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RESEARCH PRODUCT

Identification of Older People at Risk of ADL Disability Using the Life-Space Assessment : A Longitudinal Cohort Study

Merja RantakokkoAnne ViljanenErja PortegijsTaina RantanenSarianna Sipilä

subject

GerontologyMalemedicine.medical_specialtyActivities of daily livingRisk AssessmentOddsfrailInterviews as Topic03 medical and health sciencesDisability Evaluationmobility limitation0302 clinical medicinevammaisuusmedicineCutoffHumansparticipationDisabled Persons030212 general & internal medicineLongitudinal StudiesGeriatric AssessmentGeneral NursingQualitative ResearchMultinomial logistic regressionosallistuminenAgedAged 80 and overbusiness.industryHealth PolicyConfoundingagingGeneral Medicineta3142Mobility LimitationdisabilityPhysical therapyFemaleGeriatrics and GerontologyRisk assessmentbusinessactivities of daily living030217 neurology & neurosurgeryCohort study

description

Abstract Objectives Life-space mobility, assessed with the Life-Space Assessment (LSA), reflects an individual's mobility in terms of the spatial area, frequency, and need for assistance. The aims were to study associations between life-space mobility and disability status in activities of daily living (ADL), and to define cutoff scores for baseline LSA and LSA change over time identifying individuals who developed ADL inability during 2 years of follow-up. Robustness of the cutoff scores was tested accounting for potential confounders. Design Longitudinal analyses of the “Life-space mobility in old age” cohort study. Setting Home-based interviews at baseline and phone interviews 2 years later. Participants A total of 755 community-dwelling 75- to 90-year-old people living in Central Finland. Measurements LSA score (range 0–120) and ADL disability status (no difficulty, difficulty in ≥1 tasks, or inability in ≥1 tasks) were determined based on self-reports. Results Participants who developed difficulty or inability in ADL over time presented lower LSA scores at baseline and larger declines compared to those who remained without task difficulty or inability during the follow-up, respectively. Sensitivity and specificity analyses showed that baseline LSA ≤52.3 (0.86 and 0.74, respectively) and LSA decline of >11.7 (0.76 and 0.71, respectively) identified participants who developed ADL inability over the follow-up. Multinomial regression showed that, after adjustment for potential confounders, these cutoff scores increased the odds to develop new difficulty in ADL tasks, and the odds to develop ADL inability among those with baseline difficulty. Conclusion Our results suggest that restrictions and declines in life-space mobility may be early signs of increasing vulnerability to disability in old age. These longitudinally defined cutoff points may help to find clinical applications for the LSA.

yearjournalcountryeditionlanguage
2016-01-01Journal of the American Medical Directors Association
10.1016/j.jamda.2015.12.010http://juuli.fi/Record/0278631816