Examining the Association between Life-Space Mobility and Cognitive Function in Older Adults: A Systematic Review

Silva, Nileththi A. De; Gregory, Michael; Venkateshan, Shree; Verschoor, Chris P.; Kuspinar, Ayse

doi:10.1155/2019/3923574

Cited by 53 publications

(59 citation statements)

References 72 publications

(233 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Younger age, having good compared to poor general medical health, less severe dementia, better physical performance, less apathy, more agitation, and living in a smaller unit were associated with on average wider LS throughout the study period. Associations with age, comorbidity, and dementia severity are supported by previous studies’ findings of community-dwelling older adults [ 7 , 12 , 14 ]. However, these characteristics are generally not modifiable or reversible.…”

Section: Discussionsupporting

confidence: 78%

“…Group 4 residents were younger, had better physical performance and less severe dementia at admission compared to Group 2 residents. These three characteristics are associated with wider LS levels across populations [ 12 , 13 , 26 , 28 , 29 ]. These residents might have responded well to transitioning to NH care and benefited from the aid, services, and activities provided, facilitating them to increase and maintain their wide LS over time.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Exploring life-space in the nursing home. An observational longitudinal study

et al. 2021

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Exploring life-space in the nursing home. An observational longitudinal study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Modifiable factors were selected using Webber's conceptual framework of life-space mobility [9] and previous research evidence where factors that demonstrated an association with mobility were identified. Factors were categorized in accordance with Webber's framework, including physical [17,18,23], psychosocial [24,25] and cognitive determinants [26], alongside other factors that were highlighted in previous studies, such as pain [27], fatigue [28], driving status [29], nutrition [30,31], body mass index [32], smoking status [33,34] and vision [35].…”

Section: Explanatory Variablesmentioning

confidence: 99%

Modifiable factors related to life-space mobility in community-dwelling older adults: results from the Canadian Longitudinal Study on Aging

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: The most common methods for measuring mobility in older adulthood include performance-based tests, such as the Timed-Up-and-Go and gait speed. While these measures have strong predictive validity for adverse outcomes, they are limited to assessing what older adults do in standardized settings, rather than what they do in their daily life. Life-space mobility, which is the ability to move within environments that expand from one's home to the greater community, has been proposed as a more comprehensive measure of mobility. The aim of this study was to determine the association between modifiable factors and life-space mobility in older adults enrolled in the Canadian Longitudinal Study on Aging (CLSA). Methods: Life-space mobility was measured using the Life Space Index (LSI). Explanatory factors included physical, psychosocial and cognitive determinants, as well as pain, fatigue, driving status, nutrition, body mass index, smoking status, and vision. To estimate the association between the LSI and explanatory variables, univariate and multivariable ordinary least squares regression analyses were performed. Results: All adults 65 years and older (n = 12,646) were included in the analysis. Fifty percent were women and the mean age was 73.0 (SD5.7). The mean LSI score was 80.5, indicating that, on average, the sample was able to move outside of their neighborhood independently. All explanatory variables were significantly associated with the LSI except for balance and memory. The top 3 variables that explained the most variation in the LSI were driving, social support and walking speed. Conclusion: To our knowledge, this was the first study to examine the association between life-space mobility and a comprehensive set of modifiable factors that were selected based on a theoretical framework and existing research evidence. This study had two important messages. First, driving, social support and walking speed emerged as the most significant correlates of life-space mobility in older adults. Second, life-space mobility is multifactorial and interventions that are pragmatic in their design and testing are needed that consider the complexity involved. A multidisciplinary approach to examining life-space mobility in older adults is needed to optimize opportunities for healthy aging and develop strategies that support mobility in older adulthood.

show abstract

“…However, in general, studies do agree that decreased cognitive skills impede moving in larger outdoor spaces. In addition, studies like De Silva et al (2019) [90] also describe an opposite effect stating that a reduced, homogenous life-space without special cognitive, auditory, or visual stimuli causes a decline in cognitive abilities with one LSA score of 41 points seemingly being the cut-off value leading to a steeper decline of cognition.…”

Section: Skillsmentioning

confidence: 99%

Motility in Frail Older Adults: Operationalization of a New Framework and First Insights into Its Relationship with Physical Activity and Life-Space Mobility: An Exploratory Study

Seinsche

Zijlstra

Giannouli

2020

IJERPH

View full text Add to dashboard Cite

In order to design effective interventions to prevent age-related mobility loss, it is important to identify influencing factors. The concept of “motility” by Kaufmann et al. subdivides such factors into three categories: “access”, “skills”, and “appropriation”. The aim of this study was to assemble appropriate quantitative assessment tools for the assessment of these factors in frail older adults and to get first insights into their relative contribution for life-space and physical activity-related mobility. This is an exploratory cross-sectional study conducted with twenty-eight at least prefrail, retired participants aged 61–94. Life-space mobility was assessed using the “University of Alabama at Birmingham Life-space Assessment” (LSA) and physical activity using the “German Physical Activity Questionnaire” (PAQ50+). Factors from the category “appropriation”, followed by factors from the category “skills” showed the strongest associations with the LSA. Factors from the category “access” best explained the variance for PAQ50+. This study’s findings indicate the importance of accounting for and examining comprehensive models of mobility. The proposed assessment tools need to be explored in more depth in longitudinal studies with larger sample sizes in order to yield more conclusive results about the appropriateness of the motility concept for such purposes.

show abstract

Examining the Association between Life-Space Mobility and Cognitive Function in Older Adults: A Systematic Review

Cited by 53 publications

References 72 publications

Exploring life-space in the nursing home. An observational longitudinal study

Exploring life-space in the nursing home. An observational longitudinal study

Modifiable factors related to life-space mobility in community-dwelling older adults: results from the Canadian Longitudinal Study on Aging

Motility in Frail Older Adults: Operationalization of a New Framework and First Insights into Its Relationship with Physical Activity and Life-Space Mobility: An Exploratory Study

Contact Info

Product

Resources

About