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

Agathe Daria Jadczak; Suzanne Edwards; Renuka Visvanathan

doi:10.1016/j.jamda.2022.04.013

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

J Am Med Dir Assoc. 2022 Nov;23(11):1869.e1-1869.e6. doi: 10.1016/j.jamda.2022.04.013. Epub 2022 May 22.

Authors

Agathe Daria Jadczak¹, Suzanne Edwards², Renuka Visvanathan³

Affiliations

¹ National Health and Medical Research Council Center of Research Excellence Frailty and Healthy Aging, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; Adelaide Geriatrics Training and Research with Aged Care (G-TRAC) Center, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia. Electronic address: agathedaria.jadczak@adelaide.edu.au.
² Adelaide Health Technology Assessment, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
³ National Health and Medical Research Council Center of Research Excellence Frailty and Healthy Aging, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; Adelaide Geriatrics Training and Research with Aged Care (G-TRAC) Center, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Woodville South, South Australia, Australia.

PMID: 35613663
DOI: 10.1016/j.jamda.2022.04.013

Abstract

Objectives: 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.

Design: Prospective cohort study.

Setting and participants: Twelve nursing homes including 556 residents, mean age 87.73 ± 7.25 years, 73.0% female.

Methods: 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.

Results: 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.

Conclusions and implications: 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.

Keywords: Life-space mobility; aged care; nursing homes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Female
Frailty*
Humans
Male
Nursing Homes
Prospective Studies
Quality of Life
Sarcopenia*