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Bassingthwaighte L, Gustafsson L, Molineux M. Lifespace and occupational participation following acquired brain injury during driving disruption: a mixed methods study. Disabil Rehabil 2024:1-15. [PMID: 38592071 DOI: 10.1080/09638288.2024.2338192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/28/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE To examine the lifespace of participants referred for occupational therapy driving assessment following acquired brain injury, to understand how, why, where and with whom access and participation in community-based occupations is occurring during the period of driving disruption. MATERIALS AND METHODS The mixed methods, convergent research design utilised a travel diary and Lifespace Mobility Assessment-Composite quantitative elements and semi-structured interviews analysed qualitatively with an interpretive description lens. RESULTS Forty-eight participants (56.25% male) aged between 26 and 65 years, left home on average once/day, primarily to conduct instrumental activities of daily living, health management, and social participation community-based occupations. Most reported restricted lifespace (54.2%) requiring assistance to conduct community occupations (68.1%). Support was primarily provided by family members (80.3%). Analysis of semi-structured interviews (n = 15) created three themes that shaped participant occupational experience during driving disruption: (i) changes to occupational participation; (ii) reliance on others for community access and participation; and (iii) trying to move forward. CONCLUSION The period of driving disruption following the onset of acquired brain injury is a time of occupational disruption which restricts lifespace, changing how, why, where and with whom participation in community-based occupations occurs. Rehabilitation facilitating occupational adaptation process to enhance community access capacity is indicated.
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Affiliation(s)
- Louise Bassingthwaighte
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
- Driving Assessment and Rehabilitation Service, Princess Alexandra Hospital, Brisbane, Australia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - Matthew Molineux
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
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Driggers A, Kennedy RE, Williams BR, Brown CJ, Buys DR. Changes in Life-Space Mobility With Loss of Relatives and Friends Among Older Adults: Results From the UAB Study of Aging. THE GERONTOLOGIST 2024; 64:gnad116. [PMID: 37638853 PMCID: PMC10943496 DOI: 10.1093/geront/gnad116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Increasing age brings a greater risk of death of friends and family (hereafter referred to as loss) potentially impacting individuals' life-space mobility (LSM) trajectory. RESEARCH DESIGN AND METHODS Using the UAB study of aging, we examined differences in LSM trajectories of 1,000 community-dwelling older Alabamians (65 + years) with and without loss over 8.5 years. We measured LSM using UAB's Life-Space Assessment (LSA), a validated instrument assessing movement through zones ranging from their bedroom to out of town. We assessed loss every 6 months using a standard bereavement questionnaire capturing spousal, other relative, or friend loss. We used piecewise linear mixed-effects models to compare LSA trajectories. RESULTS At baseline, those who later experienced loss, compared with those who did not were younger, more likely to be female, and overall in better health. Those without loss had a baseline mean LSA score of 49.5 and a decline of 0.08 points per year (p < .001). Those with loss had a baseline LSA score of 60 and declined by 1.0 point per year before loss (p < .001), accelerating to 1.8 points per year after loss (p < .001). DISCUSSION AND IMPLICATIONS Those with loss do not experience acute decline postloss but do have an acceleration of the preexisting decline. Although additional research may explain the impact of loss on LSM; this finding suggests that more interventions such as social, mental, or health care services, may be needed for those who experience loss. Specifically, bereaved individuals may benefit from it.
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Affiliation(s)
- Amelia Driggers
- Department of Agricultural and Biological Engineering, Mississippi State University, Starkville, Mississippi, USA
| | - Richard E Kennedy
- Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Beverly Rosa Williams
- Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Cynthia J Brown
- Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - David R Buys
- Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Starkville, Mississippi, USA
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Batista PP, Perracini MR, do Carmo Correia de Lima M, de Amorim JSC, Pereira DS, Pereira LSM. Risk of sarcopenia and mobility of older adults during the COVID-19 pandemic: the longitudinal data from the REMOBILIZE study. Aging Clin Exp Res 2024; 36:80. [PMID: 38546804 PMCID: PMC10978643 DOI: 10.1007/s40520-024-02720-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/01/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND We assessed whether clinical, functional and behavioral factors were associated with the decrease in mobility trajectories reported in older people at risk of sarcopenia (RS) and without risk of sarcopenia (NRS) during COVID-19 pandemic. METHODS We prospectively analyzed mobility trajectories reported in older adults with RS and NRS over 16-month follow-up (Remobilize study). The self-perceived risk of sarcopenia and mobility were assessed using the SARC-F and the Life-Space Assessment (LSA) tools, respectively. Gender, age, comorbidities, pain, functional limitation, physical activity (time spent in walking; min/week), and sitting time (ST; hours/day) were assessed. We used a multilevel model to determine changes in mobility between groups and over time. RESULTS Mobility was lower in RS than in NRS. Older people at RS, who were women, aged 70-79 years and 80 years or older, inactive, and with moderate to severe functional limitation experienced reduced mobility trajectories reported over the pandemic. For older people at NRS, trajectories with reduce mobility reported were experienced by women with comorbidities, for those with insufficient walking time and aged 70-79 years; aged 70-79 years and with ST between 5 and 7 hours/day; for those with insufficient walking time and increased ST; and for those with pain and increased ST. CONCLUSION Mobility trajectories reported in older people at risk of sarcopenia were negatively influenced by insufficient level of physical inactivity and pre-existing moderate to severe functional limitation. Health and social interventions should be target to avoid mobility limitation during and after the COVID-19 pandemic.
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Affiliation(s)
- Patricia Parreira Batista
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6.627. Pampulha, Belo Horizonte, MG, Brazil.
| | - Monica Rodrigues Perracini
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
- Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Maria do Carmo Correia de Lima
- Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | | | - Daniele Sirineu Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6.627. Pampulha, Belo Horizonte, MG, Brazil
| | - Leani Souza Máximo Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6.627. Pampulha, Belo Horizonte, MG, Brazil
- Postgraduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte, MG, Brazil
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Wang Y, Ma L, Pei J, Li W, Zhou Y, Dou X, Wang X. The level of life space mobility among community-dwelling elderly: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 117:105278. [PMID: 37988853 DOI: 10.1016/j.archger.2023.105278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
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].
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Affiliation(s)
- Yingqiao Wang
- School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Li Ma
- LanZhou University Second Hospital, Lanzhou City, Gansu Province, China
| | - Juhong Pei
- First College of Clinical Medicine of Lanzhou University, China
| | - Weiping Li
- School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China
| | - Yihan Zhou
- LanZhou University Second Hospital, Lanzhou City, Gansu Province, China
| | - Xinman Dou
- LanZhou University Second Hospital, Lanzhou City, Gansu Province, China
| | - Xinglei Wang
- School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China; Department of Liver Diseases Branch, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
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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] [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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Ullrich P, Hummel M, Hauer K, Bauer JM, Werner C. Validity, Reliability, Responsiveness, and Feasibility of the Life-Space Assessment Administered via Telephone in Community-Dwelling Older Adults. THE GERONTOLOGIST 2024; 64:gnad038. [PMID: 37014063 DOI: 10.1093/geront/gnad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The life-space assessment (LSA) is the most commonly used questionnaire to assess life-space mobility (LSM) in older adults, with well-established psychometric properties for face-to-face (FF) administration. However, these properties have not yet been explicitly studied when the LSA is administered by telephone. The aim of this study was to evaluate the concurrent and construct validity, test-retest reliability, responsiveness, and feasibility of a telephone-based LSA version (TE-LSA) in older adults. RESEARCH DESIGN AND METHODS Fifty community-dwelling older adults (age = 79.3 ± 5.3 years) participated in the study. Concurrent validity was assessed against the FF-LSA construct validity by testing 15 a priori hypotheses on expected associations with LSM determinants, test-retest reliability via 2 telephone surveys 1 week apart, responsiveness after 8.5 ± 1.8 months in participants with improved, stable, and worsened mobility defined by 2 external criteria, and feasibility by the completion rate/time and ceiling/floor effects. RESULTS Good to excellent agreement between the 2 different administration methods was found (intraclass correlation coefficient [ICC2,1] = 0.73-0.98). Twelve of 15 (80%) hypotheses on construct validity were confirmed. ICCs for test-retest reliability were good to excellent (ICC2,1 = 0.62-0.94). Minimal detectable change for the TE-LSA total score was 20 points. Standardized response means were large for worsened (0.88), moderate for improved (0.68), and trivial for stable participants (0.04). Completion rate was 100% and mean completion time was 5.5 ± 3.3 min. No ceiling or floor effects were observed for the TE-LSA total score. DISCUSSION AND IMPLICATIONS Telephone administration of the LSA is valid, reliable, responsive, and feasible for assessing LSM in community-dwelling older adults.
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Affiliation(s)
- Phoebe Ullrich
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Merit Hummel
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Klaus Hauer
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Jürgen M Bauer
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Christian Werner
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
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Suri A, VanSwearingen J, Baillargeon EM, Crane BM, Moored KD, Carlson MC, Dunlap PM, Donahue PT, Redfern MS, Brach JS, Sejdic E, Rosso AL. Association of Gait Quality With Daily-Life Mobility: An Actigraphy and Global Positioning System Based Analysis in Older Adults. IEEE Trans Biomed Eng 2024; 71:130-138. [PMID: 37428666 PMCID: PMC10792545 DOI: 10.1109/tbme.2023.3293752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
OBJECTIVE Walking is a key component of daily-life mobility. We examined associations between laboratory-measured gait quality and daily-life mobility through Actigraphy and Global Positioning System (GPS). We also assessed the relationship between two modalities of daily-life mobility i.e., Actigraphy and GPS. METHODS In community-dwelling older adults (N = 121, age = 77±5 years, 70% female, 90% white), we obtained gait quality from a 4-m instrumented walkway (gait speed, walk-ratio, variability) and accelerometry during 6-Minute Walk (adaptability, similarity, smoothness, power, and regularity). Physical activity measures of step-count and intensity were captured from an Actigraph. Time out-of-home, vehicular time, activity-space, and circularity were quantified using GPS. Partial Spearman correlations between laboratory gait quality and daily-life mobility were calculated. Linear regression was used to model step-count as a function of gait quality. ANCOVA and Tukey analysis compared GPS measures across activity groups [high, medium, low] based on step-count. Age, BMI, and sex were used as covariates. RESULTS Greater gait speed, adaptability, smoothness, power, and lower regularity were associated with higher step-counts (0.20<|ρp| < 0.26, p < .05). Age(β = -0.37), BMI(β = -0.30), speed(β = 0.14), adaptability(β = 0.20), and power(β = 0.18), explained 41.2% variance in step-count. Gait characteristics were not related to GPS measures. Participants with high (>4800 steps) compared to low activity (steps<3100) spent more time out-of-home (23 vs 15%), more vehicular travel (66 vs 38 minutes), and larger activity-space (5.18 vs 1.88 km2), all p < .05. CONCLUSIONS Gait quality beyond speed contributes to physical activity. Physical activity and GPS-derived measures capture distinct aspects of daily-life mobility. Wearable-derived measures should be considered in gait and mobility-related interventions.
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Taylor RA, Bakitas M, Wells R, Dionne‐Odom JN, Kennedy R, Williams GR, Frank J, Li P. Restricted life-space mobility impacts physical but not mental quality of life in older cancer survivors. Cancer Med 2023; 13:e6850. [PMID: 38140781 PMCID: PMC10807608 DOI: 10.1002/cam4.6850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/04/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Older cancer survivors often value quality of life (QOL) over survival. Life-space mobility (LSM), defined as the individual's spatial geographic mobility range, is an important QOL indicator in older adults with chronic illnesses; however, this relationship is unexplored in older cancer survivors. METHODS We examined the longitudinal associations and causal relationships between LSM and QOL in 153 older cancer survivors (≥65 years) from the University of Alabama at Birmingham (UAB) Study of Aging. LSM was assessed using the UAB Life-Space Assessment-Composite score (LSA-C), and QOL was assessed by the SF-12 Mental Component Score (MCS12) and Physical Component Score (PCS12) at 0 (study entry), 6, 18, 36, 54, and 72 months. We examined the causal relationship between LSM and QOL using a cross-lagged panel model (CLPM). RESULTS The cohort (n = 153) was 76 years old on average and predominantly White (58%), female (58%), and married (55%). Longitudinal analyses found LSM decreased over time (p < 0.0001), and this decrease was associated with decreased QOL (PCS12, p < 0.0001, MCS12, p < 0.0001). In the CLPM causal analysis, lower LSM resulted in worse PCS12 (p < 0.001), but not worse MSC12. CONCLUSIONS Restricted LSM resulted in worse physical QOL over 72 months in a sample of 153 older cancer survivors. Developing and evaluating interventions to preserve greater LSM could be a promising approach to improving QOL.
