Life space and mental health: a study of older community-dwelling persons in Australia

Byles, Julie; Leigh, Lucy; Vo, Kha; Forder, Peta; Curryer, Cassie

doi:10.1080/13607863.2014.917607

Cited by 35 publications

(39 citation statements)

References 34 publications

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“…Average composite life-space scores of older women in the current study (55.4) were considerably lower than average scores of older men in a previous study (84.9). 18 It is likely that this reflects the older age distribution of women in the current study (mean age 87.6) than men in the previous study (mean age 79.3) but also suggests a sex-based difference in life-space mobility, as has been noted in previous studies, 8,10,34 and may indicate greater risk of social isolation in older women and thus greater need of older women for social and environmental supports to enable mobility.…”

Section: Discussionsupporting

confidence: 52%

“…Psychological factors may include personality, motivation, and mental health. 10 Environmental factors may include built environment features such as presence of sidewalks, green and blue spaces, destinations of interest, weather, and neighborhood safety. 32,33 To this end, the life-space assessment would be a simple, quick, easy-to-administer proxy for a host of other risk factors for mortality.…”

Section: Discussionmentioning

confidence: 99%

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Life‐Space Mobility and Mortality in Older Women: Prospective Results from the Study of Osteoporotic Fractures

Mackey

Lui

Cawthon

et al. 2016

J American Geriatrics Society

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Objectives To evaluate the relation between life-space mobility (extent, frequency, and independence of movement) and mortality in older women. Design Prospective cohort study. Setting Four U.S. clinical sites. Participants Women (N=1,498) aged 75–102 years (mean 87.6) followed from 2006–2015. Measurements Life-space during the past four weeks was assessed by interview, scored from 0 (daily restriction to bedroom) to 120 (daily trips outside town without assistance), and categorized (0–20, 21–40, 41–60, 61–80, 81–120). All-cause mortality was the primary outcome; noncancer, cardiovascular, cancer, and noncardiovascular noncancer mortality were secondary outcomes. Results Over mean 5.2 years, 842 (56.2%) women died. Unadjusted risk of all-cause mortality was 82.6% among women with the lowest level of life-space (0–20 points) compared to 36.2% among women with the highest level (81–120 points). In multivariable proportional hazards models, there was a strong relation between decreasing life-space and increasing risk of all-cause mortality (Ptrend<0.001). Women with the lowest level of life-space (0–20 points) had 2.4 times higher risk (95% confidence interval (CI) = 1.5,4.0) of all-cause mortality than women with the highest level (81–120 points); women with life-space scores between 21–60 had 1.5 times higher risk of all-cause mortality. Each SD decrease in life-space was associated with a 1.2 times higher risk (95% CI=1.1,1.4) of all-cause mortality. Women unable to travel beyond their neighborhood without assistance had 1.4 times higher (95% CI=1.1,1.7) risk of all-cause mortality. Results were similar for noncancer, cardiovascular, and other mortality and did not change after control for underlying disease or living arrangement. Conclusion Life-space scores of 60 or less were associated with mortality in older women independent of other strong risk factors.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Life‐Space Mobility and Mortality in Older Women: Prospective Results from the Study of Osteoporotic Fractures

Mackey

Lui

Cawthon

et al. 2016

J American Geriatrics Society

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“…Our results confirmed a significant and independent effect of CV diseases, hypertension, diabetes mellitus, hip fracture, malignancy, mental illness, and neurologic disorders on walking difficulty (21,23,(39)(40)(41)(42)(43)(44). However, the effects of these conditions were relatively small after controlling for OA, BMI, and PVD.…”

