Predictors of real-life mobility in community-dwelling older adults: an exploration based on a comprehensive framework for analyzing mobility

Abstract

BackgroundReduced mobility is associated with a plethora of adverse outcomes. To support older adults in maintaining their independence, it first is important to have deeper knowledge of factors that impact on their mobility. Based on a framework that encompasses demographical, environmental, physical, cognitive, psychological and social domains, this study explores predictors of different aspects of real-life mobility in community-dwelling older adults.MethodsData were obtained in two study waves with a total sample of n = 154. Real-life mobility (physical activity-based mobility and life-space mobility) was assessed over one week using smartphones. Active and gait time and number of steps were calculated from inertial sensor data, and life-space area, total distance, and action range were calculated from GPS data. Demographic measures included age, gender and education. Physical functioning was assessed based on measures of cardiovascular fitness, leg and handgrip strength, balance and gait function; cognitive functioning was assessed based on measures of attention and executive function. Psychological and social assessments included measures of self-efficacy, depression, rigidity, arousal, and loneliness, sociableness, perceived help availability, perceived ageism and social networks. Maximum temperature was used to assess weather conditions on monitoring days.ResultsMultiple regression analyses indicated just physical and psychological measures accounted for significant but rather low proportions of variance (5–30%) in real-life mobility. Strength measures were retained in most of the regression models. Cognitive and social measures did not remain as significant predictors in any of the models.ConclusionsIn older adults without mobility limitations, real-life mobility was associated primarily with measures of physical functioning. Psychological functioning also seemed to play a role for real-life mobility, though the associations were more pronounced for physical activity-based mobility than life-space mobility. Further factors should be assessed in order to achieve more conclusive results about predictors of real-life mobility in community-dwelling older adults.

Motility in Frail Older Adults: Operationalization of a New Framework and First Insights into Its Relationship with Physical Activity and Life-Space Mobility: An Exploratory Study

“…In addition, a high number of age-specific performance-based tests and questionnaires were selected and used in order to operationalize the concept of motility and served as predictors of LSA and PAQ50+. So far, just four studies examined a comparable range of possible determination factors [6,[28][29][30]. Regarding LSM, the results indicate an association of appropriation followed by skills; however, an association of access could not be proven.…”

“…Kaufmann's "motility" framework was operationalized using assessment tools specifically validated for use in older adults. The operationalization strategy was based on our previous work [6] and an additional literature review aiming to find determinants of real-life mobility (especially for older adults) and afterwards on creating a large pool of assessment tools meeting the inclusion criteria. Apart from two assessments (EAMQ and SAQ, for which own translations, verified by back translation were used for this study) all other questionnaires were already available in the German language and all tests showed acceptable to good psychometric qualities.…”

“…The domains of physical activity in real life can broadly be classified into occupational physical activity, sports, conditioning, household, and other activities [5]; (these all comprise mobility-related activities such as walking). Further important aspects of a person's mobility in real life are captured by the so-called life-space mobility (LSM) [6,7]. LSM describes the physical and social environment a person visits in real life.…”

“…Besides, studies that did focus on real-life mobility have merely analyzed mobility-related physical activity or LSM and motility at a time (e.g., [22,26,27]). All of the few studies [6,[28][29][30] that applied a comprehensive mobility framework used the one by Webber et al (2010). These studies showed that only a small proportion of variance in real-life mobility was explained by the selected multidomain factors.…”

“…These studies showed that only a small proportion of variance in real-life mobility was explained by the selected multidomain factors. What is more, these studies have assessed either healthy older adults without mobility limitations [6,30], or older adults suffering from severe neurological or cognitive disorders [29]. Kaufmann's "motility" concept, which can potentially deliver a better insight in mobility (determinants) in old age, has so far only been used in qualitative studies [31][32][33][34], with working-aged adults [35,36] or with non-frail older adults [37,38].…”