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Affiliation(s)
- Richard A. Taylor
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Marie Bakitas
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Rachel Wells
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - J. Nicholas Dionne‐Odom
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of Medicine—Division of Gerontology, Geriatrics, and Palliative CareUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Richard Kennedy
- Department of Medicine—Division of Gerontology, Geriatrics, and Palliative CareUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Grant R. Williams
- Department of Medicine—Division of Hematology & OncologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Jennifer Frank
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Peng Li
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
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Eliassen M, Sørensen BA, Hartviksen TA, Holm S, Zingmark M. Emplacing reablement co-creating an outdoor recreation model in the rural Arctic. Int J Circumpolar Health 2023; 82:2273013. [PMID: 37883476 PMCID: PMC10997308 DOI: 10.1080/22423982.2023.2273013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
Reablement aims to enable older persons with functional decline to re-engage in meaningful activities. The benefits of engagement in outdoor activities are significant; however, reablement services primarily target function in indoor environments whereas descriptions of outdoor activities are sparse. The aim of this study was to create a model that integrates outdoor recreation into reablement. We therefore elaborated on an experienced based co-design methodology to create a model that integrates outdoor recreation for older persons in reablement in an Arctic, rural context in northern Norway. Stakeholders (N = 35), including reablement participants, participated in workshops, focus groups, and individual interviews. Based on the results, we co-created a person-centred model for outdoor recreation in reablement, including an assessment tool that can guide reablement staff in goal-setting practices. Accordingly, we argue that cherished locations holds significant meaning in the lives of older people and warrant recognition in reablement programmes. There is a need to evaluate the effects and feasibility of the model and the possibility for its implementation in other health care settings.
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Affiliation(s)
- Marianne Eliassen
- Department of Health and Care Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Bodil A. Sørensen
- Department of Research, Development and Innovation, Municipality of Vestvågøy. Postboks 203, Leknes, Norway
| | - Trude A. Hartviksen
- Department of Health and Care Sciences, UiT, The Arctic University of Norway, Municipality of Vestvågøy. Postboks 203, Leknes, Norway
| | - Solrun Holm
- Department of Research, Development and Innovation, Municipality of Vestvågøy. Postboks 203, Leknes, Norway
| | - Magnus Zingmark
- Department of Epidemiology and Global Health, Faculty of medicine, Umeå University, Umeå, Sweden
- Health and Social Care administration, Municipality of Östersund, Health and Social Care Administration, Östersund, Sweden
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Yoshikawa H, Uzawa H, Ishida T, Asakawa T, Kubo J. Effects of interventions on life-space mobility for community-dwelling older adults: A systematic review and meta-analysis. Geriatr Gerontol Int 2023; 23:842-848. [PMID: 37818711 DOI: 10.1111/ggi.14694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/08/2023] [Accepted: 09/16/2023] [Indexed: 10/12/2023]
Abstract
AIM The present study aimed to conduct a meta-analysis to evaluate the methods and effects of interventions to increase life-space mobility among community-dwelling older adults. METHODS Records were identified through nine databases. Eligible study designs for inclusion in the review were randomized controlled trials of interventions on life-space mobility for community-dwelling older adults. The risk of bias was assessed using the Risk of Bias 2 tool. We followed the Grading of Recommendations, Assessment, Development, and Evaluation approach to summarize the evidence. RESULTS Four studies (558 participants) identified via search strategies were included. Two studies involved individualized exercise and lifestyle interventions. In three out of the four studies, individual interventions were applied. Overall, when compared with a control group, the intervention group was more likely to positively affect increasing life-space mobility (standardized mean difference 0.47, 95% confidence interval [0.020 to 0.92]). The heterogeneity statistic indicated considerable heterogeneity (I2 = 84%). The evidence was downgraded one step owing to imprecision. CONCLUSIONS Interventions on increasing life-space mobility for community-dwelling older adults have a positive effect. Combination interventions may be more effective than single interventions, and individual interventions may be more effective than group interventions. However, owing to the limited number of studies, conducting further research to enhance the generalizability of results is crucial. Additionally, subgroup analysis should be conducted to clarify differences in intervention methods and effects. Geriatr Gerontol Int 2023; 23: 842-848.
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Affiliation(s)
- Hiroki Yoshikawa
- Division of Rehabilitation, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan
| | - Hironobu Uzawa
- Department of Physical Therapy, International University of Health and Welfare, School of Health Sciences at Narita, Narita, Japan
| | - Takeki Ishida
- Department of Physical Therapy, International University of Health and Welfare, School of Health Sciences at Narita, Narita, Japan
| | - Takashi Asakawa
- Division of Rehabilitation, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan
| | - Jin Kubo
- Division of Rehabilitation, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan
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11
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Wang GM, Teng MY, Yu WJ, Ren H, Cui XS. Life-space mobility among community-dwelling older persons: A scoping review. Geriatr Nurs 2023; 54:108-117. [PMID: 37722235 DOI: 10.1016/j.gerinurse.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/24/2023] [Accepted: 08/24/2023] [Indexed: 09/20/2023]
Abstract
To describe and analyze the current research status of life-space mobility of the older persons in community. The literature in PubMed, Web of Science, Cochrane Library, Embase, EBSCOhost, Scopus, OpenGrey, SinoMed, CNKI, WanFang, and VIP databases was computer searched, and the time frame was build to May 23, 2023. A total of 42 literatures were included, including 35 in English and 7 in Chinese, 30 of which were cross-sectional studies. Theoretical models related to spatial mobility included the "concentric circles" model and the "cone" model. 33 literatures reported the prevalence or level of spatial mobility limitations, and 9 assessment instruments were used, The influencing factors can be divided into four categories. 9 literatures reported on the adverse effects, and 9 literatures reported on the prevention and intervention. The limitation of life-space mobility is a common and under-recognized phenomenon among the older persons in the community,with serious adverse effects, complex and diverse influencing factors.
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Affiliation(s)
- Gui-Meng Wang
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China
| | - Meng-Yuan Teng
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China
| | - Wen-Jing Yu
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China
| | - Hui Ren
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China
| | - Xiang-Shu Cui
- School of Nursing, Yanbian University, 977 Park Rood, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China.
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Sugita Y, Ohnuma T, Kogure E, Hara T. Factors associated with life-space mobility restriction in home-care older adults receiving home-visit rehabilitation: A cross-sectional multi-center study in Japan. Geriatr Gerontol Int 2023; 23:722-728. [PMID: 37678841 DOI: 10.1111/ggi.14657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/30/2023] [Accepted: 08/16/2023] [Indexed: 09/09/2023]
Abstract
AIM Life-space mobility (LSM) restriction is a serious issue among older adults using home-visit rehabilitation (HR). This study evaluated physical function, transportation, and other factors not comprehensively tested in previous studies and examined factors associated with the restriction of LSM among older adults using HR. METHODS This cross-sectional multi-center study recruited 88 HR users (49 men, 39 women, mean age 79.0 [±7.8] years) living in urban and rural areas from August to October 2020. We administered the Life-Space Assessment (LSA), the Self-Efficacy Scale on Going out among community-dwelling Elderly (SEGE), grip strength, a 30-s chair stand test, Bedside Mobility Scale, Functional Independence Measure, Frenchay Activities Index (FAI), Ikigai-9, and Home and Community Environment (HACE) test. Participants were divided into two groups based on the cut-off value of the LSA scores. In the logistic regression analysis, the dependent variable was LSA scores ≤30, and the independent variables were measured based on objective evaluation items and adjusted for confounding factors (age, sex, and frequency of use of day-care services). RESULTS Restriction of LSM was significantly associated with FAI (odds ratio [OR] = 0.817, 95% confidence interval [CI] = 0.706-0.945), HACE facilitators (OR = 1.558, 95% CI = 1.168-2.079), and living alone (OR = 12.822, 95% CI = 1.202-136.716). CONCLUSION Restriction of LSM is associated with environmental factors, such as assistive devices and household composition, and ability to engage in instrumental activities of daily living. Our findings indicate a great need for focusing on these factors among home-care older adults receiving HR. Geriatr Gerontol Int 2023; 23: 722-728.
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Affiliation(s)
- Yuta Sugita
- Nishinasuno General Home Care Center, Tochigi, Japan
| | - Takeshi Ohnuma
- Rehabilitation Progress Center Incorporated, Tokyo, Japan
| | | | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi, Japan
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Maresova P, Krejcar O, Maskuriy R, Bakar NAA, Selamat A, Truhlarova Z, Horak J, Joukl M, Vítkova L. Challenges and opportunity in mobility among older adults - key determinant identification. BMC Geriatr 2023; 23:447. [PMID: 37474928 PMCID: PMC10360303 DOI: 10.1186/s12877-023-04106-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Attention is focused on the health and physical fitness of older adults due to their increasing age. Maintaining physical abilities, including safe walking and movement, significantly contributes to the perception of health in old age. One of the early signs of declining fitness in older adults is limited mobility. Approximately one third of 70-year-olds and most 80-year-olds report restrictions on mobility in their apartments and immediate surroundings. Restriction or loss of mobility is a complex multifactorial process, which makes older adults prone to falls, injuries, and hospitalizations and worsens their quality of life while increasing overall mortality. OBJECTIVE The objective of the study is to identify the factors that have had a significant impact on mobility in recent years and currently, and to identify gaps in our understanding of these factors. The study aims to highlight areas where further research is needed and where new and effective solutions are required. METHODS The PRISMA methodology was used to conduct a scoping review in the Scopus and Web of Science databases. Papers published from 2007 to 2021 were searched in November 2021. Of these, 52 papers were selected from the initial 788 outputs for the final analysis. RESULTS The final selected papers were analyzed, and the key determinants were found to be environmental, physical, cognitive, and psychosocial, which confirms the findings of previous studies. One new determinant is technological. New and effective solutions lie in understanding the interactions between different determinants of mobility, addressing environmental factors, and exploring opportunities in the context of emerging technologies, such as the integration of smart home technologies, design of accessible and age-friendly public spaces, development of policies and regulations, and exploration of innovative financing models to support the integration of assistive technologies into the lives of seniors. CONCLUSION For an effective and comprehensive solution to support senior mobility, the determinants cannot be solved separately. Physical, cognitive, psychosocial, and technological determinants can often be perceived as the cause/motivation for mobility. Further research on these determinants can help to arrive at solutions for environmental determinants, which, in turn, will help improve mobility. Future studies should investigate financial aspects, especially since many technological solutions are expensive and not commonly available, which limits their use.
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Affiliation(s)
- Petra Maresova
- Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
| | - Ondrej Krejcar
- Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic.
