Predictive Validity of the Classification Schema for Functional Mobility Tests in Instrumental Activities of Daily Living Decline Among Older Adults

Shimada, Hiroyuki; Sawyer, Patricia; Harada, Kazuhiro; Kaneya, Satomi; Nihei, Kenji; Asakawa, Yoshinori; Yoshii, Chiharu; Hagiwara, Akiyoshi; Furuna, Taketo; Ishizaki, Tatsuro

doi:10.1016/j.apmr.2009.10.027

Cited by 67 publications

(73 citation statements)

References 23 publications

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“…The current cut-off score is not much different from those found in previous studies with slightly different approaches (LSA 56 and LSA 60). 5,10 As disability in ADL is considered a more advanced form of disability, it is not surprising that the cut-off value we found was slightly lower than those previously found for less severe forms of disability.…”

Section: Discussioncontrasting

confidence: 52%

“…4 The LSA assesses in-home as well as out-of-home mobility, consequently life-space mobility encompasses a range of activities, such as activities of daily living (ADL), and out-of-home activities, such as walking, driving or social activities. 2 When lifespace mobility becomes more limited, theoretically, activity restriction and declining physical activity may lead to a vicious circle of declining health and function, [5][6][7] and eventually, to loss of independence. 8,9 Restrictions in life-space mobility have been suggested as an early indicator of vulnerability to health decline.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Restrictions in life-space mobility have been suggested as an early indicator of vulnerability to health decline. 5,7 Several researchers have aimed to identify critical levels for the LSA that indicate poor health outcomes. According to the authors of the scale, 60 points describes a lifespace that is mainly restricted to the neighborhood area.…”

Section: Introductionmentioning

confidence: 99%

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Identification of Older People at Risk of ADL Disability Using the Life-Space Assessment: A Longitudinal Cohort Study

Portegijs

Rantakokko

Viljanen

et al. 2016

Journal of the American Medical Directors Association

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Running headline: LSA to identify risk for ADL disability 2 Identification of older people at risk of ADL disability using the Life-Space Assessmenta longitudinal cohort study Objectives. Life-space mobility, assessed with the Life-Space Assessment (LSA), reflects an individual's mobility in terms of the spatial area, frequency, and need for assistance. The aims were to study associations between life-space mobility and disability status in activities of daily living (ADL), and to define cut-off scores for baseline LSA and LSA change over time identifying individuals who developed ADL inability during two years of follow-up. Robustness of the cut-off scores was tested accounting for potential confounders.Design. Longitudinal analyses of the "Life-space mobility in old age" cohort study.Setting. Home-based interviews at baseline and phone interviews two years later.Participants. Seven-hundred-fifty-five community-dwelling 75-90-years-old people living in Central Finland.Measurements. LSA score (range 0-120) and ADL disability status (no difficulty, difficulty in ≥1 tasks, or inability in ≥1 tasks) were determined based on self-reports.Results. Participants who developed difficulty or inability in ADL over time presented lower LSA scores at baseline and larger declines compared to those who remained without task difficulty or inability during the follow-up, respectively. Sensitivity and specificity analyses showed that baseline LSA ≤52.3 (0.86 and 0.74, respectively) and LSA decline of >11.7 (0.76 and 0.71, respectively) identified participants who developed ADL inability over the follow-up. Multinomial regression showed that, after adjustment for potential confounders, these cut-off scores increased the odds to develop new difficulty in ADL tasks, and the odds to develop ADL inability among those with baseline difficulty. Conclusion.Our results suggest that restrictions and declines in life-space mobility may be early signs of increasing vulnerability to disability in old age. These longitudinally-defined cut-off points may help to find clinical applications for the LSA.

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Section: Discussioncontrasting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Identification of Older People at Risk of ADL Disability Using the Life-Space Assessment: A Longitudinal Cohort Study

Portegijs

Rantakokko

Viljanen

et al. 2016

Journal of the American Medical Directors Association

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“…Because falls and reduced life-space relate closely to physical performance [21][22][23][24][25] , functional decline 26,27) and frailty 28) in elderly people, we used a self-reported history of falls and life-space assessment (LSA) 24) as outcomes for a precursor index of functional decline.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Age-Associated Changes of Gait and Falls and Life-Space in Elderly People

et al. 2010

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Abstract.[Purpose] The aim of this study was to identify the age-associated changes in gait speed, stride length, cadence and step width, and to examine the relationship between these gait variables with a history of falls and life-space experience among elderly people.[Subjects] The participants were 848 healthy elderly adults (mean age 80 years, range 73-91, 76.8% women) living independently at home. [Methods] Gait speed, stride length, cadence and step width were measured at a normal pace using WalkWay, a device for measuring the distribution of foot pressure during walking. Any history of falls in the previous year was investigated by self-report and a life-space assessment was used to investigate the activity status of the subjects.[Results] Gait speed and stride length decreased markedly from age 85 years in women, and from age 90 years in men. Cadence and step width did not change consistently with aging. Gait speed was associated significantly with a history of falls and with life-space restriction, although these relationships were weak. [Conclusion] Gait speed reduces with age and might reflect a functional decline in elderly people.

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“…Life-space mobility was measured using a Japanese translation of the LSA [14]. The LSA provided a score based on the distance a person reported moving during the 4 weeks before the assessment [10,13].…”

Section: Life-space Assessmentmentioning

confidence: 99%

Comprehensive Physical Function Assessment in Elderly People

Ito¹

2017

Clinical Physical Therapy

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In elderly people with mobility limitations, abnormalities in posture and gait contribute to the greater decline of physical motor function. The aim of the review article was to determine the comprehensive physical motor function assessment. Muscle function was assessed with the grip strength. Gait function was assessed with walking time tests conducted at a normal pace. Balance function was assessed with one-legged standing time. The 6-min walking distance test (6MD) was performed in a 10-m, straight corridor. Walking efficiency during the 6MD trials was measured using the Cosmed K4b2 (Rome, Italy), an indirect calorimetry system specifically designed to measure energy expenditure in nonlaboratory settings. The center of pressure was recorded using a balance board (Wii; Nintendo Co., Ltd., Kyoto, Japan). A vibratory stimulus was applied alternately to two muscles by fixing two vibrators from the vibration device onto the participant's gastrocnemius and lumbar multifidus muscle. These findings show that an assessment affecting postural control under proprioceptive stimulation might be a good indicator of elderly people. Also, the objective assessment of walking efficiency might be important for identifying the risk of external activity limitation or functional limitations among the late elderly.

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Predictive Validity of the Classification Schema for Functional Mobility Tests in Instrumental Activities of Daily Living Decline Among Older Adults

Cited by 67 publications

References 23 publications

Identification of Older People at Risk of ADL Disability Using the Life-Space Assessment: A Longitudinal Cohort Study

Identification of Older People at Risk of ADL Disability Using the Life-Space Assessment: A Longitudinal Cohort Study

Relationship between Age-Associated Changes of Gait and Falls and Life-Space in Elderly People

Comprehensive Physical Function Assessment in Elderly People

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