.62-1.01)]. Q3 and Q4 of the AMI total score and physical score were associated with reduced OR of all sarcopenia indices (aOR 0.55-0.82, all P < 0.05), whereas Q4 of AMI social score was associated with all indices (aOR 0.85-0.81, all P < 0.05). CONCLUSIONS The extent of life space with physical activity was associated with sarcopenia in community-dwelling older adults. A longitudinal study is needed to examine whether life space with physical and social activities affect the development of sarcopenia.
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Affiliation(s)
- Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yuto Kiuchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.,Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Kazuhei Nishimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Medical Sciences, Medical Science Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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12
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Bayat S, Naglie G, Rapoport MJ, Stasiulis E, Widener MJ, Mihailidis A. A GPS-Based Framework for Understanding Outdoor Mobility Patterns of Older Adults with Dementia: An Exploratory Study. Gerontology 2021; 68:106-120. [PMID: 33895746 DOI: 10.1159/000515391] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/18/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION An active lifestyle may protect older adults from cognitive decline. Yet, due to the complex nature of outdoor environments, many people living with dementia experience decreased access to outdoor activities. In this context, conceptualizing and measuring outdoor mobility is of great significance. Using the global positioning system (GPS) provides an avenue for capturing the multi-dimensional nature of outdoor mobility. The objective of this study is to develop a comprehensive framework for comparing outdoor mobility patterns of cognitively intact older adults and older adults with dementia using passively collected GPS data. METHODS A total of 7 people with dementia (PwD) and 8 cognitively intact controls (CTLs), aged 65 years or older, carried a GPS device when travelling outside their homes for 4 weeks. We applied a framework incorporating 12 GPS-based indicators to capture spatial, temporal, and semantic dimensions of outdoor mobility. RESULTS Despite a small sample size, the application of our mobility framework identified several significant differences between the 2 groups. We found that PwD participated in more medical-related (Cliff's Delta = 0.71, 95% CI: 0.34-1) and fewer sport-related (Cliff's Delta = -0.78, 95% CI: -1 to -0.32) activities compared to the cognitively intact CTLs. Our results also suggested that longer duration of daily walking time (Cliff's Delta = 0.71, 95% CI: 0.148-1) and longer outdoor activities at night, after 8 p.m. (Hedges' g = 1.42, 95% CI: 0.85-1.09), are associated with cognitively intact individuals. CONCLUSION Based on the proposed framework incorporating 12 GPS-based indicators, we were able to identify several differences in outdoor mobility in PwD compared with cognitively intact CTLs.
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Affiliation(s)
- Sayeh Bayat
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,KITE Research Institute, Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Gary Naglie
- KITE Research Institute, Toronto Rehabilitation Institute, Toronto, Ontario, Canada.,Department of Medicine, Baycrest Health Sciences, Toronto, Ontario, Canada.,Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Mark J Rapoport
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Elaine Stasiulis
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Michael J Widener
- Department of Geography and Planning, University of Toronto, Toronto, Ontario, Canada
| | - Alex Mihailidis
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,KITE Research Institute, Toronto Rehabilitation Institute, Toronto, Ontario, Canada.,Department of Occupational Therapy & Occupational Science, University of Toronto, Toronto, Ontario, Canada
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13
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Ho SH, Tan DPS, Tan PJ, Ng KW, Lim ZZB, Ng IHL, Wong LH, Ginting ML, Yuen B, Mallya UJ, Chong MS, Wong CH. The development and validation of a prototype mobility tracker for assessing the life space mobility and activity participation of older adults. BMC Geriatr 2020; 20:251. [PMID: 32698799 PMCID: PMC7374961 DOI: 10.1186/s12877-020-01649-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is increasing interest in examining the life space mobility and activity participation of older adults in the community using sensor technology. Objective data from these technologies may overcome the limitations of self-reported surveys especially in older adults with age-associated cognitive impairment. This paper describes the development and validation of a prototype hybrid mobility tracker for assessing life space mobility and out-of-home activities amongst 33 community-ambulant older adults in Singapore. METHODS A hybrid mobility tracker was developed by combining a passive Global Positioning System logger, tri-axial accelerometer and radio-frequency