- Malaysia-Japan International Institute of Technology, Universiti Teknologi Malaysia Kuala Lumpur, Jalan Sultan Yahya Petra, 54100, Kuala Lumpur, Malaysia.
| | | | | | - Ali Selamat
- Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
- Malaysia-Japan International Institute of Technology, Universiti Teknologi Malaysia Kuala Lumpur, Jalan Sultan Yahya Petra, 54100, Kuala Lumpur, Malaysia
| | - Zuzana Truhlarova
- Faculty of Education, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
| | - Jiri Horak
- Faculty of Mining and Geology, VSB-Technical University of Ostrava, 17. Listopadu 2172/15, Ostrava-Poruba, 708 00, Czech Republic
| | - Miroslav Joukl
- Philosophical Faculty, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
| | - Lucie Vítkova
- Philosophical Faculty, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
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Brady B, Zhou S, Ashworth D, Zheng L, Eramudugolla R, Huque MH, Anstey KJ. A Technology-Enriched Approach to Studying Microlongitudinal Aging Among Adults Aged 18 to 85 Years: Protocol for the Labs Without Walls Study. JMIR Res Protoc 2023; 12:e47053. [PMID: 37410527 PMCID: PMC10360017 DOI: 10.2196/47053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Traditional longitudinal aging research involves studying the same individuals over a long period, with measurement intervals typically several years apart. App-based studies have the potential to provide new insights into life-course aging by improving the accessibility, temporal specificity, and real-world integration of data collection. We developed a new research app for iOS named Labs Without Walls to facilitate the study of life-course aging. Combined with data collected using paired smartwatches, the app collects complex data including data from one-time surveys, daily diary surveys, repeated game-like cognitive and sensory tasks, and passive health and environmental data. OBJECTIVE The aim of this protocol is to describe the research design and methods of the Labs Without Walls study conducted between 2021 and 2023 in Australia. METHODS Overall, 240 Australian adults will be recruited, stratified by age group (18-25, 26-35, 36-45, 46-55, 56-65, 66-75, and 76-85 years) and sex at birth (male and female). Recruitment procedures include emails to university and community networks, as well as paid and unpaid social media advertisements. Participants will be invited to complete the study onboarding either in person or remotely. Participants who select face-to-face onboarding (n=approximately 40) will be invited to complete traditional in-person cognitive and sensory assessments to be cross-validated against their app-based counterparts. Participants will be sent an Apple Watch and headphones for use during the study period. Participants will provide informed consent within the app and then begin an 8-week study protocol, which includes scheduled surveys, cognitive and sensory tasks, and passive data collection using the app and a paired watch. At the conclusion of the study period, participants will be invited to rate the acceptability and usability of the study app and watch. We hypothesize that participants will be able to successfully provide e-consent, input survey data through the Labs Without Walls app, and have passive data collected over 8 weeks; participants will rate the app and watch as user-friendly and acceptable; the app will allow for the study of daily variability in self-perceptions of age and gender; and data will allow for the cross-validation of app- and laboratory-based cognitive and sensory tasks. RESULTS Recruitment began in May 2021, and data collection was completed in February 2023. The publication of preliminary results is anticipated in 2023. CONCLUSIONS This study will provide evidence regarding the acceptability and usability of the research app and paired watch for studying life-course aging processes on multiple timescales. The feedback obtained will be used to improve future iterations of the app, explore preliminary evidence for intraindividual variability in self-perceptions of aging and gender expression across the life span, and explore the associations between performance on app-based cognitive and sensory tests and that on similar traditional cognitive and sensory tests. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47053.
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Affiliation(s)
- Brooke Brady
- School of Psychology, University of New South Wales, Randwick, Australia
- University of New South Wales Ageing Futures Institute, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Shally Zhou
- School of Psychology, University of New South Wales, Randwick, Australia
- University of New South Wales Ageing Futures Institute, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Daniel Ashworth
- School of Psychology, University of New South Wales, Randwick, Australia
- University of New South Wales Ageing Futures Institute, University of New South Wales, Sydney, Australia
| | - Lidan Zheng
- School of Psychology, University of New South Wales, Randwick, Australia
- University of New South Wales Ageing Futures Institute, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Ranmalee Eramudugolla
- School of Psychology, University of New South Wales, Randwick, Australia
- University of New South Wales Ageing Futures Institute, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Md Hamidul Huque
- School of Psychology, University of New South Wales, Randwick, Australia
- University of New South Wales Ageing Futures Institute, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Kaarin Jane Anstey
- School of Psychology, University of New South Wales, Randwick, Australia
- University of New South Wales Ageing Futures Institute, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
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Seinsche J, Jansen CP, Roth S, Zijlstra W, Hinrichs T, Giannouli E. Multidimensional interventions to increase life-space mobility in older adults ranging from nursing home residents to community-dwelling: a systematic scoping review. BMC Geriatr 2023; 23:412. [PMID: 37415132 PMCID: PMC10327334 DOI: 10.1186/s12877-023-04118-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 06/19/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Life-space mobility (LSM) is an important aspect of older adults' real-life mobility. Studies have shown that restricted LSM is a risk factor for many adverse outcomes such as low quality of life and mortality. Therefore, an increasing number of interventions aim to enhance LSM. However, the intervention approaches differ in terms of their type/content, duration, targeted populations, but also in terms of their outcome measures and assessment tools. Especially the latter impairs the comparability of studies with otherwise similar interventional approaches and thus also the interpretation of their results. Therefore, this systematic scoping review aims to provide an overview of the intervention components, assessment tools, and effectiveness of studies aiming to improve LSM in older adults. METHODS A systematic literature search was carried out in PubMed and Web of Science. We considered studies in older adults of any design that included an intervention approach and at least one outcome of LSM. RESULTS 27 studies were included in the review. These studies analyzed healthy community-dwelling as well as frail older adults in need of care or rehabilitation and nursing home residents with a mean age between 64 and 89. The percentage of female participants ranged from 3 to 100%. The types of interventions were of the following: physical, counseling, multidimensional, miscellaneous. Multidimensional interventions consisting of physical interventions plus any of the following or a combination of counseling/education/motivation/information appear to be most effective in increasing LSM. Older adults with mobility impairments were more responsive to these multidimensional interventions compared to healthy older adults. Most of the studies used the questionnaire-based Life-Space Assessment to quantify LSM. CONCLUSIONS This systematic scoping review provides a comprehensive overview of a heterogenous stock of literature investigating LSM-related interventions in older adults. Future meta-analyses are needed to provide a quantitative evaluation of the effectiveness of LSM interventions and recommendations.
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Affiliation(s)
- Julia Seinsche
- Department of Health Sciences & Technology, Institute of Human Movement Sciences & Sport, ETH Zurich, Zurich, Switzerland
| | | | - Sandro Roth
- Division of Sports and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Basel, Switzerland
| | - Wiebren Zijlstra
- Institute of Movement & Sport Gerontology, German Sport University Cologne, Cologne, Germany
| | - Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Basel, Switzerland
| | - Eleftheria Giannouli
- Department of Health Sciences & Technology, Institute of Human Movement Sciences & Sport, ETH Zurich, Zurich, Switzerland
- Division of Sports and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Basel, Switzerland
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16
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Oliva A, West JS, Smith SL, Huang RJ, Riska KM. Association Between Hearing Handicap and Life-Space Mobility in a Patient Population. Am J Audiol 2023; 32:360-368. [PMID: 37059051 PMCID: PMC10468117 DOI: 10.1044/2023_aja-22-00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 10/07/2022] [Accepted: 01/21/2023] [Indexed: 04/16/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate the association between self-reported hearing handicap and life-space mobility utilizing the Life-Space Questionnaire (LSQ). Life-space mobility reflects how an individual moves through their daily physical and social environment, and the role of hearing loss in life-space mobility is not fully understood. We hypothesized that those with higher self-reported hearing handicap would be more likely to demonstrate restricted life-space mobility. METHOD A total of 189 older adults (M age = 75.76 years, SD = 5.81) completed a mail-in survey packet including the LSQ and Hearing Handicap Inventory for the Elderly (HHIE). Participants were categorized into one of three groups ("no/none," "mild/moderate," or "severe" hearing handicap) according to HHIE total score. LSQ responses were dichotomized to either "nonrestricted/typical" or "restricted" life-space mobility groups. Logistic regression models were performed to analyze life-space mobility differences among the groups. RESULTS Logistic regression results demonstrated no statistically significant association between hearing handicap and LSQ. CONCLUSIONS The results of this study indicate that there is no association between self-reported hearing handicap and life-space mobility as evaluated using a mail-in version of the LSQ. This counters other studies that have demonstrated that life space is associated with chronic illness, cognitive functioning, and social and health integration.
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Affiliation(s)
| | - Jessica S. West
- Duke Center for the Study of Aging and Human Development, Durham, NC
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Sherri L. Smith
- Department of Head & Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC
- Duke Center for the Study of Aging and Human Development, Durham, NC
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
- Durham Veterans Affairs Health Care System, NC
| | | | - Kristal M. Riska
- Department of Head & Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC
- Duke Center for the Study of Aging and Human Development, Durham, NC
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17
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van Biljon HM, van Niekerk L, Plastow NA, Swanepoel L. Out-of-home life spaces valued by urban older adults with limited income. Afr J Disabil 2023; 12:1177. [PMID: 37293267 PMCID: PMC10244872 DOI: 10.4102/ajod.v12i0.1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/27/2023] [Indexed: 06/10/2023] Open
Abstract
Background Access to, and occupational performance in, out-of-home-life-spaces is linked to health, wellbeing and quality of life for older adults. There is little evidence of how this relates to older adults with limited resources in an African urban context. Objectives To describe the out-of-home-life-spaces accessed and valued by older adults with limited resources, living in an urban South African setting. Method An exploratory concurrent mixed methods study saw 84 rehabilitation clinicians conduct 393 face-to-face interviews with older adults. Clinicians produced reflective field notes and participated in focus groups. Quantitative data were analysed using descriptive statistics with SPSS Version X. Qualitative data were analysed through inductive content analysis. Results Older adults walked, used mini-bus taxis or private vehicles to get to places of worship, medical facilities, shops, family and friends and special interest gatherings on a weekly or monthly frequency. Lack of funds was the main barrier. Older adults aspired to travel, go on holiday and to visit out-of-town family homes. Conclusion Exploring the daily lived experience of older, urban South Africans with limited resources brought to light the value they attribute to participation in activities that contribute to the wellbeing of their families and communities. Such activities are found in a variety of life spaces. Contribution Results could inform policy makers and service providers in their planning of community mobility, transportation services and health care, for older adults with limited resources.
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Affiliation(s)
- Hester M van Biljon
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lana van Niekerk
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nicola A Plastow
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lizette Swanepoel
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Hinrichs T, Rössler R, Infanger D, Weibel R, Schär J, Peters EM, Portegijs E, Rantanen T, Schmidt-Trucksäss A, Engelter ST, Peters N. Self-reported life-space mobility in the first year after ischemic stroke: longitudinal findings from the MOBITEC-Stroke project. J Neurol 2023:10.1007/s00415-023-11748-5. [PMID: 37140729 PMCID: PMC10157571 DOI: 10.1007/s00415-023-11748-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Life-space mobility is defined as the size of the area in which a person moves about within a specified period of time. Our study aimed to characterize life-space mobility, identify factors associated with its course, and detect typical trajectories in the first year after ischemic stroke. METHODS MOBITEC-Stroke (ISRCTN85999967; 13/08/2020) was a cohort study with assessments performed 3, 6, 9 and 12 months after stroke onset. We applied linear mixed effects models (LMMs) with life-space mobility (Life-Space Assessment; LSA) as outcome and time point, sex, age, pre-stroke mobility limitation, stroke severity (National Institutes of Health Stroke Scale; NIHSS), modified Rankin Scale, comorbidities, neighborhood characteristics, availability of a car, Falls Efficacy Scale-International (FES-I), and lower extremity physical function (log-transformed timed up-and-go; TUG) as independent variables. We elucidated typical trajectories of LSA by latent class growth analysis (LCGA) and performed univariate tests for differences between classes. RESULTS In 59 participants (mean age 71.6, SD 10.0 years; 33.9% women), mean LSA at 3 months was 69.3 (SD 27.3). LMMs revealed evidence (p ≤ 0.05) that pre-stroke mobility limitation, NIHSS, comorbidities, and FES-I were independently associated with the course of LSA; there was no evidence for a significant effect of time point. LCGA revealed three classes: "low stable", "average stable", and "high increasing". Classes differed with regard to LSA starting value, pre-stroke mobility limitation, FES-I, and log-transformed TUG time. CONCLUSION Routinely assessing LSA starting value, pre-stroke mobility limitation, and FES-I may help clinicians identify patients at increased risk of failure to improve LSA.
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Affiliation(s)
- Timo Hinrichs
- Division of Sport and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland.
| | - Roland Rössler
- Division of Sport and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
- Basel Mobility Center, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
| | - Denis Infanger
- Division of Sport and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Robert Weibel
- Department of Geography, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Janine Schär
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
- Neurology and Stroke Center, Klinik Hirslanden, Zurich, Switzerland
| | - Eva-Maria Peters
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
| | - Erja Portegijs
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Arno Schmidt-Trucksäss
- Division of Sport and Exercise Medicine, Department of Sport, Exercise, and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Stefan T Engelter
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Nils Peters
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
- Neurology and Stroke Center, Klinik Hirslanden, Zurich, Switzerland
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
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Bai C, Zapata R, Karnati Y, Smail E, Hajduk AM, Gill TM, Ranka S, Manini TM, Mardini MT. Comparisons Between GPS-based and Self-reported Life-space Mobility in Older Adults. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2023; 2022:212-220. [PMID: 37128363 PMCID: PMC10148377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Assessments of Life-space Mobility (LSM) evaluate the locations of movement and their frequency over a period of time to understand mobility patterns. Advancements in and miniaturization of GPS sensors in mobile devices like smartwatches could facilitate objective and high-resolution assessment of life-space mobility. The purpose of this study was to compare self-reported measures to GPS-based LSM extracted from 27 participants (44.4% female, aged 65+ years) who wore a smartwatch for 1-2 weeks at two different site locations (Connecticut and Florida). GPS features (e.g., excursion size/span) were compared to self-reported LSM with and without an indicator for needing assistance. Although correlations between self-reported measures and GPS-based LSM were positive, none were statistically significant. The correlations improved slightly when needing assistance was included, but statistical significance was achieved only for excursion size (r=0.40, P=0.04). The poor correlations between GPS-based and self-reported indicators suggest that they capture different dimensions of life-space mobility.
