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认知未受损老年人户外行为的多维视角:探究社会人口学、认知及健康相关预测因素的差异效应

A multidimensional view of out-of-home behaviors in cognitively unimpaired older adults: examining differential effects of socio-demographic, cognitive, and health-related predictors.

作者信息

Wettstein Markus, Wahl Hans-Werner, Diehl Manfred K

机构信息

Department of Psychological Ageing Research, Heidelberg University, Heidelberg, Germany.

Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO USA.

出版信息

Eur J Ageing. 2013 Sep 28;11(2):141-153. doi: 10.1007/s10433-013-0292-6. eCollection 2014 Jun.

Abstract

Previous studies on predictors of out-of-home behavior (OOHB) have often neglected the multidimensional nature of this construct. The present study distinguished between two levels of analyzing OOHB: out-of-home mobility seen as single behavioral units (e.g., number of places visited, action range, and walking) versus OOHBs seen as engagement in integrated, larger activity units (e.g., cognitively and physically demanding activities). We examined whether a differential relationship between these levels of OOHBs with established predictors of OOHBs, i.e., socio-demographic variables, cognitive abilities, physical functioning, and depression, exists. A sample of 100 cognitively healthy, community-dwelling adults with a mean age of 70.8 years underwent a multi-method OOHB assessment using GPS- (out-of-home mobility) and questionnaire-based (out-of-home activity engagement) measures. Predictors were assessed based on internationally implemented procedures. Regression analyses showed that walking-based mobility and engagement in physical activities could be predicted by physical functioning, whereas most effects of socio-demographic variables, such as age and gender, and of depression on OOHBs were negligible. At the bivariate level, episodic memory was related to action range, global mobility, and to cognitively demanding activity engagement, but not to walking, whereas executive function was related with physically demanding activity engagement only. However, some of these connections became weaker in the full predictor model. Findings support the notion that it is necessary to assess OOHB as a multiple-indicator construct.

摘要

以往关于户外行为(OOHB)预测因素的研究往往忽视了这一概念的多维度性质。本研究区分了分析户外行为的两个层面:将户外移动性视为单一行为单位(例如,访问的地点数量、行动范围和步行),以及将户外行为视为参与综合的、更大的活动单位(例如,对认知和身体要求较高的活动)。我们研究了户外行为的这些层面与户外行为既定预测因素(即社会人口统计学变量、认知能力、身体功能和抑郁)之间是否存在差异关系。对100名认知健康、居住在社区的成年人进行了抽样,他们的平均年龄为70.8岁,采用基于GPS的(户外移动性)和基于问卷的(户外活动参与度)测量方法进行了多方法户外行为评估。预测因素是根据国际通用程序进行评估的。回归分析表明,身体功能可以预测基于步行的移动性和参与体育活动的情况,而社会人口统计学变量(如年龄和性别)以及抑郁对户外行为的大多数影响可以忽略不计。在双变量层面,情景记忆与行动范围、总体移动性以及对认知要求较高的活动参与度相关,但与步行无关,而执行功能仅与对身体要求较高的活动参与度相关。然而,在完整的预测模型中,其中一些联系变弱了。研究结果支持这样一种观点,即有必要将户外行为评估为一个多指标概念。

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