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

Abstract

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.

Life‐Space Mobility and Cognitive Decline Among Mexican Americans Aged 75 Years and Older

“…5 Life-space mobility measured by a multidimensional self-reported instrument, refers to a person's ability to move in their environment within a specific time period (e.g., within a day, week, or month), has been found to be associated with physical performance, disability, falls, fractures, physical activity, quality of life, and mortality. [6][7][8][9][10] Several studies have examined the effect of life-space mobility and cognitive function in non-Hispanic whites and African Americans. [11][12][13] For example, Crowe and colleagues found that greater life-space mobility was associated with reduced cognitive decline over 4 years of follow-up.…”

Changes in objectively measured outdoor time and physical, psychological, and cognitive function among older adults with cognitive impairments

“…Most previous studies indicating the health benefits of going outdoors have measured going outdoors only by self-report (8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Except for one study (25), the associations of objective outdoor time and health outcomes were examined using cross-sectional designs (21)(22)(23)(24).…”

“…Since going outdoors does not require any special knowledge, motivation, cost, or time, it would be easier for older adults to incorporate going outdoors into their daily lives than other health behaviors such as exercise and smoking cessation. Previous studies have reported that going outdoors, housebound status, and life space are associated with various health outcomes, including mortality (8,9), instrumental/basic activities of daily living (10-13), cognitive function (14)(15)(16), and psychological health (10,17). Some studies have also indicated that influences of going outdoors on health outcomes differ with older adults' characteristics, such as gender (13); their belief in personal control (14); and physical status (15).…”

“…Moreover, current findings about the health benefits of going outdoors, homebound status, and life-space mobility are predominantly obtained by self-reported measurements (8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Because a Global Positioning System (GPS) can accurately record the location of an individual at every moment, recent gerontology studies (18)(19)(20)(21)(22)(23) have used it to measure transportation patterns among older adults.…”

Clinical big data and deep learning: Applications, challenges, and future outlooks

“…Here, we list six public datasets that are used commonly in clinical studies and contain different types of clinical data (see Table 1). Some of them focus on specific diseases such as the Alzheimer's Disease Neuroimaging Initiative (ADNI) [69,70] , Osteoarthritis Initiative (OAI) [71] , and Study of Osteoporotic Fractures (SOF) [72] . Some of them collectd specific data type.…”