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Affiliation(s)
- Chen Bai
- University of Florida, Gainesville, Florida, USA
| | - Ruben Zapata
- University of Florida, Gainesville, Florida, USA
| | | | - Emily Smail
- University of Florida, Gainesville, Florida, USA
| | | | | | - Sanjay Ranka
- University of Florida, Gainesville, Florida, USA
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Malouka S, Mayhew AJ, So HY, Raina P, Beauchamp M, Richardson J, Kuspinar A. Sex-stratified reference values for the life-space assessment in the Canadian longitudinal study on aging. Aging Clin Exp Res 2023; 35:1073-1080. [PMID: 36947343 PMCID: PMC10031193 DOI: 10.1007/s40520-023-02382-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND The Life-Space Assessment (LSA) can compliment traditional physical performance measures of mobility by accounting for the interaction between individuals and their environment. However, there are no studies that have generated percentile curves showing sex-stratified reference values in a large population-based sample of community-dwelling adults, making its interpretation difficult. Therefore, this study aimed to establish sex-stratified reference values for the LSA in middle-aged and older Canadians. METHODS Baseline data for participants aged 45-84 years old from the Canadian Longitudinal Study on Aging (CLSA) were used (n = 22,154). Quantile regression was used to estimate specific percentiles, with age as the independent variable and LSA scores as the dependent variable. Models were run for the whole sample, then separately for males and females. The models were cross-validated to assess their reliability. CLSA inflation and analytic weights were applied. RESULTS On average, the sample was 62.5 ± 10.0 y.o. (51.1% males), with a weighted mean LSA score of 89.2 ± 17.0. There was also a decrease in LSA scores with age, where scores were lower for older age groups compared to younger groups, and LSA scores were lower for females relative to males. DISCUSSION AND CONCLUSIONS Reference data will aid in interpreting, comparing, and making inferences related to LSA scores obtained in clinical and research settings for Canadian adults.
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Affiliation(s)
- Selina Malouka
- School of Rehabilitation Science, McMaster University, IAHS, 1400 Main St. W. Room 435, Hamilton, ON, L8S 1C7, Canada
| | - Alexandra Jean Mayhew
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Labarge Centre for Mobility in Aging, McMaster, University, Hamilton, ON, Canada
- McMaster Institute for Research on Aging, McMaster University, Hamilton, ON, Canada
| | - Hon Yiu So
- Department of Mathematics and Statistics, Oakland University, Rochester, MI, USA
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Labarge Centre for Mobility in Aging, McMaster, University, Hamilton, ON, Canada
- McMaster Institute for Research on Aging, McMaster University, Hamilton, ON, Canada
| | - Marla Beauchamp
- School of Rehabilitation Science, McMaster University, IAHS, 1400 Main St. W. Room 435, Hamilton, ON, L8S 1C7, Canada
- McMaster Institute for Research on Aging, McMaster University, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, IAHS, 1400 Main St. W. Room 435, Hamilton, ON, L8S 1C7, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, IAHS, 1400 Main St. W. Room 435, Hamilton, ON, L8S 1C7, Canada.
- McMaster Institute for Research on Aging, McMaster University, Hamilton, ON, Canada.
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Singhal S, Walter LC, Smith AK, Loh KP, Cohen HJ, Zeng S, Shi Y, Boscardin WJ, Presley CJ, Williams GR, Magnuson A, Mohile SG, Wong ML. Change in four measures of physical function among older adults during lung cancer treatment: A mixed methods cohort study. J Geriatr Oncol 2023; 14:101366. [PMID: 36058839 PMCID: PMC9974579 DOI: 10.1016/j.jgo.2022.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Functional outcomes during non-small cell lung cancer (NSCLC) treatment are critically important to older adults. Yet, data on physical function and which measures best capture functional change remain limited. MATERIALS AND METHODS This multisite, mixed methods cohort study recruited adults ≥65 years with advanced NSCLC starting systemic treatment (i.e., chemotherapy, immunotherapy, and/or targeted therapy) with non-curative intent. Participants underwent serial geriatric assessments prior to starting treatment and at one, two, four, and six months, which included the Karnofsky Performance Scale (KPS, range: 0-100%), instrumental activities of daily living (IADL, range: 0-14), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Physical Functioning subscale (EORTC QLQ-C30 PF, range: 0-100), and Life-Space Assessment (LSA, range: 0-120). For all measures, higher scores represent better functioning. In a qualitative substudy, 20 patients completed semi-structured interviews prior to starting treatment and at two and six months to explore how treatment affected their daily functioning. We created joint displays for each interview participant that integrated their longitudinal KPS, IADL, EORTC QLQ-C30 PF, and LSA scores with patient quotes describing their function. RESULTS Among 87 patients, median age was 73 years (range 65-96). Mean pretreatment KPS score was 79% (standard deviation [SD] 13), EORTC QLQ-C30 PF was 69 (SD 23), and LSA was 67 (SD 28); median IADL was 13 (interquartile range [IQR] 10-14). At two months after treatment initiation, 70% of patients experienced functional decline on at least one measure, with only 13% of these patients recovering at six months. At two and six months, decline in LSA was the most common (48% and 35%, respectively). Joint displays revealed heterogeneity in how well each quantitative measure of physical function captured the qualitative patient experience. DISCUSSION Functional decline during NSCLC treatment is common among older adults. LSA is a useful measure to detect subtle functional decline that may be missed by other measures. Given heterogeneity in how well each quantitative measure captures changes in physical function, there is value to including more than one functional measure in geriatric oncology research studies.
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Affiliation(s)
- Surbhi Singhal
- Division of Medical Oncology, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Louise C Walter
- Division of Geriatrics, University of California, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Alexander K Smith
- Division of Geriatrics, University of California, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Kah Poh Loh
- James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Harvey Jay Cohen
- Center for the Study of Aging & Human Development and Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Sandra Zeng
- Division of Hematology/Oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Ying Shi
- Division of Geriatrics, University of California, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - W John Boscardin
- Division of Geriatrics, University of California, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Carolyn J Presley
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Grant R Williams
- Divisions of Hematology/Oncology and Gerontology, Geriatrics, and Palliative Care, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allison Magnuson
- James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Supriya G Mohile
- James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Melisa L Wong
- Division of Geriatrics, University of California, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Division of Hematology/Oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
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22
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What happens behind doors? Exploring everyday indoor activities when ageing in place. J Aging Stud 2023; 64:101109. [PMID: 36868621 DOI: 10.1016/j.jaging.2023.101109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/13/2023] [Accepted: 01/23/2023] [Indexed: 02/05/2023]
Abstract
Engaging in social interaction and physical movement during everyday activities has a positive influence on wellbeing in later life. For older adults who age in place, the majority of activities occur indoors, yet studies typically focus on outdoors. Gender influences social and physical activities but is understudied in an ageing-in-place context. We aim to address these gaps by increasing insight into the indoor activities in later life, with a focus on gender differences in social interaction and physical movement. Through a mixed-methods approach, data were collected using global positioning system (GPS) trackers, pedometers and activity diaries. Twenty community-dwelling older adults (11 women and 9 men) who were living in Lancashire collected these data over seven days. An exploratory spatio-temporal analysis was conducted on the 820 activities they undertook. We discovered that our participants spend large amounts of time indoors. We also found that social interaction increases the duration of the activity and, conversely, decreases levels of physical movement. When zooming in to gender differences, men's activities took significantly longer than women's activities and were characterised by higher level of social interaction. Based on these results, we argue that there is a trade-off between social interaction and physical movement in everyday activities. We suggest establishing a balance between socialising and moving in everyday activities in later life, specifically because maintaining high levels of movement and social interaction at the same time seems unachievable. In conclusion, it is important to design indoor environments that facilitate choice between being active and resting, and between being social and being on one's own rather than assume they are mutually-exclusive and/or universally "good" or "bad" per se.
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23
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Portegijs E, Lee C, Zhu X. Activity-friendly environments for active aging: The physical, social, and technology environments. Front Public Health 2023; 10:1080148. [PMID: 36711401 PMCID: PMC9875594 DOI: 10.3389/fpubh.2022.1080148] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Affiliation(s)
- Erja Portegijs
- Center of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Chanam Lee
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, United States,*Correspondence: Chanam Lee ✉
| | - Xuemei Zhu
- Department of Architecture, Texas A&M University, College Station, TX, United States
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24
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Andrews AW, Vallabhajosula S, Boise S, Bohannon RW. Normal gait speed varies by age and sex but not by geographical region: a systematic review. J Physiother 2023; 69:47-52. [PMID: 36528509 DOI: 10.1016/j.jphys.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/02/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022] Open
Abstract
QUESTIONS What are comfortable gait speed values for apparently healthy adults? How do these differ by age group, sex and geographical region? DESIGN Systematic review of observational studies with meta-analysis. PARTICIPANTS Apparently healthy, community-dwelling adults who have undergone measurement of comfortable gait speed. SEARCH METHOD Potentially relevant studies were identified in four databases. Extracted data from studies that satisfied the eligibility criteria were added to a database containing the same information from a meta-analysis published a decade ago. OUTCOME MEASURES The weighted mean comfortable gait speed was calculated along with the 95% confidence interval for each stratum of age/sex using a random-effects model. Mean gait speeds were further stratified by the continent where the study took place. Tests of homogeneity included I2 and prediction intervals. RESULTS Meta-analysis of data from 51,248 apparently healthy adults was stratified by age (in decades) and sex. Male gait speed slowed beyond age 50 years whereas female gait speed slowed beyond age 30 years. The weighted mean gait speed ranged from 97 cm/s (females aged ≥ 80 years) to 140 cm/s (males aged 40 to 49 years). The I2 values ranged from 0 to 34.07; prediction interval ranges varied from a low of 30 (125 to 155 cm/s; males aged 40 to 49 years) to a high of 77 (83 to 160 cm/s; females aged 60 to 69 years). There was considerable overlap in confidence intervals between continents for each sex/age group. CONCLUSIONS Comfortable gait speed slowed through the adult years, but males maintained a faster walking speed than females. Further stratification of comfortable gait speed by geographical region is not warranted.
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Affiliation(s)
| | | | - Sarah Boise
- Department of Physical Therapy Education, Elon University, Elon, USA
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25
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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] [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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26
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Freytag J, Mishra RK, Street RL, Catic A, Dindo L, Kiefer L, Najafi B, Naik AD. Using Wearable Sensors to Measure Goal Achievement in Older Veterans with Dementia. SENSORS (BASEL, SWITZERLAND) 2022; 22:9923. [PMID: 36560290 PMCID: PMC9782012 DOI: 10.3390/s22249923] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/01/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
Aligning treatment with patients' self-determined goals and health priorities is challenging in dementia care. Wearable-based remote health monitoring may facilitate determining the active participation of individuals with dementia towards achieving the determined goals. The present study aimed to demonstrate the feasibility of using wearables to assess healthcare goals set by older adults with cognitive impairment. We present four specific cases that assess (1) the feasibility of using wearables to monitor healthcare goals, (2) differences in function after goal-setting visits, and (3) goal achievement. Older veterans (n = 17) with cognitive impairment completed self-report assessments of mobility, then had an audio-recorded encounter with a geriatrician and wore a pendant sensor for 48 h. Follow-up was conducted at 4-6 months. Data obtained by wearables augments self-reported data and assessed function over time. Four patient cases illustrate the utility of combining sensors, self-report, notes from electronic health records, and visit transcripts at baseline and follow-up to assess goal achievement. Using data from multiple sources, we showed that the use of wearable devices could support clinical communication, mainly when patients, clinicians, and caregivers work to align care with the patient's priorities.