identification. Objective measures of life space, derived from 1 week of tracking data using Geographic Information Systems, were the maximum Euclidean distance from home (Max Euclid) and the area of the minimum convex polygon surrounding all GPS waypoints (MCP area). Out-of-home activities were quantified by visually identifying the total number of activity nodes, or places where participants spent ≥5 min, from mobility tracks. Self-reported measure of life space in 4 weeks was obtained using the University of Alabama at Birmingham Study of Life Space Assessment (UAB-LSA) questionnaire. Self-reported out-of-home activities were recorded daily in a travel diary for 1 week. Bivariate correlations were used to examine convergent validity between objective and subjective measures of life space and out-of-home activities. RESULTS The mean age of participants was 69.2 ± 7.1 years. The mean UAB-LSA total score was 79.1 ± 17.4. The median (range) Max Euclid was 2.44 km (0.26-7.50) per day, and the median (range) MCP area was 3.31 km2 (0.03-34.23) per day. The UAB-LSA total score had good correlation with Max Euclid (r = 0.51, p = 0.002), and moderate correlation with MCP area (r = 0.46, p = 0.007). The median (range) total number of activity nodes measured by tracker of 20 (8-47) per week had a good correlation with the total activity count recorded in the travel diaries of 15 (6-40) per week (r = 0.52, p = 0.002). CONCLUSIONS The tracking system developed to understand out-of-home travel was feasible and reliable. Comparisons with the UAB-LSA and travel diaries showed that it provided reliable and valid spatiotemporal data to assess the life space mobility and activity participation of older adults.
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Affiliation(s)
- Soon Hoe Ho
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Dion Piu Sern Tan
- NDR Medical Technology Pte Ltd, 75 Ayer Rajah Crescent #02-19, Singapore, 139953, Singapore
| | - Pey June Tan
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Ka Wei Ng
- NDR Medical Technology Pte Ltd, 75 Ayer Rajah Crescent #02-19, Singapore, 139953, Singapore
| | - Zoe Zon Be Lim
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Isabel Hui Leng Ng
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Lok Hang Wong
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Mimaika Luluina Ginting
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore
| | - Belinda Yuen
- Lee Kuan Yew Centre for Innovative Cities, Singapore University of Technology and Design, 8 Somapah Road, Singapore, 487372, Singapore
| | - Ullal Jagadish Mallya
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore
| | - Mei Sian Chong
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore.,The Geriatric Practice, 38 Irrawaddy Road #09-21, Mount Elizabeth Novena Specialist Centre, Singapore, 329563, Singapore
| | - Chek Hooi Wong
- Geriatric Education and Research Institute Ltd, 2 Yishun Central 2, Singapore, 768024, Singapore. .,Department of Geriatric Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore. .,Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
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14
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Taylor JK, Buchan IE, van der Veer SN. Assessing life-space mobility for a more holistic view on wellbeing in geriatric research and clinical practice. Aging Clin Exp Res 2019; 31:439-45. [PMID: 30078096 DOI: 10.1007/s40520-018-0999-5] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 07/02/2018] [Indexed: 11/06/2022]
Abstract
Life-space mobility (LSM) is a holistic measure of resilience to physical decline and social isolation in later life. To promote its use as an outcome in geriatric studies and in clinical practice, this review paper explains the concept of LSM; outlines available questionnaires for LSM assessment, provides an overview of associations between LSM and other outcomes, and discusses emerging methods to measure LSM using wearable sensors. Based on performed activity around a central geographical anchor, LSM aims to quantify the observed contraction of daily activities associated with ageing. Several questionnaires are available to assess LSM in different contexts: the University of Alabama Life-Space Assessment and the Life-Space Questionnaire (community settings), the Nursing Home Life-Space Diameter (nursing home settings) and Life Space at Home (for house-bound populations). Some studies using GPS trackers to calculate life-space parameters reported promising results. Although these techniques reduce data collection burden, battery life and older people’s willingness to wear a tracker require further improvement before they can be used more widely. Regardless of the assessment method used, LSM was associated with measures of functional and cognitive abilities, nursing home admission and mortality. The current availability of instruments, the ongoing development of less burdensome data collection techniques, and evidence of construct validity support a case for promoting integration of LSM assessments into geriatric research studies and clinical practice. Ultimately, this will provide a more holistic view on older people’s health and wellbeing.
