Bayat Sayeh, Naglie Gary, Rapoport Mark J, Stasiulis Elaine, Widener Michael J, Mihailidis Alex
Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.
KITE Research Institute, Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
Gerontology. 2022;68(1):106-120. doi: 10.1159/000515391. Epub 2021 Apr 23.
An active lifestyle may protect older adults from cognitive decline. Yet, due to the complex nature of outdoor environments, many people living with dementia experience decreased access to outdoor activities. In this context, conceptualizing and measuring outdoor mobility is of great significance. Using the global positioning system (GPS) provides an avenue for capturing the multi-dimensional nature of outdoor mobility. The objective of this study is to develop a comprehensive framework for comparing outdoor mobility patterns of cognitively intact older adults and older adults with dementia using passively collected GPS data.
A total of 7 people with dementia (PwD) and 8 cognitively intact controls (CTLs), aged 65 years or older, carried a GPS device when travelling outside their homes for 4 weeks. We applied a framework incorporating 12 GPS-based indicators to capture spatial, temporal, and semantic dimensions of outdoor mobility.
Despite a small sample size, the application of our mobility framework identified several significant differences between the 2 groups. We found that PwD participated in more medical-related (Cliff's Delta = 0.71, 95% CI: 0.34-1) and fewer sport-related (Cliff's Delta = -0.78, 95% CI: -1 to -0.32) activities compared to the cognitively intact CTLs. Our results also suggested that longer duration of daily walking time (Cliff's Delta = 0.71, 95% CI: 0.148-1) and longer outdoor activities at night, after 8 p.m. (Hedges' g = 1.42, 95% CI: 0.85-1.09), are associated with cognitively intact individuals.
Based on the proposed framework incorporating 12 GPS-based indicators, we were able to identify several differences in outdoor mobility in PwD compared with cognitively intact CTLs.
积极的生活方式可能会保护老年人免受认知能力下降的影响。然而，由于户外环境的复杂性，许多痴呆症患者参与户外活动的机会减少。在这种情况下，对户外移动性进行概念化和测量具有重要意义。使用全球定位系统（GPS）为捕捉户外移动性的多维性质提供了一条途径。本研究的目的是开发一个综合框架，用于使用被动收集的GPS数据比较认知功能正常的老年人和患有痴呆症的老年人的户外移动模式。
共有7名65岁及以上的痴呆症患者（PwD）和8名认知功能正常的对照者（CTLs）在离家外出时佩戴GPS设备，为期4周。我们应用了一个包含12个基于GPS的指标的框架来捕捉户外移动性的空间、时间和语义维度。
尽管样本量较小，但我们的移动性框架的应用确定了两组之间的几个显著差异。我们发现，与认知功能正常的CTLs相比，PwD参与更多与医疗相关的活动（Cliff's Delta = 0.71，95%CI：0.34 - 1），而参与与运动相关的活动较少（Cliff's Delta = -0.78，95%CI：-1至-0.32）。我们的结果还表明，每日步行时间较长（Cliff's Delta = 0.71，95%CI：0.148 - 1）以及晚上8点以后的户外活动时间较长（Hedges' g = 1.42，95%CI：0.85 - 1.09）与认知功能正常的个体有关。
基于所提出的包含12个基于GPS的指标的框架，我们能够确定PwD与认知功能正常的CTLs在户外移动性方面的几个差异。
