Abstract
BackgroundThe most common methods for measuring mobility in older adulthood include performance-based tests, such as the Timed-Up-and-Go and gait speed. While these measures have strong predictive validity for adverse outcomes, they are limited to assessing what older adults do in standardized settings, rather than what they do in their daily life. Life-space mobility, which is the ability to move within environments that expand from one’s home to the greater community, has been proposed as a more comprehensive measure of mobility. The aim of this study was to determine the association between modifiable factors and life-space mobility in older adults enrolled in the Canadian Longitudinal Study on Aging (CLSA).MethodsLife-space mobility was measured using the Life Space Index (LSI). Explanatory factors included physical, psychosocial and cognitive determinants, as well as pain, fatigue, driving status, nutrition, body mass index, smoking status, and vision. To estimate the association between the LSI and explanatory variables, univariate and multivariable ordinary least squares regression analyses were performed.ResultsAll adults 65 years and older (n = 12,646) were included in the analysis. Fifty percent were women and the mean age was 73.0 (SD5.7). The mean LSI score was 80.5, indicating that, on average, the sample was able to move outside of their neighborhood independently. All explanatory variables were significantly associated with the LSI except for balance and memory. The top 3 variables that explained the most variation in the LSI were driving, social support and walking speed.ConclusionTo our knowledge, this was the first study to examine the association between life-space mobility and a comprehensive set of modifiable factors that were selected based on a theoretical framework and existing research evidence. This study had two important messages. First, driving, social support and walking speed emerged as the most significant correlates of life-space mobility in older adults. Second, life-space mobility is multifactorial and interventions that are pragmatic in their design and testing are needed that consider the complexity involved. A multi-disciplinary approach to examining life-space mobility in older adults is needed to optimize opportunities for healthy aging and develop strategies that support mobility in older adulthood.
Highlights
The most common methods for measuring mobility in older adulthood include performance-based tests, such as the Timed-Up-and-Go and gait speed
The top 3 variables that explained the most variation in the Life Space Index (LSI) were driving, social support and walking speed followed by Body mass index (BMI), grip strength, smoking, vision, depressive symptoms, pain, nutritional risk, fatigue, executive function, balance and memory
To our knowledge, this was the first study to examine the association between life-space mobility and a comprehensive set of modifiable factors that were carefully selected based on a theoretical framework and existing research evidence
Summary
The most common methods for measuring mobility in older adulthood include performance-based tests, such as the Timed-Up-and-Go and gait speed. But are not limited to the Timed Up and Go [2], gait speed [3], as well as selfreported problems with mobility, including difficulty walking [4] While many of these measures have strong predictive validity for adverse health outcomes [5,6,7], they are focused on specific aspects of physical performance, and fail to recognize the interaction between individuals and their environment. Such measures are limited to assessing what older adults do in standardized conditions, rather than what they are able to do in their everyday life [8]. There has been a call for a more comprehensive conceptualization and corresponding means of measuring mobility [8, 9]
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