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15
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Fuchs T. The Interactive Phenomenal Field and the Life Space: A Sketch of an Ecological Concept of Psychotherapy. Psychopathology 2019; 52:67-74. [PMID: 31394534 DOI: 10.1159/000502098] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 07/12/2019] [Indexed: 11/19/2022]
Abstract
Based on the phenomenology of the body and ecological psychology, this paper introduces a series of concepts that enable us to overcome the still prevailing idea of an inner psyche and a corresponding individualistic view of psychopathology. These concepts are the phenomenal field, lived space, intercorporeality, and body memory; they correspond to an embodied, enactive, and ecological view of the mind. On their basis, psychiatric illnesses may be conceived as relational disorders resulting in various restrictions and impairments of the patient's lived space. The main tasks of psychotherapy, then, are to use the interactive phenomenal field as a means of restructuring the patient's relational patterns and to support his or her capacity to engage in more beneficial interactions with others. In this way, phenomenology can valuably contribute to a deeper understanding of the intricate processes of the psychotherapeutic encounter.
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Affiliation(s)
- Thomas Fuchs
- Klinik für Allgemeine Psychiatrie, Universitätsklinikum Heidelberg, Heidelberg, Germany,
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16
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Matsuda N, Murata S, Ono R. [Association between life space and health literacy in community-dwelling older adults]. Nihon Ronen Igakkai Zasshi 2018; 55:650-656. [PMID: 30542031 DOI: 10.3143/geriatrics.55.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM To examine the association between health literacy (HL) and life space in community-dwelling older adults. METHODS In this cross-sectional study, we analyzed 210 community-dwelling older adults (mean age: 74.6 years, women: 63.8%). Health literacy was measured using the 14-item Health Literacy Scale (HLS-14). The 14 items consist of 5 items for functional HL (FHL), 5 items for interactive HL (CHL), and 4 items for critical HL (IHL). We calculated the total score, FHL score, CHL score, and IHL score. Life space was measured using the life-space assessment (LSA). A linear regression model was used to analyze the association between the HLS-14 score and LSA score. We adjusted for variables associated with the LSA score. RESULTS The FHL score was significantly associated with the LSA score (crude model: β = 1.40, p < 0.01, adjusted model: β = 1.11, p = 0.01). However, the total score, IHL, and CHL were not significantly associated with the LSA score. CONCLUSIONS A higher FHL is significantly associated with a greater larger life space in community-dwelling older adults. This finding may help elderly people maintain a greater life space which will help them to improve their HL while also making it possible for them to obtain easy-to-understand information.
