Life‐Space Mobility Change Predicts 6‐Month Mortality

Abstract

Background / Objective Limited mobility in the community, measured by life-space, is associated with long-term mortality; but little is known about changes in life-space over time predicting short-term mortality. We examined 6-month change in life-space mobility as a predictor of subsequent 6-month mortality for community-dwelling older adults. Design Prospective cohort study. Setting Community-dwelling older adults from five Alabama counties in the University of Alabama at Birmingham (UAB) Study of Aging. Participants A random sample of 1000 Medicare beneficiaries, stratified by gender, race, and rural/urban residence, recruited between November 1999 and February 2001, followed by telephone interview every 6 months for the subsequent 8.5 years. Interventions None. Measures Mortality data was determined from informant contacts and confirmed by the National Death Index and Social Security Death Index. Life-space was measured at each interview using the UAB Life-Space Assessment, a validated instrument for assessing community mobility. A total of 11,817 6-month life-space change scores were calculated over 8.5 years of follow-up. Generalized linear mixed models were used to test predictors of mortality in subsequent 6-month intervals. Results There were 354 deaths that occurred within 6 months of two sequential life-space assessments. Controlling for age, gender, race, rural/urban residence, and comorbidity, life-space score and life-space decline over the preceding 6-month interval predicted mortality. A 10-point decrease in life-space resulted in a 72% increase in odds of dying over the subsequent 6 months (OR = 1.723, p < 0.001). Conclusions Both life-space score at the beginning of a 6-month interval and life-space decline over 6 months were associated with significant increases in subsequent 6-month mortality. Life-space assessment may assist clinicians to identify older adults at risk for short-term mortality.

Effects of an Intervention to Improve Life-Space Mobility and Self-Efficacy in Patients following Total Knee Arthroplasty

“…22 Restricted life-space mobility is an important risk factor for the development of frailty, 18 cognitive decline, 3,4 and mortality. 6,7,18 Thus, an extended life-space mobility plays an important role in maintaining health and function in patients following TKA. In this study, the LSA score of 83.1 in the control group was lower than in communitydwelling older adults 22 ; however, the LSA score of 96.3 after the event in the intervention group exceeded the score of 91.8 of community-dwelling older adults in Japan.…”

“…1 Restricted life-space mobility in older adults causes disability, 2 cognitive decline, 3,4 loss of independence, 5 and mortality. 6,7 A previous study reported that 61.1% of patients with knee and hip osteoarthritis (OA) have restricted life-space mobility as compared with 10.2% of people in the general population. 8 This restricted life-space mobility in patients with knee OA is associated with knee pain and restricted walking ability.…”

After Three Decades of Study, Hospital‐Associated Disability Remains a Common Problem

“…The current study provides additional details about what components of mobility are impaired after hospitalization, specifically ability to walk a quarter mile, climb stairs, and drive, all of which have the potential to reduce community mobility. Unfortunately, loss of community mobility is also associated with nursing home placement and death, so it is an important marker of function for older adults …”

“…Unfortunately, loss of community mobility is also associated with nursing home placement and death, so it is an important marker of function for older adults. 7,8 The study by Dharmarajan et al 5 also highlights the incomplete recovery from incident disability after hospitalization experienced by many older adults. While the majority of older adults recovered their ADL and IADL abilities, many did not recover.…”

Frequency of Leaving the House and Mortality from Age 70 to 95

“…[2][3][4][5][6][7] Furthermore, reduced life-space mobility has been shown to predict greater mortality at 6 months and 2, 3, and 8 years. [8][9][10][11][12] Frequency of leaving ones house is a simple and easily quantifiable measure that may serve as a real-world surrogate for the more complex measurement of life-space mobility. Frequency of leaving the house was shown to predict subsequent functional status in frail, 13,14 and nonfrail community-dwelling people aged 70 to 78, 15 but a detailed analysis of frequency of leaving the house at different points over the aging trajectory has not been performed.…”