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Affiliation(s)
- Jennifer Freytag
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| | - Ram Kinker Mishra
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
- BioSensics, Boston, MA 02458, USA
| | - Richard L. Street
- Department of Communications, Texas A&M University, College Station, TX 77843, USA
| | - Angela Catic
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Lilian Dindo
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Lea Kiefer
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Bijan Najafi
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Aanand D. Naik
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Department of Management, Policy and Community Health, School of Public Health, University of Texas Health Science Center, Houston, TX 77030, USA
- UTHealth Consortium on Aging, University of Texas Health Science Center, Houston, TX 77030, USA
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27
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Browne RAV, Cabral LLP, Oliveira GTA, Macêdo GAD, Sócrates J, Silva RDM, Araújo MBF, Freire YA, Costa EC. Life-Space Mobility and Objectively Measured Movement Behavior in Older Adults with Hypertension after Receiving COVID-19 Vaccination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12532. [PMID: 36231832 PMCID: PMC9566032 DOI: 10.3390/ijerph191912532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/10/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
This study examined the changes in life-space (LS) mobility and objectively measured movement behavior in older adults with hypertension after receiving the COVID-19 vaccine and their associations with housing type. A total of 32 participants were included in this exploratory longitudinal study with a 1-year follow-up. LS mobility and accelerometer-based physical activity (PA) and sedentary behavior (SB) were assessed before and ~2 months after receiving COVID-19 vaccination. Participants residing in apartment/row housing showed an increase in LS mobility composite score (β = 14, p < 0.05). In addition, they showed an increase in light PA on weekdays and the weekend (β = 3.5%; β = 6.5%; p < 0.05) and a decrease in SB on weekdays and the weekend (β = -3.7%; β = -6.6%; p < 0.05). Furthermore, changes in SB pattern were found (less time spent in bouts of ≥10 and 30 min, more breaks/day and breaks/hour). Significant associations were found between changes in LS mobility composite score and PA (positive association) and SB (negative association) in older adults residing in apartment/row housing (p < 0.05). Older adults with hypertension, particularly those who resided in houses with limited outdoor space (apartment/row housing), showed positive changes in LS mobility and objectively measured movement behavior in a period after receiving the COVID-19 vaccine and characterized by social distancing policies without mobility restrictions when compared with the period of social distancing policies with high mobility restrictions and without vaccine.
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Affiliation(s)
- Rodrigo A. V. Browne
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil
| | - Ludmila L. P. Cabral
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil
| | - Gledson T. A. Oliveira
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil
| | - Geovani A. D. Macêdo
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
| | - Júlio Sócrates
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil
| | - Raíssa de M. Silva
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
| | - Maria B. F. Araújo
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
| | - Yuri A. Freire
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil
| | - Eduardo C. Costa
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
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28
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Youdan GA, Chihuri ST, Wong CK. Preliminary analysis of reliability and validity of the Life Space Questionnaire as a real-world mobility measure for people with lower limb loss: A technical note. Prosthet Orthot Int 2022; 46:491-495. [PMID: 36215058 PMCID: PMC9551355 DOI: 10.1097/pxr.0000000000000148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 03/23/2022] [Indexed: 02/03/2023]
Abstract
People with lower-limb loss (PLL) often have reduced mobility that translates into limited community access. The Life Space Questionnaire (LSQ) measures a person's real-world mobility within their home environment and community but has not been used among PLL. This study assessed preliminary LSQ test-retest reliability and discriminant validity from subjective and objective balance and walking measures in PLL. In addition, LSQ was hypothesized to have an inverse association with overall health status. Nine subjects were analyzed with mean age 48.2 ± 13.1 years and 4.8 ± 3.9 years' time since amputation. Six had transtibial and three had transfemoral amputations due to diabetes (4), vascular disease (3), and trauma (2). The primary outcome was the LSQ, a 9-level scale quantifying the extent to which people accessed their life space including home, yard, and community. Test-retest reliability for the LSQ was moderate (intraclass coefficient = 0.61 with 90% confidence interval: 0.19-0.87). Discriminant validity from balance and walking function was demonstrated by lack of correlation between LSQ score and the Activities-specific Balance Confidence and Berg Balance Scale and the Prosthetic Evaluation Questionnaire mobility subscale and walking speed (r < 0.50, P > .05). LSQ correlated with health status assessed with the Charlson Comorbidity Index (r = -0.84, P = .005). In this sample of PLL, the LSQ demonstrated moderate test-retest reliability as a measure of real-world mobility distinct as a construct from subjective and objective balance or walking measures. People may access their communities using various levels of assistance and methods of transportation. For this sample of PLL, health status was most strongly associated with LSQ score.
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Affiliation(s)
- Gregory A Youdan
- Columbia University, Teacher's College, New York, NY, USA
- Currently with Brown University, Providence, RI, USA
| | | | - Christopher K Wong
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
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29
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Zhang Y, Zhang X, Li Y, Lin Z, Li X, Tu X, Zhou Y, Qian D, Liu H. The Utilization of Mobile Phones in Health Information Seeking in Rural China. LIBRI 2022. [DOI: 10.1515/libri-2021-0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
This study aims to investigate the mobile phone utilization for health information seeking among adults who are 45 years or older in rural areas in China. Using Andersen’s Behavioral Model (BM), we examine the factors that influence the target group’s behaviors of online health information seeking and contacting healthcare providers via mobile phones. By using stratified sampling method, we conducted a survey among 607 rural adults who were 45 years or older from six villages in Jiangsu Province, China. The results reveal that participants can be excluded from such services for not using a smartphone. eHealth information literacy could serve as a strong influential factor for online health information seeking and contacting healthcare providers via mobile phones. Participants with lower emotional wellbeing are more inclined to seek health information online via mobile phones. The results indicate variables such as utilization of technological devices and eHealth literacy should be included in Andersen’s model when investigating the utilization of mHealth services. This study contributes to the literature on mHealth adoption in rural areas in China and has implications for practitioners to tailor the mHealth service for socio-economically disadvantaged groups.
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Affiliation(s)
- Yao Zhang
- Business School, Nankai University , 121 Baidi Road, Nankai, 300071 , Tianjin , China
| | - Xueying Zhang
- Department of Journalism and Mass Communication , North Carolina Agricultural and Technical State University , 6113 Morgan Ashley Dr. , Greensboro , NC , 27410 , USA
| | - Yuelin Li
- Business School, Nankai University , 121 Baidi Road, Nankai, 300071 , Tianjin , China
| | - Zhenping Lin
- School of Health Policy and Management , Nanjing Medical University , 101 Longmian Avenue, Jiangning, 211166 , Nanjing , Jiangsu , China
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior , University of South Carolina , Columbia , SC , USA
| | - Xiaoming Tu
- Department of Mathematics & Computer Science , School of Basic Medical Science, Nanjing Medical University , Nanjing , China
| | - Yeqin Zhou
- School of Humanities and Social Sciences , Nanjing Medical University , Nanjing , Jiangsu , China
| | - Dongfu Qian
- School of Health Policy and Management , Nanjing Medical University , Nanjing , Jiangsu , China
| | - Huan Liu
- Department of Marketing , Business School, Nankai University , Tianjin , China
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30
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Hashimoto K, Hirashiki A, Oya K, Sugioka J, Tanioku S, Sato K, Ueda I, Itoh N, Kokubo M, Shimizu A, Kagaya H, Kondo I. Life-Space Activities Are Associated with the Prognosis of Older Adults with Cardiovascular Disease. J Cardiovasc Dev Dis 2022; 9:jcdd9100323. [PMID: 36286275 PMCID: PMC9604436 DOI: 10.3390/jcdd9100323] [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: 08/28/2022] [Revised: 09/18/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
Life-space activities are a measure of daily activity level. Here, we examined the association between life-space activities and prognosis in 129 cardiovascular diseases (CVD) patients 65 years of age or older (average age, 79.2 ± 7.6 years; mean left ventricular ejection fraction, 56.7 ± 13.2%) who had been admitted to our hospital for worsening CVD. Subjects were followed, and the primary endpoints were cardiovascular hospitalization and cardiovascular death. Receiver operating characteristic analysis produced a cutoff value for life-space assessment (LSA) score for increased risk of cardiovascular hospitalization for two years of 53.0 points (sensitivity, 55.9%; specificity, 82.1%). Kaplan−Meier analysis using this cutoff value revealed that the rates of cardiovascular hospitalization and cardiovascular death were significantly higher in subjects with an LSA score below the cutoff than in those with a score above the cutoff (both p < 0.001). Cox proportional analysis revealed that low LSA score was independently associated with cardiovascular hospitalization (HR, 2.540; 95% CI, 1.135−5.680; p = 0.023) and cardiovascular death (HR, 15.223; 95% CI, 1.689−137.180; p = 0.015), even after adjusting for age, sex, left ventricular ejection fraction, and log-transformed brain natriuretic peptide level. Thus, life-space activities are associated with prognosis in older adults with CVD.
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Affiliation(s)
- Kakeru Hashimoto
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Akihiro Hirashiki
- Department of Cardiology, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
- Correspondence: ; Tel.: +81-562-46-2311
| | - Koharu Oya
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Junpei Sugioka
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Shunya Tanioku
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Kenji Sato
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Ikue Ueda
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Naoki Itoh
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Manabu Kokubo
- Department of Cardiology, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Atsuya Shimizu
- Department of Cardiology, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Izumi Kondo
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
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31
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Pérez-Trujillo M, Curcio CL, Duque-Méndez N, Delgado A, Cano L, Gomez F. Predicting restriction of life-space mobility: a machine learning analysis of the IMIAS study. Aging Clin Exp Res 2022; 34:2761-2768. [PMID: 36070079 DOI: 10.1007/s40520-022-02227-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/09/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Some studies have employed machine learning (ML) methods for mobility prediction modeling in older adults. ML methods could be a helpful tool for life-space mobility (LSM) data analysis. AIM This study aimed to evaluate the predictive value of ML algorithms for the restriction of life-space mobility (LSM) among elderly people and to identify the most important risk factors for that prediction model. METHODS A 2-year LSM reduction prediction model was developed using the ML-based algorithms decision tree, random forest, and eXtreme gradient boosting (XGBoost), and tested on an independent validation cohort. The data were collected from the International Mobility in Aging Study (IMIAS) from 2012 to 2014, comprising 372 older patients (≥ 65 years of age). LSM was measured by the Life-Space Assessment questionnaire (LSA) with five levels of living space during the month before assessment. RESULTS According to the XGBoost algorithm, the best model reached a mean absolute error (MAE) of 10.28 and root-mean-square error (RMSE) of 12.91 in the testing portion. The variables frailty (39.4%), mobility disability (25.4%), depression (21.9%), and female sex (13.3%) had the highest importance. CONCLUSION The model identified risk factors through ML algorithms that could be used to predict LSM restriction; these risk factors could be used by practitioners to identify older adults with an increased risk of LSM reduction in the future. The XGBoost model offers benefits as a complementary method of traditional statistical approaches to understand the complexity of mobility.
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Affiliation(s)
- Manuel Pérez-Trujillo
- Departamento de Informática y Computación, Facultad de Administración, Grupo GAIA, Universidad Nacional de Colombia, Manizales, Colombia
| | - Carmen-Lucía Curcio
- Research Group in Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Manizales, Colombia.
| | - Néstor Duque-Méndez
- Departamento de Informática y Computación, Facultad de Administración, Grupo GAIA, Universidad Nacional de Colombia, Manizales, Colombia
| | - Alejandra Delgado
- Research Group in Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Manizales, Colombia
| | - Laura Cano
- Research Group in Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Manizales, Colombia
| | - Fernando Gomez
- Research Group in Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Manizales, Colombia
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Fricke M, Morawietz C, Wunderlich A, Muehlbauer T, Jansen CP, Gramann K, Wollesen B. Successful wayfinding in age: A scoping review on spatial navigation training in healthy older adults. Front Psychol 2022; 13:867987. [PMID: 36051192 PMCID: PMC9424919 DOI: 10.3389/fpsyg.2022.867987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Spatial navigation is a complex cognitive function that declines in older age. Finding one’s way around in familiar and new environments is crucial to live and function independently. However, the current literature illustrates the efficacy of spatial navigation interventions in rehabilitative contexts such as pathological aging and traumatic injury, but an overview of existing training studies for healthy older adults is missing. This scoping review aims to identify current evidence on existing spatial navigation interventions in healthy older adults and analyze their efficacy. Methods To identify spatial navigation interventions and assessments and investigate their effectiveness, four electronic databases were searched (Pubmed, Web of Science, CINAHL and EMBASE). Two independent reviewers conducted a screening of title, abstract and full-texts and performed a quality assessment. Studies were eligible if (1) published in English, (2) the full text was accessible, (3) at least one group of healthy older adults was included with (4) mean age of 65 years or older, (5) three or more spatial navigation-related training sessions were conducted and (6) at least one spatial ability outcome was reported. Results Ten studies were included (N = 1,003, age-range 20–95 years, 51.5% female), only healthy older adults (n = 368, mean age ≥ 65) were assessed further. Studies differed in sample size (n = 22–401), type of training, total intervention duration (100 min–50 h), and intervention period (1–16 weeks). Conclusion The spatial navigation abilities addressed and the measures applied to elicit intervention effects varied in quantity and methodology. Significant improvements were found for at least one spatial ability-related outcome in six of 10 interventions. Two interventions achieved a non-significant positive trend, another revealed no measurable post-training improvement, and one study did not report pre-post-differences. The results indicate that different types of spatial navigation interventions improve components of spatial abilities in healthy older adults. The existing body of research does not allow conclusions on transferability of the trained components on everyday life spatial navigation performance. Future research should focus on reproducing and extending the promising approaches of available evidence. From this, valuable insights on healthy aging could emerge. Trial Registration This scoping review was preregistered at Open Science Framework (https://osf.io/m9ab6).
