Mobility In Community-dwelling Adults Research Articles

The Toronto Concussion Study: Reference Data for Balance and Gait Measures in Community-Dwelling Adults With Concussion.

Concussion can cause deficits in balance and gait. Much of what is known about how concussion affects balance and gait has been derived from studies involving youth, high school, and university athletes. However, investigation into the effects of concussion on balance and gait in community-dwelling young, middle-age, and older aged adults is limited. This study aimed to present descriptive reference values for common balance and gait measures in community-dwelling adults between the ages of 20 and 69years with concussion. In this observational study, 318 participants were enrolled from a concussion care clinic at a rehabilitation hospital in an urban center and were assessed within 7days of injury. Balance measures included the Balance Error Scoring System (BESS), modified BESS, and center-of-pressure root mean square during quiet standing. Gait measures included velocity (absolute and height adjusted), cadence, and step length during self-paced gait. Data were binned by decade-long age range. Mean (SD) per-decade scores for the BESS ranged from 14.8 (5.1) to 21.8 (5.6) errors and 4.0 (3.0) to 9.4 (4.6) errors for the modified BESS. Mean values for center-of-pressure root mean square in the anteroposterior direction ranged from 0.42 (0.18) to 0.52 (0.26) with the eyes open, and from 0.49 (0.19) to 0.62 (0.39) with eyes closed. Mean absolute gait velocity ranged from 98.5 (9.1) to 119.3 (21.3) cm/s. The range of step length values was 58.2 (6.8) to 66.3 (7.3) cm and cadence ranged from 102.1 (9.8) to 108.6 (10.8) steps/min across age groups. These data provide insight into the impact of concussion on balance and mobility in community-dwelling adults across the lifespan. Community-dwelling adults can experience concussion across the lifespan. Availability of reference values for commonly used balance and gait measures can help to inform clinical strategies and progression of recovery of balance and mobility after injury.

Assessment of Functional Mobility After COVID-19 in Adults Aged 50 Years or Older in the Canadian Longitudinal Study on Aging

The association of COVID-19 not requiring hospitalization with functional mobility in community-dwelling adults above and beyond the impact of the pandemic control measures implemented in 2020 remains to be elucidated. To evaluate the association between a COVID-19 diagnosis and change in mobility and physical function of adults in Canada aged 50 years or older during the initial pandemic lockdown. This population-based cohort study used data from the Canadian Longitudinal Study on Aging (CLSA) COVID-19 study. This study was launched on April 15, 2020, and the exit questionnaires were completed between September and December 2020. Prepandemic data from the first CLSA follow-up (2015-2018) were also used. Respondents included middle-aged and older community-dwelling participants residing in Canadian provinces. Data were analyzed from February to May 2021. The assessment for self-reported COVID-19 status was adapted from the Public Health Agency of Canada and the Centers for Disease Control and Prevention case definition available at the time of data collection; cases were classified as confirmed or probable, suspected, or non-COVID-19. Changes in mobility since the start of the COVID-19 pandemic were assessed using global rating of change in mobility scales at the COVID-19 exit questionnaire. Participant-reported new onset of difficulty in 3 physical function tasks was also examined. Among 51 338 participants at baseline, 21 491 participants (41.9%) were 65 years or older and 26 155 participants (51.0%) were women and 25 183 (49.1%) were men. Of 2748 individuals with confirmed or probable or suspected COVID-19, 113 (94.2%) were not hospitalized. Individuals with confirmed or probable COVID-19 had higher odds of worsening mobility in terms of ability to engage in household activity (odds ratio [OR], 1.89; 95% CI, 1.11-3.22), physical activity (OR, 1.91; 95% CI, 1.32-2.76), and standing up after sitting in a chair (OR, 2.33; 95% CI, 1.06-5.11) compared with adults without COVID-19 during the same pandemic time period. Similar results were found for suspected COVID-19 status (eg, household activity: OR, 2.09; 95% CI, 1.82-2.41). This cohort study among older adults in Canada found that receiving a COVID-19 diagnosis was significantly associated with worse mobility and functioning outcomes even in the absence of hospitalization. These findings suggest that interventions may be needed for individuals with mild to moderate COVID-19 who do not require hospitalization.

Mobility in community-dwelling adults with chronic conditions: the contribution of age and sex

Objectives: The study aimed to determine whether age and sex predict self-reported and performance-based mobility-related outcomes in community-dwelling middle and older aged adults with chronic conditions; and if sociodemographic factors and comorbidity influence this relationship.Methods: Data from a previous randomised controlled trial where the intervention had no clinical effect was analysed (n = 271). Unadjusted regression models and multivariate regression analyses including linear, median, logistic and ordered logistic regression were performed examining the relationship between participant characteristics at baseline and 9 months. Independent variables were: age, sex, comorbidity, education level, income level, marital status and age and sex interaction term. The dependent variables were: self-reported outcomes: fall history, Late Life Function and Disability Instrument function component score, Short Form 36 Health Survey Questionnaire physical component score and performance-based mobility outcomes: 2-minute walk distance, [Short Physical Performance Battery (SPPB)] balance, chair stands, eight-foot walk and SPPB total score.Results: Older age and female sex predicted poorer self-reported mobility, but only older age predicted performance-based mobility outcomes. Participants with more comorbidity, low income and lived alone had poorer mobility.Conclusion: The differences of the self-reported mobility outcomes but not the performance measures between males and females may be implicated by gender differences, more than sex differences. Our findings support the need for more mechanistic studies on the impacts of sex and gender on mobility.

Oral Health-Related Quality of Life and Life-Space Mobility in Community-dwelling Older Adults

To quantify the associations between measures of oral health-related quality of life (OHRQoL) and life-space mobility (LSM) in community-dwelling older adults. Cross-sectional study using a 54-item OHRQoL questionnaire. Five counties in central Alabama: Jefferson and Tuscaloosa (urban), and Bibb, Hale, and Pickens (rural). The 288 dental study volunteers were recruited from participants in the University of Alabama at Birmingham Study of Aging, a longitudinal study of mobility in community-dwelling adults aged 65 and older. Participants completed an in-home interview about their OHRQoL and LSM. Life-space was assessed by asking questions about where and how often participants got to areas ranging from the home to beyond town and the degree of independence in getting there. Unadjusted and adjusted regression models were used to quantify associations between OHRQoL and LSM. Other factors examined were age, race, sex, income, education, residence, transportation difficulty, marital status, depressive symptoms, and comorbidity. Unadjusted and adjusted analyses suggested significant associations between OHRQoL and LSM in oral functional limitation, oral pain and discomfort, oral disadvantage, and self-rated oral health. OHRQoL decrements that participants reported were associated with less LSM, suggesting that perceptions of oral well-being have a significant effect on mobility and the social participation of older adults.