supporting

confidence: 68%

Impact of Osteoarthritis on Difficulty Walking: A Population‐Based Study

King

Kendzerska

Waugh

et al. 2017

Arthritis Care & Research

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Objective. To assess the relationship of hip and knee osteoarthritis (OA) to walking difficulty. Methods. A population cohort ages ≤55 years recruited from 1996 to 1998 (n = 28,451) completed a standardized questionnaire assessing demographics, health conditions, joint symptoms, and functional limitations, including difficulty walking in the past 3 months. Survey data were linked to health administrative databases; self-report and administrative data were used to identify health conditions. Hip/knee OA was defined as self-reported swelling, pain, or stiffness in a hip or knee lasting ≥6 weeks in the past 3 months without an inflammatory arthritis diagnosis. Using multivariable logistic regression, we examined the determinants of walking difficulty and constructed a clinical nomogram. Results. A total of 18,490 cohort participants were eligible (mean age 68 years, 60% women), and 25% reported difficulty walking. Difficulty walking was significantly and independently associated with older age, female sex, body mass index, and several health conditions. Of the conditions examined, the likelihood of walking difficulty was greatest with hip and knee OA and increased with the number of hip/knee joints affected. The predicted probability of difficulty walking for a 60-year-old middle-income, normal-weight woman was 5-10% with no health conditions, 10-20% with diabetes mellitus and cardiovascular (CV) disease, 40% with OA in 2 hips/knees, 60-70% with diabetes mellitus, CV disease, and OA in 2 hips/knees, and 80% with diabetes mellitus, CV disease, and OA in all hips/knees. Conclusion. In a population cohort, symptomatic hip/knee OA was the strongest contributor to walking difficulty. Given the importance of walking to engagement in physical activity for chronic disease management, greater attention to OA is warranted.

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“…The Life Space Questionnaire, with responses ranging from activity restricted to one's home, porch, yard, neighborhood, town, or beyond within the past week, was used as a complementary assessment of mobility (28)(29)(30). Further, as a surrogate for social interaction that predicts neuropsychological function (28-30), we included this measure to contextualize survivors' post-critical illness experience.…”

Section: Long-term Outcomesmentioning

confidence: 99%

“…We assessed survivors' neuropsychological and physical function, resilience, and health-related quality of life, using a telephone battery of standardized instruments (Table 1) (22)(23)(24)(25)(26)(27)(28)(29)(30)(31). As a telephone-based assessment, we selected instruments that permitted us to identify self-reported impairments in neuropsychological and physical function.…”

Section: Data Collectionmentioning

confidence: 99%

Resilience in Survivors of Critical Illness in the Context of the Survivors’ Experience and Recovery

Maley¹,

et al. 2016

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Rationale: Post-intensive care syndrome (PICS), defined as new or worsening impairment in cognition, mental health, or physical function after critical illness, is an important development in survivors. Although studies to date have focused on the frequency of these impairments, fundamental questions remain unanswered regarding the survivor experience and the impact of the critical illness event on survivor resilience and recovery.Objectives: To examine the association between resilience and neuropsychological and physical function and to contextualize these findings within the survivors' recovery experience. Methods:We conducted a mixed-methods pilot investigation of resilience among 43 survivors from two medical intensive care units (ICUs) within an academic health-care system. We interviewed survivors to identify barriers to and facilitators of recovery in the ICU, on the medical ward, and at home, using qualitative methods. We used a telephone battery of standardized tests to examine resilience, neuropsychological and physical function, and quality of life. We examined PICS in two ways. First, we identified how frequently survivors were impaired in one or more domains 6-12 months postdischarge. Second, we identified how frequently survivors reported that neuropsychological or physical function was worse. Measurements and Main Results:Resilience was low in 28% of survivors, normal in 63% of survivors, and high in 9% of survivors. Resilience was inversely correlated with self-reported executive dysfunction, symptoms of anxiety, depression, and post-traumatic stress disorder, difficulty with self-care, and pain (P , 0.05). PICS was present in 36 survivors (83.7%; 95% confidence interval, 69.3-93.2%), whereas 23 survivors (53.5%; 95% confidence interval, 37.6-68.8%) reported worsening of neuropsychological or physical function after critical illness. We identified challenges along the recovery path of ICU survivors, finding that physical limitations and functional dependence were the most frequent challenges experienced in the ICU, medical ward, and on return to home. Spiritual and family support facilitated recovery. Conclusions:Resilience was inversely correlated with neuropsychological impairment, pain, and difficulty with self-care. PICS was present in most survivors of critical illness, and 54% reported neuropsychological or physical function to be worse, yet resilience was normal or high in most survivors. Survivors experienced many challenges during recovery, while spiritual and family support facilitated recovery.

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Life space and mental health: a study of older community-dwelling persons in Australia

Cited by 35 publications

References 34 publications

Life‐Space Mobility and Mortality in Older Women: Prospective Results from the Study of Osteoporotic Fractures

Life‐Space Mobility and Mortality in Older Women: Prospective Results from the Study of Osteoporotic Fractures

Impact of Osteoarthritis on Difficulty Walking: A Population‐Based Study

Resilience in Survivors of Critical Illness in the Context of the Survivors’ Experience and Recovery

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