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

  • Agathe Daria Jadczak
    Correspondence
    Address correspondence to Agathe Daria Jadczak, PhD, National Health and Medical Research Council Center of Research Excellence Frailty and Healthy Aging, Adelaide Medical School, Faculty of Health and Medical Sciences, Basil Hetzel Institute, 37 Woodville Rd, Woodville South, South Australia 5011, Australia.
    Affiliations
    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
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  • Suzanne Edwards
    Affiliations
    Adelaide Health Technology Assessment, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
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  • Renuka Visvanathan
    Affiliations
    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
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      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

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