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Affiliation(s)
- Madeleine Fricke
- Department of Biological Psychology and Neuroergonomics, Technical University of Berlin, Berlin, Germany
- *Correspondence: Madeleine Fricke,
| | - Christina Morawietz
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany
| | - Anna Wunderlich
- Department of Biological Psychology and Neuroergonomics, Technical University of Berlin, Berlin, Germany
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany
| | - Carl-Philipp Jansen
- Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
- Clinic for Geriatric Rehabilitation, Robert-Bosch-Krankenhaus Stuttgart, Stuttgart, Germany
| | - Klaus Gramann
- Department of Biological Psychology and Neuroergonomics, Technical University of Berlin, Berlin, Germany
| | - Bettina Wollesen
- Department of Biological Psychology and Neuroergonomics, Technical University of Berlin, Berlin, Germany
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
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Felipe SGB, Parreira Batista P, da Silva CCR, de Melo RC, de Assumpção D, Perracini MR. Impact of COVID-19 pandemic on mobility of older adults: A scoping review. Int J Older People Nurs 2022; 18:e12496. [PMID: 35941278 PMCID: PMC9538411 DOI: 10.1111/opn.12496] [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: 11/15/2021] [Revised: 05/12/2022] [Accepted: 07/03/2022] [Indexed: 01/13/2023]
Abstract
AIMS AND OBJECTIVES To identify the most frequent determinants of contact limitation on older adults' mobility addressed by the recommendations to mitigate mobility limitation during the COVID-19 pandemic and identify the recommendations characteristics and means of dissemination that might guide coping actions. BACKGROUND Measures for physical contact restriction were implemented to prevent COVID-19 spread. These measures directly impacted older people, reducing their mobility, especially outside home environment. Health systems worldwide need to be prepared to implement strategies to mitigate negative effects of reduced mobility in this population. DESIGN Scoping review using Arksey and O'Malley's methodological framework. METHOD Therefore, a scoping review was conducted in LILACS, CINAHL, MEDLINE, WEB OF SCIENCE and SCOPUS databases. Documents and reports with recommendations from government agencies were also consulted. Results were presented in a narrative synthesis based on a conceptual model of mobility proposed by Webber (The Gerontologist, 2010, 50, 443) regarding the most frequently addressed determinants, characteristics of the proposed interventions, and means of dissemination for the older person population. FINDINGS Twenty-eight studies were selected for the final sample. According to Webber's model, most articles (n = 14) presented the impacts on mobility from the perspective of physical determinants, relating this aspect to biological losses in the musculoskeletal system, and a minority assessed mobility in vital spaces, encompassing environmental (n = 3) and financial (n = 1) determinants. Also, the most frequent recommendation was that physical activity promotes maintenance of mobility and prevents the occurrence of adverse results, such as falls, fractures and functional decline. As to dissemination, digital technologies were recognised as a strategy to motivate, instruct and monitor exercise practice to increase mobility in older adults. CONCLUSION The main conditions related to the decline in mobility of older adults during COVID-19 pandemic were physical inactivity and sedentary lifestyle. The practice of physical activity is widespread and needs to be adapted according to individual needs. Finally, digital technologies are essential tools in this period, but other alternatives should also be considered for low-income seniors. IMPLICATIONS FOR PRACTICE It is hoped that the gaps identified through this scoping review can help enhance the discussion on the broader assessment of mobility in older adults and the design of interventions when contact restriction is a reality.
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Affiliation(s)
| | | | | | | | | | - Monica Rodrigues Perracini
- Universidade Estadual de Campinas (UNICAMP)CampinasSão PauloBrazil,Universidade Cidade de São Paulo (UNICID)São PauloSão PauloBrazil
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Chitalu P, Tsui A, Searle SD, Davis D. Life-space, frailty, and health-related quality of life. BMC Geriatr 2022; 22:646. [PMID: 35931955 PMCID: PMC9356461 DOI: 10.1186/s12877-022-03355-2] [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: 01/20/2022] [Accepted: 07/30/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Life-space and frailty are closely linked to health-related quality of life and understanding their inter-relationship could indicate potential intervention targets for improving quality of life. We set out to examine the relationship between frailty and life-space and their relative impact on quality of life measures. METHODS Using cross-sectional data from a population-representative cohort of people aged ≥ 70 years, we assessed quality of life with the EuroQol Health Index tool (5-levels) (EQ-5D-5L). We also undertook a life-space assessment and derived a frailty index. Linear regression models estimated EQ-5D-5L scores (dependent variable) using life-space assessment, frailty index and interactions between them. All models were adjusted by age, sex, lifestyle, and social care factors. RESULTS A higher EQ-5D Index was associated with higher life-space (0.02 per life-space assessment score, 95%CI: 0.01 to 0.03, p < 0.01) and decreasing frailty (-0.1 per SD, 95%CI: -0.1 to -0.1, p < 0.01). There was evidence of an interaction between life-space and frailty, where the steepest gradient for life-space and EQ-5D was in those with the highest frailty (interaction term = 0.02 per SD of frailty, 95%CI: 0.01 to 0.03, p < 0.01). CONCLUSION Individuals with the highest frailty were twice as likely to have higher quality of life in association with a larger life-space. Interventions designed to improve quality of life in frail older people could focus on increasing a person's life-space.
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Affiliation(s)
- Petronella Chitalu
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Alex Tsui
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Samuel D Searle
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, WC1E 7HB, UK.,Division of Geriatric Medicine, Dalhousie University, Nova Scotia, Canada
| | - Daniel Davis
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London, WC1E 7HB, UK
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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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Thiel C, Günther L, Osterhoff A, Sommer S, Grüneberg C. Feasibility of smartphone-supported, combined physical and cognitive activities in the Neighbourhood for stimulating social participation of the elderly. BMC Geriatr 2022; 22:629. [PMID: 35907804 PMCID: PMC9338648 DOI: 10.1186/s12877-022-03303-0] [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: 10/15/2020] [Accepted: 07/15/2022] [Indexed: 11/22/2022] Open
Abstract
Background Combining smartphone-assisted group activities in the neighbourhood and training in physical and cognitive skills may offer the potential to promote social participation and connectedness of older adults. This non-controlled proof-of-concept, retrospectively registered study aimed to determine the feasibility of such an intervention approach, including its evaluation. Methods In two consecutive six-month intervention cycles, 39 community-dwelling adults were provided with weekly smartphone, physical and cognitive training by two tutors. Using a specifically designed app, the participants were also encouraged to join and later self-organise physically and cognitively stimulating activities related to hot spots in their Bochum neighbourhood. Indicators of feasibility were documented. Results The recruitment and assessments took 3 hours per participant. Excluding smartphone support, the preparation and the implementation of the intervention amounted to nine person-hours per week. Six participants dropped out, and 13 did not complete one or more assessments. The participants attended 76 ± 15% of the weekly training sessions. The instructors deemed the programme feasible, but familiarisation with the smartphone and the app was very time-consuming. Twenty-seven of 29 participants reported high overall satisfaction, and 22 agreed that the programme helped them to establish social contacts. The smartphones attracted substantial interest and were used frequently, despite mixed satisfaction with the project-specific app. From baseline to follow-up, the six-minute walking distance, lower extremity strength and moderate to vigorous physical activity, as well as quality of life, were preserved at a high level, while balance performance was significantly improved. Of the 11 tests related to cognitive functioning, 4 tests (a memory test, the Stroop test and 2 tests of verbal fluency) indicated significant improvement. No moderate or serious adverse events occurred in relation to the assessments or the intervention. Conclusions The multimodal approach seems safe and feasible and offers the potential to promote social connectedness, bonds in the residential neighbourhood and smartphone competency, as well as to preserve or improve physical and cognitive functions. Adaptations of the intervention and of the outcome assessments may contribute to better assessment and exploitation of the potential of this approach in a future study involving socially, physically and cognitively less active elderly persons.
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Affiliation(s)
- Christian Thiel
- Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Division of Physiotherapy, Gesundheitscampus 6-8, 44801, Bochum, Germany. .,Faculty of Sports Science, Training and Exercise Science, Ruhr-University, Bochum, Germany.
| | - Liane Günther
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Anke Osterhoff
- Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Speech and Language Therapy Program, Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Sascha Sommer
- Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Speech and Language Therapy Program, Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Christian Grüneberg
- Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Division of Physiotherapy, Gesundheitscampus 6-8, 44801, Bochum, Germany
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Schaller SJ, Kiselev J, Loidl V, Quentin W, Schmidt K, Mörgeli R, Rombey T, Busse R, Mansmann U, Spies C. Prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome assessor-blinded trial. Trials 2022; 23:468. [PMID: 35668532 PMCID: PMC9167908 DOI: 10.1186/s13063-022-06401-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Frailty is expressed by a reduction in physical capacity, mobility, muscle strength, and endurance. (Pre-)frailty is present in up to 42% of the older surgical population, with an increased risk for peri- and postoperative complications. Consequently, these patients often suffer from a delayed or limited recovery, loss of autonomy and quality of life, and a decrease in functional and cognitive capacities. Since frailty is modifiable, prehabilitation may improve the physiological reserves of patients and reduce the care dependency 12 months after surgery. METHODS Patients ≥ 70 years old scheduled for elective surgery or intervention will be recruited in this multicenter, randomized controlled study, with a target of 1400 participants with an allocation ratio of 1:1. The intervention consists of (1) a shared decision-making process with the patient, relatives, and an interdisciplinary and interprofessional team and (2) a 3-week multimodal, individualized prehabilitation program including exercise therapy, nutritional intervention, mobility or balance training, and psychosocial interventions and medical assessment. The frequency of the supervised prehabilitation is 5 times/week for 3 weeks. The primary endpoint is defined as the level of care dependency 12 months after surgery or intervention. DISCUSSION Prehabilitation has been proven to be effective for different populations, including colorectal, transplant, and cardiac surgery patients. In contrast, evidence for prehabilitation in older, frail patients has not been clearly established. To the best of our knowledge, this is currently the largest prehabilitation study on older people with frailty undergoing general elective surgery. TRIAL REGISTRATION ClinicalTrials.gov NCT04418271 . Registered on 5 June 2020. Universal Trial Number (UTN): U1111-1253-4820.
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Affiliation(s)
- Stefan J Schaller
- Department of Anesthesiology and Operative Intensive Care Medicine (CVK/CCM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Chariteplatz 1, 10117, Berlin, Germany
| | - Jörn Kiselev
- Department of Anesthesiology and Operative Intensive Care Medicine (CVK/CCM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Chariteplatz 1, 10117, Berlin, Germany
| | - Verena Loidl
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Wilm Quentin
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
| | - Katrin Schmidt
- Department of Anesthesiology and Operative Intensive Care Medicine (CVK/CCM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Chariteplatz 1, 10117, Berlin, Germany
| | - Rudolf Mörgeli
- Department of Anesthesiology and Operative Intensive Care Medicine (CVK/CCM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Chariteplatz 1, 10117, Berlin, Germany
| | - Tanja Rombey
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
| | - Reinhard Busse
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
| | - Ulrich Mansmann
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Claudia Spies
- Department of Anesthesiology and Operative Intensive Care Medicine (CVK/CCM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Chariteplatz 1, 10117, Berlin, Germany.
