School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Health Sciences North Research Institute, Sudbury, Ontario, Canada.
BMC Geriatr. 2020 Jan 31;20(1):35. doi: 10.1186/s12877-020-1431-5.
The most common methods for measuring mobility in older adulthood include performance-based tests, such as the Timed-Up-and-Go and gait speed. While these measures have strong predictive validity for adverse outcomes, they are limited to assessing what older adults do in standardized settings, rather than what they do in their daily life. Life-space mobility, which is the ability to move within environments that expand from one's home to the greater community, has been proposed as a more comprehensive measure of mobility. The aim of this study was to determine the association between modifiable factors and life-space mobility in older adults enrolled in the Canadian Longitudinal Study on Aging (CLSA).
Life-space mobility was measured using the Life Space Index (LSI). Explanatory factors included physical, psychosocial and cognitive determinants, as well as pain, fatigue, driving status, nutrition, body mass index, smoking status, and vision. To estimate the association between the LSI and explanatory variables, univariate and multivariable ordinary least squares regression analyses were performed.
All adults 65 years and older (n = 12,646) were included in the analysis. Fifty percent were women and the mean age was 73.0 (SD5.7). The mean LSI score was 80.5, indicating that, on average, the sample was able to move outside of their neighborhood independently. All explanatory variables were significantly associated with the LSI except for balance and memory. The top 3 variables that explained the most variation in the LSI were driving, social support and walking speed.
To our knowledge, this was the first study to examine the association between life-space mobility and a comprehensive set of modifiable factors that were selected based on a theoretical framework and existing research evidence. This study had two important messages. First, driving, social support and walking speed emerged as the most significant correlates of life-space mobility in older adults. Second, life-space mobility is multifactorial and interventions that are pragmatic in their design and testing are needed that consider the complexity involved. A multi-disciplinary approach to examining life-space mobility in older adults is needed to optimize opportunities for healthy aging and develop strategies that support mobility in older adulthood.
衡量老年人活动能力最常用的方法包括基于表现的测试，如计时起立行走和步速。虽然这些测量方法对不良后果具有很强的预测效度，但它们仅限于评估老年人在标准化环境中做什么，而不是他们在日常生活中做什么。生活空间移动能力，即能够在从家庭扩展到更大社区的环境中移动的能力，已被提出作为衡量移动能力的更全面的指标。本研究的目的是确定可改变因素与参加加拿大老龄化纵向研究（CLSA）的老年人生活空间移动能力之间的关系。
使用生活空间指数（LSI）测量生活空间移动能力。解释因素包括身体、心理社会和认知决定因素，以及疼痛、疲劳、驾驶状况、营养、体重指数、吸烟状况和视力。为了估计 LSI 与解释变量之间的关联，进行了单变量和多变量普通最小二乘回归分析。
所有 65 岁及以上的成年人（n=12646）均纳入分析。50%为女性，平均年龄为 73.0（SD5.7）。LSI 平均得分为 80.5，表明样本平均能够独立在社区外移动。除了平衡和记忆外，所有解释变量与 LSI 均显著相关。解释 LSI 变化最多的前 3 个变量是驾驶、社会支持和步行速度。
据我们所知，这是第一项研究，探讨了生活空间移动能力与基于理论框架和现有研究证据选择的一组可改变因素之间的关联。本研究有两个重要信息。首先，驾驶、社会支持和步行速度是老年人生活空间移动能力的最重要相关因素。其次，生活空间移动能力是多因素的，需要设计和测试务实的干预措施，考虑到所涉及的复杂性。需要采取多学科方法来研究老年人的生活空间移动能力，以优化健康老龄化的机会，并制定支持老年人移动能力的策略。
