Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,USA.
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania,USA.
J Gerontol A Biol Sci Med Sci. 2023 May 11;78(5):811-820. doi: 10.1093/gerona/glac185.
Objective measures of community mobility are advantageous for capturing movement outside the home. Compared with subjective, self-reported techniques, global positioning system (GPS) technologies leverage passive, real-time location data to reduce recall bias and increase measurement precision. We developed methods to quantify community mobility among community-dwelling older adults and assessed how GPS-derived indicators relate to clinical measures of physical and cognitive performance.
Participants (n = 149; M ± standard deviation [SD] = 77.1 ± 6.5 years) from the program to improve mobility in aging (PRIMA) study, a physical therapy intervention to improve walking ability, carried a GPS device for 7 days. Community mobility was characterized by assessing activity space, shape, duration, and distance. Associations between GPS-derived indicators and cognition and physical function were evaluated using Spearman correlations.
In adjusted models, a larger activity space, greater duration (eg, time out-of-home), and greater distance traveled from home were correlated with better 6-Minute Walk Test performance (ρ = 0.17-0.23, p's < .05). A more circular activity shape was related to poorer performance on the Trail Making Test, Part A (ρ = 0.18, p < .05). More time out-of-home and a larger activity space were correlated with faster times on the Trail Making Test, Part B (ρ = -0.18 to -0.24, p's < .05). Community mobility measures were not associated with global cognition, skilled walking, or usual gait speed.
GPS-derived community mobility indicators capture real-world activity among older adults and were correlated with clinical measures of executive function and walking endurance. These findings will guide the design of future interventions to promote community mobility.
社区流动性的客观测量有利于捕捉家庭以外的活动。与主观的、自我报告的技术相比，全球定位系统（GPS）技术利用被动、实时的位置数据减少回忆偏差，提高测量精度。我们开发了量化社区内居住的老年人社区流动性的方法，并评估了 GPS 衍生指标与身体和认知表现的临床测量结果之间的关系。
来自改善老龄化移动能力计划（PRIMA）研究的参与者（n=149；平均年龄±标准差为 77.1±6.5 岁），该研究是一项旨在通过物理治疗来提高行走能力的干预措施，他们携带 GPS 设备 7 天。通过评估活动空间、形状、持续时间和距离来描述社区流动性。使用 Spearman 相关系数评估 GPS 衍生指标与认知和身体功能之间的关联。
在调整后的模型中，更大的活动空间、更长的持续时间（例如，离家时间）和离家更远的距离与 6 分钟步行测试表现更好相关（ρ=0.17-0.23，p<0.05）。活动形状更圆与 Trail Making Test，Part A 表现更差相关（ρ=0.18，p<0.05）。更多的离家时间和更大的活动空间与 Trail Making Test，Part B 的更快时间相关（ρ=-0.18 至-0.24，p<0.05）。社区流动性测量结果与整体认知、熟练行走或正常步速无关。
GPS 衍生的社区流动性指标捕捉了老年人的真实活动，与执行功能和行走耐力的临床测量结果相关。这些发现将指导未来促进社区流动性的干预措施的设计。
