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Mobility in older adults is typically discussed in terms of component maneuvers including analysis of gait and postural instability; activities that depend on mobility such as bathing, dressing, or shopping; or adverse events during mobility such as falls or motor vehicle crashes. None of these approaches reflects a key aspect of mobility—the extent of movement within a person's environment, or life space in the gerontological literature. Here we describe this concept as it applies to mobility and present a questionnaire instrument designed to measure life space in community-dwelling older adults. Results indicate that the Life Space Questionnaire (LSQ) is reliable and has construct and criterion validity in a sample of olderadults. The LSQ can be used to establish the spatial extent of an older person's mobility and may ultimately be useful as an outcome measure in studies evaluating interventions designed to enhance mobility and independence in community-dwelling older populations. In broad terms, mobility refers to a person's purposeful movement through the environment from one place to another. Mobility can be conceptualized as a continuum from bed bound (immobility) on one extreme to making excursions to distant locations on the other extreme. With increasing age, threats to mobility increase in prevalence and include problems such as

Context Motor vehicle crash risk in older drivers is elevated in those with cataract, a condition that impairs vision and is present in half of adults aged 65 years or older. Objective To determine the impact of cataract surgery on the crash risk for older adults in the years following surgery, compared with that of older adults who have cataract but who elect to not have surgery. Design, Setting, and Patients Prospective cohort study of 277 patients with cataract, aged 55 to 84 years at enrollment, who were recruited from 12 eye clinics in Alabama from October 1994 through March 1996, with 4 to 6 years of follow-up (to March 1999). Main Outcome Measure Police-reported motor vehicle crash occurrence involving patients who elected to have surgery compared with those who did not. Results Comparing the cataract surgery group (n=174) with the no surgery group (n=103), the rate ratio for crash involvement was 0.47 (95% confidence interval, 0.23-0.94), adjusting for race and baseline visual acuity and contrast sensitivity. The absolute rate reduction associated with cataract surgery was 4.74 crashes per million miles of travel. Conclusions In our sample, patients with cataract who underwent cataract surgery and intraocular lens implantation had half the rate of crash involvement during the follow-up period compared with cataract patients who did not undergo surgery. Cataract surgery thus may have a previously undocumented benefit for older driver safety, reducing subsequent crash rate.

Older adults' timed performance in everyday tasks is related to various aspects of visual function independent of the influences of other functional and health problems and advanced age. This suggests that TIADL tasks may eventually be useful as performance outcomes in intervention evaluations targeted at reversing vision impairment or minimizing its impact. To understand the relationship between vision impairment and TIADL task performance in older adults, cognitive impairment needs to be taken into account because it has a relatively strong and independent relationship with visual TIADL task performance.