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Life-Space Mobility in Aged Care Residents: Frailty In Residential Sector over Time (FIRST) Study Findings

医学 置信区间 优势比 生活质量(医疗保健) 社会心理的 老年学 前瞻性队列研究 日常生活活动 人口学 物理疗法 内科学 护理部 精神科 社会学
作者
Agathe Daria Jadczak,Suzanne Edwards,Renuka Visvanathan
出处
期刊:Journal of the American Medical Directors Association [Elsevier]
卷期号:23 (11): 1869.e1-1869.e6 被引量:5
标识
DOI:10.1016/j.jamda.2022.04.013
摘要

Life-space mobility is a measure of the extent and frequency of mobility in older adults reflecting not only physical function, but also cognitive, psychosocial, and environmental factors. This study aimed to (1) develop life-space mobility profiles for nursing home residents; (2) examine independent factors associated with these profiles; and (3) identify health outcomes [ie, mortality, quality of life (QoL) and falls] associated with the life-space mobility profiles at 1 year.Prospective cohort study.Twelve nursing homes including 556 residents, mean age 87.73 ± 7.25 years, 73.0% female.Life-space mobility was measured using the Nursing Home Life-Space Diameter (NHLSD). Mortality and falls were extracted from residents' records. QoL was measured using the QoL in Alzheimer Disease (QoL-AD) scale.NHLSD scores ranged from 0 to 50 with a mean score of 27.86 ± 10.12. Resident life-space mobility was mainly centered around their room (94.8%, n = 527) and wing (86.4%, n = 485). One-half of the residents left their wing daily (51.0%, n = 284), and over one-quarter (26.4%, n = 147) ventured outside their nursing home at least weekly. Significant associations (P < .05) with high life-space mobility, identified through multivariable analyses, included lower age [odds ratio (OR) 0.70, 95% confidence interval (CI) 0.51, 0.96]; lower frailty levels (OR 0.67, 95% CI 0.50, 0.86); lower sarcopenia risk (OR 0.72, 95% CI 0.65, 0.79); and a better nutritional status (OR 1.16, 95% CI 1.05, 1.29). High life-space mobility was a predictor (P < .05) of lower mortality, lower falls rate, and higher QoL at 1 year when compared with moderate or low mobility.Given the independent association between high life-space mobility and lower frailty status, lower sarcopenia risk, and a better nutritional status, physical activity and nutritional interventions may be beneficial in leading to improved life-space use. This requires further investigation. Improved life-space mobility can lead to improved health outcomes, such as lower mortality, lower falls rate, and improved QoL.
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