<p>Life-Space Mobility in the Elderly: Current Perspectives</p>

Abstract

Life-space mobility (LSM) is a concept for assessing patterns of functional mobility over time. LSM is gaining traction in the research of geriatric population health. Several instruments have been developed to measure LSM, such as the University of Alabama at Birmingham Life-Space Assessment (LSA) or the Nursing Home Life-Space Diameter instrument. There has been exponential growth in the use of instruments measuring LSM in studies of older adults since the concept was introduced in 1985. In response to the increased volume of publications with clinical applicability to those working in geriatric health or conducting population-based research in older adults, we conducted a narrative review: a) to provide a summary of the articles that have assessed validation of the University of Alabama at Birmingham LSA instrument, the most widely used instrument to assess LSM in older adults; and b) to provide a summary of the research articles that have examined LSM as independent or outcome variable. Studies for this review were obtained with an organized search format and were included if they were published in the past 20 years, written in English, published in peer-reviewed literature, and included LSM as an independent or outcome variable. Seventy-nine articles were identified: 36 that employed a cross-sectional design and 22 that employed a longitudinal/prospective design to examine LSM as outcome variable; 17 longitudinal/prospective design articles that examined LSM as primary independent variable; 3 review articles; and 1 systematic review. Areas of research included physical function, cognitive function, sensory impairment, mental health, falls, frailty, comorbidities, healthcare use, mortality, and social/environmental factors. These studies showed that LSM instruments can accurately predict morbidity, mortality, and healthcare use.

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

“…Of the four groups, Group 3 residents started with the widest LS but progressed to a substantial decline over time. Compared to Group 2, residents in Group 3 were younger and had better physical performance at baseline, characteristics positively associated with LS in NH residents [ 26 , 28 , 29 ] and community-dwelling older adults [ 7 , 11 ]. LS in NHs is strongly determined by daily routines and activities [ 26 ], which should facilitate a stable wide LS in this group.…”

“…Several studies have examined LS and its associated characteristics in community-dwelling older adults. These indicate that restricted LS is associated with older age, more severe depression, apathy, comorbidity, cognitive impairment, impairments in physical performance, and environmental barriers [ 7 , 11 – 15 ]. Further, restricted LS can predict healthcare utilization [ 16 ], nursing-home (NH) admission [ 17 ], falls [ 18 ], and mortality [ 19 , 20 ].…”

Driving habits, cognition, and health-related quality of life in middle-aged and older adults with HIV

“…This association between frequent driving and increased social functioning is particularly relevant since active engagement in social activities is a key component of successful aging (Cosco et al, 2013;Fazeli et al, 2020). Previous studies measuring mobility and life space, or the size of a person's physical and social environment, have shown that limited life space is associated with older age, low income, and rural residence (Johnson et al, 2020;Peel et al, 2005). Further, people lacking driving mobility are less likely to travel within and beyond their city (i.e., have limited life space), whether due to age-related physical limitations, less access to public transportation, or lack of disposable income for activities (Peel et al, 2005).…”

Psychometric Properties of the Proxy-Reported Life-Space Assessment in Institutionalized Settings (LSA-IS-Proxy) for Older Persons with and without Cognitive Impairment

“…Since the concept of LSM was introduced in 1985 by May [ 10 ], it is increasingly being used to characterize the status or time course of LSM impairment, or to initiate, adjust and evaluate therapies or interventions. Several instruments have been developed to measure LSM in older adults [ 11 ]; however, with a focus on community-dwelling older persons [ 12 ].…”