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Tran Y, Hashimoto N, Ando T, Sato T, Konishi N, Takeda Y, Akamatsu M. Associations between motorized transport access, out-of-home activities, and life-space mobility in older adults in Japan. BMC Public Health 2022; 22:676. [PMID: 35392850 PMCID: PMC8988112 DOI: 10.1186/s12889-022-13033-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Motorized transport access and out-of-home activities are two potential correlates of Life-space mobility (LSM), a common research topic in mobility studies of older adults. These correlates remain mostly unexplored in previous literature and relating them with LSM can reveal directions for improving the LSM of older adults. METHODS The associations between motorized transport access, out-of-home activities, and LSM were examined using data from 1,333 older adults (mean age = 70.63) living in 15 cities and towns in Japan. LSM was assessed using composite life-space assessment (LSA) scores. Motorized transport access was measured using dummies showing whether a person had car access (divided into five levels) and used public transport (bus and railway), and out-of-home activities were measured using the number of various activities that were conducted during the most recent weekday and weekend day. Generalized linear models were used to assess the associations. RESULTS The sample was dominated by males (74.42%), with more than half of the sample had their own cars. On average, each respondent had four activities during two survey days, and shopping was the most common activity. The results showed that owning a car and using railway, as well as various activities were associated with increased composite LSA scores, whereas no cars or only shared cars in home were associated with decreased composite LSA scores. However, these associations differed between males and females. CONCLUSIONS In this study, different levels of motorized transport access and different types of out-of-home activities were found to associate differently with composite LSA scores. Based on these findings, we suggest that policymakers should provide more transport access, pay more attention to the LSM of older adults with high clinics/hospital activities, and trigger more shopping and daily leisure activities for older adults to improve the LSM of this population.
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Affiliation(s)
- Yen Tran
- The National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan.
| | - Naohisa Hashimoto
- The National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Takafumi Ando
- The National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Toshihisa Sato
- The National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Naoki Konishi
- The National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Yuji Takeda
- The National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Motoyuki Akamatsu
- The National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
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Kwan RYC, Liu JYW, Yin YH, Lee PH, Ng SY, Cheung DSK, Kor PPK, Lam SC, Lo SKL, Yang L, Chan SK, Chiang VCL. Sarcopenia and its association with objectively measured life-space mobility and moderate-to-vigorous physical activity in the oldest-old amid the COVID-19 pandemic when a physical distancing policy is in force. BMC Geriatr 2022; 22:250. [PMID: 35337278 PMCID: PMC8956332 DOI: 10.1186/s12877-022-02861-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 02/16/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction The oldest-old are highly vulnerable to sarcopenia. Physical distancing remains a common and effective infection-control policy to minimize the risk of COVID-19 transmission during the pandemic. Sarcopenia is known to be associated with impaired immunity. Moderate-to-vigorous physical activity (MVPA) and life-space mobility (LSM) are potential strategies for minimizing the risk of sarcopenia. However, a physical distancing policy might jeopardize the practice of MVPA and LSM. The purposes of this study were to identify the prevalence of sarcopenia and examine the association between MVPA and LSM with sarcopenia in the community-dwelling oldest-old during the COVID-19 pandemic. Methods This study employed a cross-sectional and observational design. The study was conducted in 10 community centres for older people in Hong Kong during the period of the COVID-19 pandemic (September to December 2020). Eligible participants were the oldest-old people aged ≥85 years, who were community-dwelling and had no overt symptoms of cognitive impairment or depression. Key variables included sarcopenia as measured by SARC-F, LSM as measured by a GPS built into smartphones, and MVPA as measured by a wrist-worn ActiGraph GT3X+. Variables were described by mean and frequency. A multiple linear regression was employed to test the hypotheses. The dependent variable was sarcopenia and the independent variables included LSM and MVPA. Results This study recruited 151 eligible participants. Their mean age was 89.8 years and the majority of them were female (n = 93/151, 61.6%). The prevalence of sarcopenia was 24.5% (n = 37/151) with a margin of error of 6.86%. MVPA was negatively associated with sarcopenia in older people (β = − 0.002, SE = 0.001, p = 0.029). However, LSM was not associated with sarcopenia. Conclusion The prevalence of sarcopenia in the community-dwelling oldest-old population is high. MVPA is negatively associated with sarcopenia. LSM is unrelated to sarcopenia. Sarcopenia should be recognized and the oldest-old with sarcopenia should be accorded priority treatment during the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02861-7.
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Affiliation(s)
| | - Justina Yat Wa Liu
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. .,Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Yue-Heng Yin
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Paul Hong Lee
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Daphne Sze Ki Cheung
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.,Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Patrick Pui Kin Kor
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | | | - Shirley Ka Lai Lo
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | | | - Vico Chung Lim Chiang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Ryder‐Burbidge C, Wieler M, Nykiforuk CI, Jones CA. Life-Space Mobility and Parkinson's Disease. A Multiple-Methods Study. Mov Disord Clin Pract 2022; 9:351-361. [PMID: 35402649 PMCID: PMC8974890 DOI: 10.1002/mdc3.13406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 01/21/2023] Open
Abstract
Background Life-space mobility (LSM) captures a broad spectrum of mobility in physical and social environments; however, it has not been extensively studied in Parkinson's disease. Using a multiple-methods approach, individual, social and environmental factors that impact LSM were explored in PD. Methods Two hundred twenty-seven participants with PD (n = 113) and a comparative group without PD (n = 114) were recruited from the community. Within a cross-sectional survey, LSM (University of Alabama Birmingham Life-Space Assessment, LSA) was compared in the two groups. Using multiple linear regression, socio-demographics, lifestyle behaviors, medical, mobility and social factors were examined to identify factors that explained LSM. A qualitative narrative inquiry was completed to augment the findings from the survey; 10 participants with PD were interviewed regarding facilitators and barriers to mobility. Results The mean overall LSA-composite score for the PD group was 64.2 (SD = 25.8) and 70.3 (SD = 23.1) for the community comparative group (mean difference = 6 points, 95%CI:-0.4, 12.5) indicating most participants moved independently beyond their neighborhoods. A higher proportion of the PD group required assistance with mobility than the community comparison group. Not driving, receiving caregiving, lower social participation, and lower monthly family finances were associated with restricted LSM in the PD group. Data from qualitative interviews supported quantitative findings and offered insights into the features of the built environment that facilitate and restrict mobility. Conclusion Individual, social and environmental factors are associated with the LSM among persons with PD. Clinicians and policy-makers should include both individual and community-based factors when developing interventions to encourage the LSM of the PD population.
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Affiliation(s)
| | - Marguerite Wieler
- Department of Physical TherapyUniversity of AlbertaEdmontonAlbertaCanada
| | | | - C. Allyson Jones
- School of Public Health, University of AlbertaEdmontonAlbertaCanada,Department of Physical TherapyUniversity of AlbertaEdmontonAlbertaCanada
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41
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Thompson MQ, Jadczak AD, Yu S, Tucker GR, Visvanathan R. Sarcopenia risk in nursing home residents using SARC-F: FIRST study findings. Geriatr Gerontol Int 2022; 22:206-212. [PMID: 35029041 DOI: 10.1111/ggi.14327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/11/2021] [Accepted: 11/20/2021] [Indexed: 12/25/2022]
Abstract
AIM Sarcopenia is a common disorder of loss of muscle mass and function among older adults; however, few studies have examined screening instruments for sarcopenia risk in residential aged care services (RACS). The aims of this study were to measure sarcopenia risk in RACS residents using the SARC-F, describe factors associated with sarcopenia risk and examine the predictive validity of the SARC-F for 12-month mortality. METHODS This was a prospective cohort study carried out in South Australian RACS across 12 sites. In total, 541 residents (mean age 87.7 [7.3] years, 72.6% women) were included in the study. Sarcopenia risk was measured using a modified SARC-F (≥4 point cut point). RESULTS We identified 89.5% (n = 484) of residents at risk of sarcopenia. Significant (P > 0.05) predictors of sarcopenia risk in multivariable analysis included the presence of diabetes (relative risk [RR] = 1.08), classification as most-frail (RR = 1.06) and smaller Nursing Home Life Space Diameter (NHLSD) score (RR = 0.99). Mortality was observed in 20.9% (n = 113) of residents over a 12-month follow-up. Classification as at-risk of sarcopenia was a significant predictor of 12-month mortality; however, it had a poor area under the receiver operator curve (0.56), and a low positive predictive value (23.1%). The best performing cut-point of ≥7 also had poor discriminative ability (under the receiver operator curve = 0.66, positive predictive value = 30.8%). CONCLUSIONS Sarcopenia risk is extremely common among RACS residents and its presence is a significant contributor to 12-month mortality. Low discriminative ability for the SARC-F was noted across multiple cut-off scores for predicting mortality at 12 months. Diabetes management and promoting physical activity and nutrition among RACS residents are likely to influence sarcopenia risk positively. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Mark Q Thompson
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence: Frailty and Healthy Ageing, University of Adelaide, Adelaide, South Australia, Australia
| | - Agathe D Jadczak
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence: Frailty and Healthy Ageing, University of Adelaide, Adelaide, South Australia, Australia
| | - Solomon Yu
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence: Frailty and Healthy Ageing, University of Adelaide, Adelaide, South Australia, Australia.,Adelaide Geriatrics Training & Research with Aged Care (G-TRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Graeme R Tucker
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence: Frailty and Healthy Ageing, University of Adelaide, Adelaide, South Australia, Australia
| | - Renuka Visvanathan
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence: Frailty and Healthy Ageing, University of Adelaide, Adelaide, South Australia, Australia.,Adelaide Geriatrics Training & Research with Aged Care (G-TRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
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42
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Assessing life-space mobility : A systematic review of questionnaires and their psychometric properties. Z Gerontol Geriatr 2022; 55:660-666. [PMID: 35244765 PMCID: PMC9726808 DOI: 10.1007/s00391-022-02035-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/27/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Life-space mobility (LSM), as the extent of mobility within one's environment, is a key for successful aging and has become a relevant concept in gerontology and geriatric research. Adequate assessment instruments are needed to identify older persons with LSM restrictions, and to initiate, adapt or evaluate intervention strategies. OBJECTIVE To systematically identify, describe and analyze the psychometric properties of LSM questionnaires, with a special focus on their availability in the German language. METHODS A systematic literature search was conducted in PubMed, PsycINFO, Cochrane Library, CINAHL, and Web of Science. Studies that examined at least one psychometric property of LSM questionnaires published up to August 2021 were included and evaluated based on the consensus-based standards for the selection of health measurement instruments (COSMIN) guidelines. RESULTS This study included 37 validation studies describing 13 different LSM questionnaires. Methodological quality and comprehensiveness of validations were heterogeneous. Based on comprehensive and high-quality results, four LSM questionnaires stood out: the University of Alabama at Birmingham life-space assessment (UAB-LSA), life-space assessment in persons with cognitive impairment (LSA-CI), interview-based and proxy-based versions of the life-space assessment in institutionalized settings (LSA-IS), all of them available in the German language. CONCLUSION This systematic review provides a concise overview of available LSM questionnaires and their psychometric properties to facilitate the selection for use in clinical practice and research. The UAB-LSA and LSA-CI for community settings and the interview-based or proxy-based LSA-IS for institutional settings were found to be the most appropriate LSM questionnaires.