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Affiliation(s)
- Naoka Matsuda
- Department of Community Health Sciences, Kobe University, Graduate School of Health Sciences
| | - Shunsuke Murata
- Department of Community Health Sciences, Kobe University, Graduate School of Health Sciences.,Research Fellowship for Young Scientists, Japan Society for the Promotion of Science
| | - Rei Ono
- Department of Community Health Sciences, Kobe University, Graduate School of Health Sciences
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17
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Abstract
PURPOSE We examined the factors related to life space and changes in the care level after one year in daycare center users. METHODS The participants were 83 older adults (age, > 65 years; mean age, 79.5±6.8 years) with MMSE scores of ≥20, who could walk independently, who needed support (1-2) or care (1), and who underwent rehabilitation at a daycare center. The life space was evaluated by the Life Space Assessment (LSA). The subjects' basic information (i.e., age, medical history.) was collected, and their physical function (i.e., grip strength, timed up and go test [TUG]), mental function (i.e., vitality, fear of falls), and social function (i.e., friends, hobbies, public transportation) were assessed to investigate the factors associated with their LSA scores. In addition, a follow-up survey was conducted on the care level at approximately one year later. RESULTS A multiple regression analysis indicated that TUG scores (β=-0.33), hobbies (β=0.30), friends (β=0.29), public transportation (β=0.26), and grip strength (β=0.24) were related to the life space. Next, the participants were divided into LSA-high and LSA-low groups, and changes in the care level (improvement, maintenance, deterioration) at approximately one year after the initial assessment were examined using a chi-squared test. A significant difference was observed in the distribution of the groups (p=0.03). CONCLUSIONS Multiple factors were related to the life space. Moreover, it is possible that improvements in the level of care may be achieved by improving the life space.
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Affiliation(s)
| | - Chikako Kato
- College of Life and Health Sciences, Chubu University
| | - Izumi Kondo
- National Center for Geriatrics and Gerontology
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18
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Sverdrup K, Bergh S, Selbæk G, Røen I, Kirkevold Ø, Tangen GG. Mobility and cognition at admission to the nursing home - a cross-sectional study. BMC Geriatr 2018; 18:30. [PMID: 29378518 PMCID: PMC5789666 DOI: 10.1186/s12877-018-0724-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 01/23/2018] [Indexed: 11/25/2022] Open
Abstract
Background Earlier studies show that the main reasons for admission to long-term nursing home care are cognitive impairment and functional impairments of activities of daily life. However, descriptive evidence of mobility is scant. The aims of this study were to describe mobility at admission to nursing homes and to assess the association between mobility and degree of dementia. Methods We included 696 residents at admission to 47 nursing homes in Norway. Inclusion criteria were expected stay for more than 4 weeks and 65 years or older. In addition, younger residents with dementia were included. Residents with life expectancy shorter than six weeks were excluded. Mobility was assessed using the Short Physical Performance Battery (SPPB) and the Nursing Home Life Space Diameter (NHLSD). The Clinical Dementia Rating Scale (CDR) was used to describe the degree of dementia. The associations between mobility and degree of dementia was analysed using the Chi-square and the Kruskal-Wallis test (KW-test). When the KW-test indicated a statistical significant difference, we proceeded with planned group comparisons with the Mann-Whitney U-test. In addition, we performed multiple linear regression analyses to control for potential confounders. Results Forty-three percent of the residents were not able to perform the balance test in SPPB. Twenty-four percent of the residents were not able to walk four meters, while only 17.6% had a walking speed of 0.83 m/s or higher. Sixty-two percent of the residents were not able to rise from a chair or spent more than 60 s doing it. The median score on NHLSD area was 22 (IQR 17) and the median score on NHLSD dependency was 36 (IQR 26). Residents with severe dementia had significantly lower levels of mobility than residents with moderate dementia. Cognitive function was associated with SPPB and NHLSD dependency in the adjusted models. Conclusion Nursing home residents form a frail, but heterogeneous group both in terms of cognition and mobility at admission. Mobility was negatively associated with cognitive function, and residents with severe dementia had significantly lower levels of mobility than residents with moderate dementia.
