School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Ontario, Canada.
Psychogeriatrics. 2022 Jul;22(4):553-573. doi: 10.1111/psyg.12848. Epub 2022 May 9.
Although many factors have been associated with mobility among older adults, there is paucity of research that explores the complexity of factors that influence mobility. This review aims to synthesise the available evidence for factors comprising the cognitive, psychological, and social mobility determinants and their associations with mobility self-reported and performance-based outcomes in older adults (60 years). We followed Arksey and O'Malley's five stages of a scoping review and searched PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature and Sociological Abstract databases. Reviewers in pairs independently conducted title, abstract, full-text screening and data extraction. We reported associations by analyses rather than articles because articles reported multiple associations for factors and several mobility outcomes. Associations were categorised as significantly positive, negative, or not significant. We included 183 peer-reviewed articles published in 27 countries, most of which were cross-sectional studies and conducted among community-dwelling older adults. The 183 articles reported 630 analyses, of which 381 (60.5%) were significantly associated with mobility outcomes in the expected direction. For example, older adults with higher cognitive functioning such as better executive functioning had better mobility outcomes (e.g., faster gait speed), and those with poor psychological outcomes, such as depressive symptoms, or social outcomes such as reduced social network, had poorer mobility outcomes (e.g., slower gait speed) compared to their counterparts. Studies exploring the association between cognitive factors, personality (a psychological factor) and self-reported mobility outcomes (e.g., walking for transportation or driving), and social factors and performance-based mobility outcomes in older adults are limited. Understanding the additive relationships between cognitive, psychological, and social factors highlights the complexity of older adults' mobility across different forms of mobility, including independence, use of assistive devices, transportation, and driving.
尽管许多因素与老年人的活动能力有关,但对于影响活动能力的因素的复杂性,研究还很少。本综述旨在综合现有证据,探讨构成认知、心理和社会活动能力决定因素的因素及其与老年人(60 岁及以上)的自我报告和基于表现的活动能力结果之间的关联。我们遵循阿斯基尔和奥马利的范围综述五个阶段,并在 PubMed、EMBASE、PsychINFO、Web of Science、AgeLine、联合和补充医学数据库、护理学和联合健康文献累积索引以及社会学摘要数据库中进行了搜索。审查员成对地独立进行标题、摘要和全文筛选以及数据提取。我们报告了关联,而不是文章,因为文章报告了多个因素和几个活动能力结果的关联。关联被归类为显著正、负或不显著。我们纳入了 183 篇发表在 27 个国家的同行评议文章,其中大多数为横断面研究,对象为居住在社区的老年人。这 183 篇文章报告了 630 项分析,其中 381 项(60.5%)与活动能力结果呈预期方向显著相关。例如,认知功能较高的老年人,如执行功能较好,活动能力结果较好(例如,步行速度较快),而心理结果较差的老年人,如抑郁症状,或社会结果较差的老年人,如社交网络减少,活动能力结果较差(例如,步行速度较慢)与他们的同龄人相比。探索认知因素、个性(心理因素)与自我报告的活动能力结果(例如,步行交通或驾驶)之间的关联,以及社会因素与老年人基于表现的活动能力结果之间的关联的研究有限。了解认知、心理和社会因素之间的附加关系突出了老年人在不同形式的活动能力(包括独立性、使用辅助设备、交通和驾驶)方面的活动能力的复杂性。