Abstract
Life-space mobility (LSM) is a holistic measure of resilience to physical decline and social isolation in later life. To promote its use as an outcome in geriatric studies and in clinical practice, this review paper explains the concept of LSM; outlines available questionnaires for LSM assessment, provides an overview of associations between LSM and other outcomes, and discusses emerging methods to measure LSM using wearable sensors. Based on performed activity around a central geographical anchor, LSM aims to quantify the observed contraction of daily activities associated with ageing. Several questionnaires are available to assess LSM in different contexts: the University of Alabama Life-Space Assessment and the Life-Space Questionnaire (community settings), the Nursing Home Life-Space Diameter (nursing home settings) and Life Space at Home (for house-bound populations). Some studies using GPS trackers to calculate life-space parameters reported promising results. Although these techniques reduce data collection burden, battery life and older people’s willingness to wear a tracker require further improvement before they can be used more widely. Regardless of the assessment method used, LSM was associated with measures of functional and cognitive abilities, nursing home admission and mortality. The current availability of instruments, the ongoing development of less burdensome data collection techniques, and evidence of construct validity support a case for promoting integration of LSM assessments into geriatric research studies and clinical practice. Ultimately, this will provide a more holistic view on older people’s health and wellbeing.
Highlights
The maintenance of an active lifestyle and social participation in older age is fundamental for overall wellbeing
Life-space mobility (LSM) aims to provide a more holistic measure of resilience to physical decline and social isolation in later life [2], with life space describing the physical and social environment a person inhabits on a day-to-day basis
LSM is graded on a numerical scale and reflects the way in which a person moves across life-space zones over a given time period, while incorporating the frequency and independence of these movements
Summary
MrOS The Osteoporotic Fractures in Men Study, SAOS The South Australian Omnibus Survey, E-SAS The Elderly Status Assessment Set, UAB University of Alabama at Birmingham Study of Ageing, LISPE Life-Space Mobility in Old Age Study, IMIAS International Mobility in Aging Study, ACTIVE Advanced Cognitive Training for Independent and Vital Elderly, WHAS-1 The Women’s Health and Aging Study I, MAP Rush Memory and Aging Project, MARS The Minority Aging Research Study, Nordic RCTNordic multi-centre study on physical and daily activities for residents in nursing home settings, REDNICNH Recourse Use and Disease Course in dementia—Nursing Home study a Self-report used with modified versions only b Some modified versions have adapted to include this c Some modified versions have expanded this d Modified version used. The LSH assessment was designed to measure LSM for housebound older people only It was developed and validated by Hashidate et al [29], who included 20 housebound community-dwelling older people undergoing a home-care rehabilitation programme. Four unique life-space ‘destinations’ within the participant’s home are defined (for example, entrance, dining room, bathroom, and toilet), and a measurement of distance between each destination and the participant’s bedroom is taken. This makes the assessment relatively complex, and may limit the instrument’s use outside a research context. As with the NHLSD questionnaire, scores will be influenced by the availability of assistive services, LSM score will be more dependent on external factors than in regular community settings
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