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Affiliation(s)
- Karen Sverdrup
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway. .,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Irene Røen
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway.,Department of Health Science, Norwegian University of Science and Technology, Gjøvik, Trondheim, Norway
| | - Gro Gujord Tangen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
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19
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Abstract
Objective To evaluate the reliability of the practical life space in post-stroke patients using the Korean version of the Life-Space Assessment (K-LSA) questionnaire and to assess the relationships between the K-LSA and physical function, daily activity, quality of life, and post-stroke depression. Methods The LSA questionnaire was translated into Korean, and the translated version was authorized by the author of the LSA questionnaire. In a cross-sectional study, the performance of the K-LSA was evaluated in 34 stroke patients (20 males and 14 females; mean age 65.11±2.39 years) who were receiving physical and occupational therapy at the outpatient clinic in the rehabilitation medicine department of a university medical center at the time of evaluation. Performances were assessed twice by one examiner at a 2-week interval to test the reliability. The patients were evaluated using the Functional Ambulation Category (FAC) scale, Functional Independence Measure (FIM) scale, and mobility subscale of the FIM to assess their relationships with the K-LSA. They were also evaluated using the EuroQol 5 Dimensions questionnaire (EQ-5D) and Geriatric Depression Scale (GDS) to determine the relationship with quality of life and post-stroke depression. Results Test-retest reliability at the first (62.20±32.14) and second (63.15±32.22) assessment was 0.993 (p<0.01). The K-LSA showed significant correlations with the FAC (r=0.848, p<0.01), FIM (r=0.765, p<0.01), mobility category of the FIM (r=0.764, p<0.01), GDS (r=-0.657, p<0.01), and EQ-5D (r=0.506, p<0.01). Conclusion This study suggests that the practical life space of post-stroke patients, assessed by the K-LSA, has a significant correlation with patients' functional mobility, independence in daily activity, quality of life, and depression.
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Affiliation(s)
- You-Na Yang
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea
| | - Bo-Ram Kim
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea
| | - Kyeong Eun Uhm
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea
| | - Soo Jin Kim
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea
| | - Seunghwan Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea
| | - Mooyeon Oh-Park
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA; Kessler Institute for Rehabilitation, West Orange, NJ; Kessler Foundation, West Orange NJ, USA
| | - Jongmin Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea.,International Healthcare Research Institute, Konkuk University, Seoul, Korea
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Tsutsumimoto K, Doi T, Shimada H, Makizako H, Uemura K, Ando H, Suzuki T. Self-reported Exhaustion is Associated with Small Life Space in Older Adults with Mild Cognitive Impairment. J Phys Ther Sci 2014; 26:1979-83. [PMID: 25540512 PMCID: PMC4273072 DOI: 10.1589/jpts.26.1979] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 06/23/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Older adults experience exhaustion-induced health problems, such as poor
physical function and low physical activity levels. The associations between self-reported
exhaustion and physical function and activity are not clear in older adults with mild
cognitive impairment (MCI). The aim of this study was to investigate the relationships
between self-reported exhaustion and physical function and activity in older adults with
mild cognitive impairment. [Subjects] A total of 356 older adults with mild cognitive
impairment (mean age = 71.6 ± 0.3 years, 50.8% women) were included in this study.
[Methods] Self-reported exhaustion was identified by one item from the Study of
Osteoporotic Fractures index. Gait speed, gait endurance, and life space were also
assessed. [Results] Sixty-two participants reported having exhaustion, giving a 17.4%
prevalence of self-reported exhaustion among these individuals. Logistic regression
analysis showed that the Life-Space Assessment score was the only parameter significantly
independently associated with exhaustion status (adjusted odds ratio 0.97, 95% confidence
interval 0.95–0.99). [Conclusion] These results suggest that self-reported exhaustion is
associated with life space. Future research is needed to identify ways for older people
with MCI to improve their exhaustion status.
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Affiliation(s)
- Kota Tsutsumimoto
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Japan ; Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Takehiko Doi
- Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Hiroyuki Shimada
- Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Hyuma Makizako
- Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Kazuki Uemura
- Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Hiroshi Ando
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Japan
| | - Takao Suzuki
- Research Institute, National Center for Geriatrics and Gerontology, Japan
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