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Matsuda K, Ariie T, Okoba R, Hamachi N, Suzuki A, Kaneko H, Morita M. Gender Differences in Life-space Mobility-associated Factors and Structures in Community-dwelling Older People. Prog Rehabil Med 2022; 7:20220023. [PMID: 35611094 PMCID: PMC9090662 DOI: 10.2490/prm.20220023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/11/2022] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Kensuke Matsuda
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Takashi Ariie
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Ryota Okoba
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Nozomi Hamachi
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Akari Suzuki
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Hideo Kaneko
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Masaharu Morita
- Department of Physical Therapy, School of Health Sciences at Odawara, International University of Health and Welfare, Kanagawa, Japan
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Liddle J, Ireland D, Krysinska K, Harrison F, Lamont R, Karunanithi M, Kang K, Reppermund S, Sachdev PS, Gustafsson L, Brauer S, Pachana NA, Brodaty H. Lifespace metrics of older adults with mild cognitive impairment and dementia recorded via geolocation data. Australas J Ageing 2021; 40:e341-e346. [PMID: 34698431 DOI: 10.1111/ajag.13007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Lifespace, the physical area in which someone conducts life activities, indicates lived community mobility. This study explored the feasibility of technology-based lifespace measurement for older people with dementia and mild cognitive impairment (MCI), including the generation of a range of lifespace metrics, and investigation of relationships with health and mobility status. METHODS An exploratory study was conducted within a longitudinal observational study. Eighteen older adults (mean age 86.7 years (SD: 3.2); 8 men; 15 MCI), participated. Lifespace metrics were generated from geolocation data (GPS and Bluetooth beacon) collected through a smartphone application for one week (2015-2016). Cognitive and mobility-related outcomes were compared from study data sets at baseline (2005-2007) and 6-year follow-up (2011-2014). RESULTS Lifespace data could be collected from all participants, and metrics were generated including percentage of time at home, maximum distance from home, episodes of travel in a week, days in a week participants left home, lifespace area (daily, weekly and total), indoor lifespace (regions in the home/hour), and a developed lifespace score that combined time, frequency of travel, distance and area. Results indicated a large range of lifespace areas (0.1 - 97.88 km2 ; median 6.77 km2 ) with similar patterns across lifespace metrics. Significant relationships were found between lifespace metrics and concurrent driving status and anteceding scores on the sit-to-stand test (at baseline and follow-up). CONCLUSIONS Further longitudinal exploration of lifespace is required to develop an understanding of the nature of lifespace of older community-dwelling people, and its relationship with health, mobility and well-being outcomes.
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Affiliation(s)
- Jacki Liddle
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Qld, Australia
| | - David Ireland
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Qld, Australia
| | - Karolina Krysinska
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia.,Centre for Mental Health, School of Population and Global Health, University of Melbourne, Melbourne, Vic, Australia
| | - Fleur Harrison
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Robyn Lamont
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Mohan Karunanithi
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Qld, Australia
| | - Kristan Kang
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Simone Reppermund
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Louise Gustafsson
- School of Allied Health Sciences, Griffith University, Brisbane, Qld, Australia
| | - Sandra Brauer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Nancy A Pachana
- School of Psychology, University of Queensland, Brisbane, Qld, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
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45
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Athan V, Bissett M, Boland N, Owen K, Collins J. Engagement of Older Adults in out-of-Home Occupations: Transitioning from Hospital to Home. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2021.1986194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Victoria Athan
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Southport, Australia
| | - Michelle Bissett
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Southport, Australia
| | - Niamh Boland
- Transition Care Program, Metro South Health, Eight Mile Plains, Queensland, Australia
| | - Kasey Owen
- Transition Care Program, Metro South Health, Eight Mile Plains, Queensland, Australia
| | - Jacqueline Collins
- Transition Care Program, Metro South Health, Eight Mile Plains, Queensland, Australia
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46
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Ho LYW, Lai CKY, Ng SSM. Psychometric properties testing of a Cantonese version of the Life-Space Assessment in people with stroke. Sci Rep 2021; 11:20614. [PMID: 34663852 PMCID: PMC8523561 DOI: 10.1038/s41598-021-00140-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 10/07/2021] [Indexed: 12/03/2022] Open
Abstract
The Life-Space Assessment (LSA) advances measurements of mobility by determining the extent of the spatial area in which a person moves in real life. Yet there is no Cantonese version of the LSA. This study aimed to translate and culturally adapt the LSA into Cantonese (C-LSA) and examine its psychometric properties in people with stroke. Psychometric properties were examined in 112 people with stroke. The life-space of stroke survivors was compared with that of healthy older people with and without depressive symptoms. The content validity of the C-LSA was good. The Cronbach’s α was 0.73. The test–retest reliability was 0.95. The standard error of measurement was 4.21 and the minimal detectable change was 11.66, without any ceiling or floor effects in the C-LSA composite score. The composite score correlated significantly with the Fugl-Meyer Assessment of lower extremities score (rs = 0.31), the Five Times Sit-To-Stand time (rs = − 0.43), and the Frenchay Activities Index score (rs = 0.48). People with stroke had significantly lower C-LSA composite scores than healthy older people. Depressive symptoms worsened the composite and assisted life-space scores only of people with stroke. The C-LSA is a reliable and valid tool for measuring life-space in stroke populations.
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Affiliation(s)
- Lily Y W Ho
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Claudia K Y Lai
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China.
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47
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Fricke M, Kruse A, Schwenk M, Jansen CP, Muehlbauer T, Gramann K, Wollesen B. Requirements of a cognitive-motor spatial orientation training for nursing home residents: an iterative feasibility study. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2021. [PMCID: PMC8515784 DOI: 10.1007/s12662-021-00762-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A sedentary lifestyle in nursing home residents is often accompanied with reduced life space mobility and in turn affects satisfaction with life. One of the reasons for this may be limited ability to find one’s way around the care facility and its environment. However, spatial orientation exercises might reduce these problems if they are integrated into an adequate cognitive-motor training. Therefore, we integrated six novel and target group-specific spatial orientation exercises into an established multicomponent cognitive-motor group training for nursing home residents and evaluated its feasibility. Forty nursing home residents (mean age: 87.3 ± 7 years) participated in the spatial orientation cognitive motor training (45–60 min, twice a week over a period of 12 weeks). The main outcomes included the feasibility criteria (adherence, completion time, acceptance, instructions, motor performance, materials/set up, complexity) and first measurements of mobility and satisfaction with life (SPPB [Short Physical Performance Battery], SWLS [Satisfaction with Life Scale]). Adherence increased over time. The increase was associated with the adaptions and modifications of the spatial orientation exercises that were made to meet the participants’ requirements. A positive trend was discerned for mobility and life satisfaction, comparing pre- and posttraining data. In summary, the feasibility analysis revealed that future interventions should consider that (a) instructions of demanding spatial tasks should be accompanied by an example task, (b) trainers should be encouraged to adjust task complexity and materials on an individual basis, (c) acceptance of the training should be promoted among nursing staff, and (d) surroundings with as little disturbance as possible should be selected for training.
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Affiliation(s)
- Madeleine Fricke
- Department of Biological Psychology and Neuroergonomics, TU Berlin, Fasanenstr. 1, 10623 Berlin, Germany
| | - Adele Kruse
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Michael Schwenk
- Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Carl-Philipp Jansen
- Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
- Clinic for Geriatric Rehabilitation, Robert-Bosch-Krankenhaus Stuttgart, Stuttgart, Germany
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany
| | - Klaus Gramann
- Department of Biological Psychology and Neuroergonomics, TU Berlin, Fasanenstr. 1, 10623 Berlin, Germany
| | - Bettina Wollesen
- Department of Biological Psychology and Neuroergonomics, TU Berlin, Fasanenstr. 1, 10623 Berlin, Germany
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
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48
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Mümken SA, Gellert P, Stollwerck M, O'Sullivan JL, Kiselev J. Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults. BMJ Open 2021; 11:e049926. [PMID: 34230022 PMCID: PMC8261868 DOI: 10.1136/bmjopen-2021-049926] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults. DESIGN Cross-sectional validation study. SETTING Two study centres in urban and rural German outpatient hospital settings. PARTICIPANTS In total, N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 years (SD=5.4); 49.4% men). PRIMARY AND SECONDARY OUTCOME MEASURES The final version of the translated LSA-D was related to limitations in activities and instrumental activities of daily living (ADL/iADL) as primary outcome measure (primary hypothesis); and with sociodemographic factors, functional mobility, self-rated health, balance confidence and history of falls as secondary outcome measures to obtain construct validity. Further descriptive measurements of health included hand grip strength, screening of cognitive function, comorbidities and use of transportation. To assess construct validity, correlations between LSA-D and the primary and secondary outcome measures were examined for the total sample, and urban and rural subsamples using bivariate regression and multiple adjusted regression models. Descriptive analyses of LSA-D included different scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure. RESULTS In the multiple adjusted model for the total sample, number of ADL/iADL limitations (β=-0.26; 95% CI=-0.42 to -0.08), Timed Up and Go Test (β=-0.37; 95% CI=-0.68 to -0.14), shared living arrangements (β=0.22; 95% CI=0.01 to 0.44) and history of falls in the past 6 months (β=-0.22; 95% CI=-0.41 to -0.05) showed significant associations with the LSA-D composite score, while living in urban area (β=-0.19; 95% CI=-0.42 to 0.03) and male gender (β=0.15; 95% CI=-0.04 to 0.35) were not significant. CONCLUSION The LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past 4 weeks in ambulant urban and rural settings. TRIAL REGISTRATION NUMBER DRKS00019023.
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Affiliation(s)
- Sandra Angelika Mümken
- Institute of Medical Sociology and Rehabilitation Science, Charité University Medicine Berlin, Berlin, Germany
| | - Paul Gellert
- Institute of Medical Sociology and Rehabilitation Science, Charité University Medicine Berlin, Berlin, Germany
| | - Malte Stollwerck
- Institute of Medical Sociology and Rehabilitation Science, Charité University Medicine Berlin, Berlin, Germany
| | - Julie Lorraine O'Sullivan
- Institute of Medical Sociology and Rehabilitation Science, Charité University Medicine Berlin, Berlin, Germany
| | - Joern Kiselev
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité University Medicine Berlin, Berlin, Germany
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49
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Sverdrup K, Bergh S, Selbæk G, Benth JŠ, Husebø B, Røen IM, Thingstad P, Tangen GG. Exploring life-space in the nursing home. An observational longitudinal study. BMC Geriatr 2021; 21:396. [PMID: 34187380 PMCID: PMC8243900 DOI: 10.1186/s12877-021-02345-0] [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: 11/02/2020] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Traditional performance-based measurements of mobility fail to recognize the interaction between the individual and their environment. Life-space (LS) forms a central element in the broader context of mobility and has received growing attention in gerontology. Still, knowledge on LS in the nursing home (NH) remains sparse. The aim of this study was to identify LS trajectories in people with dementia from time of NH admission, and explore characteristics associated with LS over time. METHODS In total, 583 people with dementia were included at NH admission and assessed biannually for 3 years. LS was assessed using the Nursing Home Life-Space Diameter. Association with individual (age, sex, general medical health, number of medications, pain, physical performance, dementia severity, and neuropsychiatric symptoms) and environmental (staff-to-resident ratio, unit size, and quality of the physical environment) characterises was assessed. We used a growth mixture model to identify LS trajectories and linear mixed model was used to explore characteristics associated with LS over time. RESULTS We identified four groups of residents with distinct LS trajectories, labelled Group 1 (n = 19, 3.5%), Group 2 (n = 390, 72.1%), Group 3 (n = 56, 10.4%), Group 4 (n = 76, 14.0%). Being younger, having good compared to poor general medical health, less severe dementia, more agitation, less apathy, better physical performance and living in a smaller unit were associated with a wider LS throughout the study period. CONCLUSION From NH admission most NH residents' LS trajectory remained stable (Group 2), and their daily lives unfolded within their unit. Better physical performance and less apathy emerged as potentially modifiable characteristics associated with wider LS over time. Future studies are encouraged to determine whether LS trajectories in NH residents are modifiable, and we suggest that future research further explore the impact of environmental characteristics.
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Affiliation(s)
- Karen Sverdrup
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Aldring og Helse, Postboks 2136, 3103, Tønsberg, Norway. .,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway. .,Department of Interdisciplinary Health Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Aldring og Helse, Postboks 2136, 3103, Tønsberg, Norway.,Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Brumunddal, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Aldring og Helse, Postboks 2136, 3103, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Brumunddal, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Bettina Husebø
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway.,Department of Nursing Home Medicine, Bergen, Norway
| | - Irene Mari Røen
- Centre for Development of Institutional and Home Care Services, Innlandet (Hedmark), Norway
| | - Pernille Thingstad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Gro Gujord Tangen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Aldring og Helse, Postboks 2136, 3103, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
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50
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Lach HW. Home Sweet Home: Resources for Promoting Mobility for Aging in Place Across Settings. J Gerontol Nurs 2021; 47:3-6. [PMID: 34039096 DOI: 10.3928/00989134-20210407-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Helen W Lach
- Saint Louis University, Trudy Busch Valentine School of Nursing, St. Louis, Missouri
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