Nishinasuno General Home Care Center, Tochigi, Japan.
Rehabilitation Progress Center Incorporated, Tokyo, Japan.
Geriatr Gerontol Int. 2023 Oct;23(10):722-728. doi: 10.1111/ggi.14657. Epub 2023 Sep 7.
Life-space mobility (LSM) restriction is a serious issue among older adults using home-visit rehabilitation (HR). This study evaluated physical function, transportation, and other factors not comprehensively tested in previous studies and examined factors associated with the restriction of LSM among older adults using HR.
This cross-sectional multi-center study recruited 88 HR users (49 men, 39 women, mean age 79.0 [±7.8] years) living in urban and rural areas from August to October 2020. We administered the Life-Space Assessment (LSA), the Self-Efficacy Scale on Going out among community-dwelling Elderly (SEGE), grip strength, a 30-s chair stand test, Bedside Mobility Scale, Functional Independence Measure, Frenchay Activities Index (FAI), Ikigai-9, and Home and Community Environment (HACE) test. Participants were divided into two groups based on the cut-off value of the LSA scores. In the logistic regression analysis, the dependent variable was LSA scores ≤30, and the independent variables were measured based on objective evaluation items and adjusted for confounding factors (age, sex, and frequency of use of day-care services).
Restriction of LSM was significantly associated with FAI (odds ratio [OR] = 0.817, 95% confidence interval [CI] = 0.706-0.945), HACE facilitators (OR = 1.558, 95% CI = 1.168-2.079), and living alone (OR = 12.822, 95% CI = 1.202-136.716).
Restriction of LSM is associated with environmental factors, such as assistive devices and household composition, and ability to engage in instrumental activities of daily living. Our findings indicate a great need for focusing on these factors among home-care older adults receiving HR. Geriatr Gerontol Int 2023; 23: 722-728.
生活空间移动(LSM)受限是接受居家康复(HR)治疗的老年人面临的一个严重问题。本研究评估了身体功能、交通等之前研究中未全面测试的因素,并探讨了与接受 HR 的老年人 LSM 受限相关的因素。
这是一项横断面多中心研究,于 2020 年 8 月至 10 月期间招募了 88 名接受 HR 的老年人(男性 49 名,女性 39 名,平均年龄 79.0[±7.8]岁),他们居住在城市和农村地区。我们使用生活空间评估(LSA)、社区居住老年人外出自我效能量表(SEGE)、握力、30 秒椅站测试、床边移动量表、功能独立性测量(FIM)、法国活动指数(FAI)、生活意义量表(Ikigai-9)和居家和社区环境(HACE)测试对参与者进行评估。根据 LSA 评分的截断值将参与者分为两组。在逻辑回归分析中,因变量为 LSA 评分≤30,自变量根据客观评估项目进行测量,并根据年龄、性别和日间护理服务使用频率进行了混杂因素调整。
LSM 受限与 FAI(比值比 [OR] = 0.817,95%置信区间 [CI] = 0.706-0.945)、HACE 促进因素(OR = 1.558,95%CI = 1.168-2.079)和独居(OR = 12.822,95%CI = 1.202-136.716)显著相关。
LSM 受限与环境因素(如辅助器具和家庭构成)和进行工具性日常生活活动的能力有关。我们的研究结果表明,对于接受 HR 的居家老年患者,需要重点关注这些因素。国际老年医学杂志 2023;23:722-728。