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在尼日利亚社区居住的老年人中,使用自我报告和基于表现的活动能力结果来测试韦伯综合活动能力框架。

Testing the Webber's Comprehensive Mobility Framework Using Self-Reported and Performance-Based Mobility Outcomes Among Community-Dwelling Older Adults in Nigeria.

作者信息

Nwachuwku Ernest C, Rayner Daniel, Ibekaku Michael C, Uduonu Ekezie C, Ezema Charles I, Kalu Michael E

机构信息

Emerging Researchers & Professionals in Aging- African Network, Nigeria and Canada.

Faculty of Health Science, McMaster University, Hamilton, Ontario, Canada.

出版信息

Innov Aging. 2023 Mar 1;7(3):igad019. doi: 10.1093/geroni/igad019. eCollection 2023.

Abstract

BACKGROUND AND OBJECTIVES

In 2010, Webber and colleagues conceptualized the interrelationships between mobility determinants, and researchers tested Webber's framework using data from developed countries. No studies have tested this model using data from developing nations (e.g., Nigeria). This study aimed to simultaneously explore the cognitive, environmental, financial, personal, physical, psychological, and social influences and their interaction effects on the mobility outcomes among community-dwelling older adults in Nigeria.

RESEARCH DESIGN AND METHODS

This cross-sectional study recruited 227 older adults (mean age [standard deviation] = 66.6 [6.8] years). Performance-based mobility outcomes included gait speed, balance, and lower extremity strength, and were assessed using the Short Physical Performance Battery, whereas the self-reported mobility outcomes included inability to walk 0.5 km, 2 km, or climb a flight of stairs, assessed using the Manty Preclinical Mobility Limitation Scale. Regression analysis was used to determine the predictors of mobility outcomes.

RESULTS

The number of comorbidities (physical factor) negatively predicted all mobility outcomes, except the lower extremity strength. Age (personal factor) negatively predicted gait speed (β = -0.192), balance (β = -0.515), and lower extremity strength (β = -0.225), and a history of no exercise (physical factor) positively predicted inability to walk 0.5 km ( = 1.401), 2 km ( = 1.295). Interactions between determinants improved the model, explaining the most variations in all the mobility outcomes. Living arrangement is the only factor that consistently interacted with other variables to improve the regression model for all mobility outcomes, except balance and self-reported inability to walk 2 km.

DISCUSSION AND IMPLICATIONS

Interactions between determinants explain the most variations in all mobility outcomes, highlighting the complexity of mobility. This finding highlighted that factors predicting self-reported and performance-based mobility outcomes might differ, but this should be confirmed with a large data set.

摘要

背景与目的

2010年,韦伯及其同事对行动能力决定因素之间的相互关系进行了概念化,研究人员使用来自发达国家的数据对韦伯的框架进行了测试。尚无研究使用来自发展中国家(如尼日利亚)的数据对该模型进行测试。本研究旨在同时探讨认知、环境、经济、个人、身体、心理和社会影响及其对尼日利亚社区居住老年人行动能力结果的交互作用。

研究设计与方法

这项横断面研究招募了227名老年人(平均年龄[标准差]=66.6[6.8]岁)。基于表现的行动能力结果包括步态速度、平衡能力和下肢力量,使用简短身体表现电池进行评估,而自我报告的行动能力结果包括无法行走0.5公里、2公里或爬一段楼梯,使用曼蒂临床前行动能力受限量表进行评估。采用回归分析来确定行动能力结果的预测因素。

结果

共病数量(身体因素)对除下肢力量外的所有行动能力结果均有负面预测作用。年龄(个人因素)对步态速度(β=-0.192)、平衡能力(β=-0.515)和下肢力量(β=-0.225)有负面预测作用,而无运动史(身体因素)对无法行走0.5公里(=1.401)、2公里(=1.295)有正面预测作用。决定因素之间的相互作用改善了模型,解释了所有行动能力结果中最大的变异。居住安排是唯一一个始终与其他变量相互作用以改善所有行动能力结果回归模型的因素,但平衡能力和自我报告的无法行走2公里除外。

讨论与启示

决定因素之间的相互作用解释了所有行动能力结果中最大的变异,凸显了行动能力的复杂性。这一发现突出表明,预测自我报告和基于表现的行动能力结果的因素可能不同,但这一点应通过大数据集加以证实。

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