Abstract
BackgroundTraditional performance-based measurements of mobility fail to recognize the interaction between the individual and their environment. Life-space (LS) forms a central element in the broader context of mobility and has received growing attention in gerontology. Still, knowledge on LS in the nursing home (NH) remains sparse. The aim of this study was to identify LS trajectories in people with dementia from time of NH admission, and explore characteristics associated with LS over time.MethodsIn total, 583 people with dementia were included at NH admission and assessed biannually for 3 years. LS was assessed using the Nursing Home Life-Space Diameter. Association with individual (age, sex, general medical health, number of medications, pain, physical performance, dementia severity, and neuropsychiatric symptoms) and environmental (staff-to-resident ratio, unit size, and quality of the physical environment) characterises was assessed. We used a growth mixture model to identify LS trajectories and linear mixed model was used to explore characteristics associated with LS over time.ResultsWe identified four groups of residents with distinct LS trajectories, labelled Group 1 (n = 19, 3.5%), Group 2 (n = 390, 72.1%), Group 3 (n = 56, 10.4%), Group 4 (n = 76, 14.0%). Being younger, having good compared to poor general medical health, less severe dementia, more agitation, less apathy, better physical performance and living in a smaller unit were associated with a wider LS throughout the study period.ConclusionFrom NH admission most NH residents’ LS trajectory remained stable (Group 2), and their daily lives unfolded within their unit. Better physical performance and less apathy emerged as potentially modifiable characteristics associated with wider LS over time. Future studies are encouraged to determine whether LS trajectories in NH residents are modifiable, and we suggest that future research further explore the impact of environmental characteristics.
Highlights
Traditional performance-based measurements of mobility fail to recognize the interaction between the individual and their environment
Characteristics associated with LS over time In the multiple model, younger age (p < 0.001), having good compared to poor general medical health (p = 0.008), better physical performance (SPPB, p < 0.001), more agitation (NPI agitation) (p = 0.005), less apathy (NPI apathy) (p < 0.001), and living in a smaller unit (p = 0.003) were associated with on average wider LS throughout the study period (Table 3)
Younger age, having good compared to poor general medical health, less severe dementia, better physical performance, less apathy, more agitation, and living in a smaller unit were associated with on average wider LS throughout the study period
Summary
Traditional performance-based measurements of mobility fail to recognize the interaction between the individual and their environment. Life-space (LS) forms a central element in the broader context of mobility and has received growing attention in gerontology. The aim of this study was to identify LS trajectories in people with dementia from time of NH admission, and explore characteristics associated with LS over time. Several studies have examined LS and its associated characteristics in community-dwelling older adults. These indicate that restricted LS is associated with older age, more severe depression, apathy, comorbidity, cognitive impairment, impairments in physical performance, and environmental barriers [7, 11,12,13,14,15]. LS has received scant attention in NH care environments
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
