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德国生活空间评估(LSA-D)的验证:城市和农村社区居住的老年成年人的横断面验证研究。

Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults.

机构信息

Institute of Medical Sociology and Rehabilitation Science, Charité University Medicine Berlin, Berlin, Germany

Institute of Medical Sociology and Rehabilitation Science, Charité University Medicine Berlin, Berlin, Germany.

出版信息

BMJ Open. 2021 Jul 6;11(7):e049926. doi: 10.1136/bmjopen-2021-049926.

Abstract

OBJECTIVES

To develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults.

DESIGN

Cross-sectional validation study.

SETTING

Two study centres in urban and rural German outpatient hospital settings.

PARTICIPANTS

In total, N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 years (SD=5.4); 49.4% men).

PRIMARY AND SECONDARY OUTCOME MEASURES

The final version of the translated LSA-D was related to limitations in activities and instrumental activities of daily living (ADL/iADL) as primary outcome measure (primary hypothesis); and with sociodemographic factors, functional mobility, self-rated health, balance confidence and history of falls as secondary outcome measures to obtain construct validity. Further descriptive measurements of health included hand grip strength, screening of cognitive function, comorbidities and use of transportation. To assess construct validity, correlations between LSA-D and the primary and secondary outcome measures were examined for the total sample, and urban and rural subsamples using bivariate regression and multiple adjusted regression models. Descriptive analyses of LSA-D included different scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure.

RESULTS

In the multiple adjusted model for the total sample, number of ADL/iADL limitations (β=-0.26; 95% CI=-0.42 to -0.08), Timed Up and Go Test (β=-0.37; 95% CI=-0.68 to -0.14), shared living arrangements (β=0.22; 95% CI=0.01 to 0.44) and history of falls in the past 6 months (β=-0.22; 95% CI=-0.41 to -0.05) showed significant associations with the LSA-D composite score, while living in urban area (β=-0.19; 95% CI=-0.42 to 0.03) and male gender (β=0.15; 95% CI=-0.04 to 0.35) were not significant.

CONCLUSION

The LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past 4 weeks in ambulant urban and rural settings.

TRIAL REGISTRATION NUMBER

DRKS00019023.

摘要

目的

为了测量过去四周内老年人的社区活动能力,我们开发了原始的伯明翰阿拉巴马大学老龄化生活空间评估(LSA-D)的德语版本,并评估了其在城市和农村老年人中的结构有效性。

设计

横断面验证研究。

地点

城市和农村德国门诊医院环境中的两个研究中心。

参与者

共招募了 83 名社区居住的老年人(城市 40 名,农村 43 名;平均年龄 78.5 岁(SD=5.4);49.4%为男性)。

主要和次要结果

翻译后的 LSA-D 与活动和日常生活活动(ADL/iADL)受限有关,作为主要结果测量(主要假设);并与社会人口因素、功能性移动能力、自我评估健康状况、平衡信心和跌倒史作为次要结果测量,以获得结构有效性。健康的进一步描述性测量包括手握力强度、认知功能筛查、合并症和交通方式使用情况。为了评估结构有效性,使用二元回归和多调整回归模型,对总样本以及城市和农村子样本的 LSA-D 与主要和次要结果测量之间进行了相关性检验。LSA-D 的描述性分析包括每个区域的不同评分方法。所有参数均使用非参数引导程序进行估计。

结果

在总样本的多调整模型中,ADL/iADL 受限数量(β=-0.26;95%CI=-0.42 至 -0.08)、计时起立行走测试(β=-0.37;95%CI=-0.68 至 -0.14)、共享居住安排(β=0.22;95%CI=0.01 至 0.44)和过去 6 个月内的跌倒史(β=-0.22;95%CI=-0.41 至 -0.05)与 LSA-D 综合评分呈显著相关,而居住在城市地区(β=-0.19;95%CI=-0.42 至 0.03)和男性(β=0.15;95%CI=-0.04 至 0.35)则不显著。

结论

LSA-D 是一种在城市和农村地区门诊环境中测量过去四周内德国社区居住的老年人生活空间移动能力的有效工具。

试验注册号

DRKS00019023。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b4e/8261868/a63d3a0092b6/bmjopen-2021-049926f01.jpg

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