Abstract
Mobility is essential to maintaining independence for older adults. This systematic review aimed to summarize evidence about self-reported risk factors for self-reported mobility decline; and to provide an overview of published prognostic models for self-reported mobility decline among community-dwelling older adults. Databases were searched from inception to June 2, 2020. Studies were screened by two independent reviewers who extracted data and assessed study quality. Sixty-one studies (45,187 participants) were included, providing information on 107 risk factors. High-quality evidence and moderate/large effect sizes for the association with mobility decline were found for older age beyond 75 years, the presence of widespread pain, and mobility modifications. Moderate-high quality evidence and small effect sizes were found for a further 21 factors. Three model development studies demonstrated acceptable model performance, limited by high risk of bias. These findings should be considered in intervention development, and in developing a prediction instrument for practical application.
Highlights
Mobility is defined as “the ability to move oneself within community environments that expand from one’s home, to the neighborhood, and to regions beyond” (Webber, Porter, & Menec, 2010)
Consolidated evidence of self-reported risk factors contributing to self-reported mobility decline is needed to inform clinical decision making and to inform the development of a prognostic tool to help clinicians and researchers identify older adults at risk of mobility decline
(via OVID), PsycINFO, and CINAHL databases to identify studies that assessed the predictive value of selfreported risk factors on self-reported mobility decline
Summary
Mobility is defined as “the ability to move oneself within community environments that expand from one’s home, to the neighborhood, and to regions beyond” (Webber, Porter, & Menec, 2010). Maintaining mobility is fundamental to aging well for older adults (Guralnik et al, 1993). Mobility may be assessed using objective or self-reported measures. Potential risk factors for mobility decline may be measured objectively or by self-report. Consolidated evidence of self-reported risk factors contributing to self-reported mobility decline is needed to inform clinical decision making and to inform the development of a prognostic tool to help clinicians and researchers identify older adults at risk of mobility decline. The primary objective of this systematic review was to synthesize available evidence for self-reported factors which predict decline in self-reported mobility after 12 months to 5 years of follow-up among community-dwelling older adults. The secondary objective was to identify, describe, and synthesize the predictive accuracy of prognostic models developed to predict risk of selfreported mobility decline in community-dwelling older adults
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