scholarly journals Community Mobility in Older Adults: Novel Methodologies, Risk Factors, and Interventions

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 564-564
Author(s):  
Andrea Rosso ◽  
Michelle Carlson ◽  
Jana Hirsch
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Physical Function ◽  
Social Engagement ◽  
Independent Living ◽  
Objective Measures ◽  
Current View ◽  
Clinical Settings ◽  
Life Space ◽  
Community Mobility

Abstract Community mobility is an individual’s movement outside the home. It is essential for the completion of many instrumental activities of daily living, such as shopping and healthcare, and promotes physical function, social engagement, independent living, and quality of life. Mobility research often focuses on gait speed measured in clinical settings, a critical but not sufficient determinant of community mobility. Here we present four talks that assess community mobility and its determinants using novel methodologies to enhance our understanding of how to maintain independence in older ages. First, Andrea Rosso presents characteristics of individuals with the strongest associations between environmental walkability, as assessed by virtual audits, and walking. Second, Kyle Moored demonstrates associations of self-reported fatigability with life space among older men, independent of their physical functioning. Breanna Crane introduces GPS-based objective measures of community mobility and their associations with cognitive and physical function of older adults. Finally, Pam Dunlap presents results of a randomized clinical trial of a physical therapy intervention to improve walking in older adults on subjective and objective measures of life space. These talks will provide a better understanding of the factors related to community mobility, introduce attendees to novel methodologies in the assessment of both community mobility and risk factors associated with the loss of community mobility, and demonstrate approaches to improve community mobility in at-risk older adults. The discussant, Jana Hirsch, will provide perspectives on how these data inform our current view of community mobility and will lead a discussion with the audience.

scholarly journals Older adults, falls and technologies for independent living: a life space approach

2011 ◽  
Vol 31 (5) ◽  
pp. 829-848 ◽  
Author(s):  
CATHY BAILEY ◽  
TIMOTHY G. FORAN ◽  
CLIODHNA NI SCANAILL ◽  
BEN DROMEY
Keyword(s):  
Older Adults ◽  
Independent Living ◽  
Fear Of Falling ◽  
Research Programme ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Daily Activities ◽  
Life Space ◽  
Risky Behaviour ◽  
Fear Of Falls

ABSTRACTThis paper draws attention to the need for further understanding of the fine details of routine and taken-for-granted daily activities and mobility. It argues that such understanding is critical if technologies designed to mitigate the negative impacts of falls and fear-of-falling are to provide unobtrusive support for independent living. The reported research was part of a large, multidisciplinary, multi-site research programme into responses to population ageing in Ireland, Technologies for Independent Living (TRIL). A small, exploratory, qualitative life-space diary study was conducted. Working with eight community-dwelling older adults with different experiences of falls or of fear-of-falls, data were collected through weekly life-space diaries, daily-activity logs, two-dimensional house plans and a pedometer. For some participants, self-recording of their daily activities and movements revealed routine, potentially risky behaviour about which they had been unaware, which may have implications for falls-prevention advice. The findings are presented and discussed around four key themes: ‘being pragmatic’, ‘not just a faller’, ‘heightened awareness and blind spots’ and ‘working with technology’. The findings suggest a need to think creatively about how technological and other solutions best fit with people's everyday challenges and needs and of critical importance, that their installation does not reduce an older adult to ‘just a faller’ or a person with a fear-of-falls.

scholarly journals Community Mobility Among Older Adults With Reduced Kidney Function: A Study of Life-Space

2014 ◽  
Vol 63 (3) ◽  
pp. 429-436 ◽  
Author(s):  
C. Barrett Bowling ◽  
Paul Muntner ◽  
Patricia Sawyer ◽  
Paul W. Sanders ◽  
Nancy Kutner ◽  
...  
Keyword(s):  
Older Adults ◽  
Kidney Function ◽  
Life Space ◽  
Community Mobility ◽  
Reduced Kidney Function

scholarly journals The M. Powell Lawton Award Lecture: The Person-Environment Fit Framework, Older Adults and Technology Interactions

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 556-556
Author(s):  
Sara Czaja
Keyword(s):  
Older Adults ◽  
Social Engagement ◽  
Independent Living ◽  
Social Environments ◽  
User Centered Design ◽  
Dynamic Interactions ◽  
Training Interventions ◽  
Policy Environments ◽  
Person Environment Fit ◽  
Technology Systems

Abstract M. Powell Lawton made significant contributions throughout his illustrious career to improve the quality of life of older adults. His landmark theory of person-environment fit (P-E Fit) recognized the importance of understanding the dynamic interactions between older adults and their physical and social environments and the subsequent impact of these interactions on independent living. In today’s living environments, technology is ubiquitous and can serve as both a barrier and facilitator to the ability of older people to live independently. This presentation will discuss how the P-F Fit Model can be used to clarify potential mismatches between technology systems and the characteristics, abilities, and preferences of older adult and how it can be used to guide design and training interventions to maximize the ability of aging adults to interact successfully with technology systems. Examples will be drawn from the Center for Research and Education on Aging and Technology Enhancement (CREATE) in the domains of social engagement, work, and health from technology design and intervention perspectives. The CREATE conceptual framework, consistent with the P-E Fit Model posits that users have varying needs, abilities, and attitudes; technology systems and tasks vary in demands; social, physical, and policy environments influence a person’s access to and support for technology transactions; and human-technology interactions are dynamic. A focus of the presentation will be on how a user-centered design approach is compatible with the P-E Fit model and can optimize the fit between older adults and technology systems.

scholarly journals Methods and Rationale for Using GPS-Derived Objective Technologies to Examine Community Mobility in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 565-565
Author(s):  
Kyle Moored ◽  
Andrea Rosso ◽  
Michelle Carlson ◽  
Breanna Crane
Keyword(s):  
Older Adults ◽  
Community Dwelling ◽  
Objective Measures ◽  
Walking Ability ◽  
Time Data ◽  
Walking Test ◽  
Community Mobility ◽  
Trail Making ◽  
Community Dwelling Older Adults ◽  
Therapy Intervention

Abstract Objective measures of community mobility are advantageous for capturing life-space activity. In contrast to subjective, self-reported approaches, GPS-derived objective measures leverage passive, real-time data collection techniques to mitigate recall bias and minimize participant burden. We present methods to quantify community mobility among a sample of 164 community-dwelling older adults (Mean age=77.3±6.5) from a physical therapy intervention aimed at improving walking ability. We characterized community mobility using activity space metrics (e.g., standard deviation ellipse (SDE) area), timing (e.g., time outside home), and shape (e.g., SDE compactness). We will discuss challenges and solutions to generating these metrics as well as their associations with physical and cognitive performance. Time outside of home and SDE area, but not SDE compactness, were correlated with better performance on the 6-Minute Walking Test and Trail-Making Test (Part B) (ρ=.20-.23, p’s<.05). These findings will aid in understanding which community mobility measures are associated with functional capacity.

scholarly journals Exploring Use of Digital Home Assistants for Older Adults: A Demonstration Project

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 425-426
Author(s):  
Maya Malecki ◽  
Leonardo Galoso ◽  
Saahithya Gowrishankar ◽  
Amy Brown ◽  
Ramavarapu Sreenivas ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Engagement ◽  
Independent Living ◽  
Environmental Control ◽  
Health Management ◽  
Medication Management ◽  
Demonstration Project ◽  
Digital Home ◽  
Telephone Interviews ◽  
Social Companion

Abstract Emerging digital home assistant technology has potential to support older adults in their homes. Voice-activated assistants can be used for entertainment, environmental control, physical activities, health management, and social engagement. However, many older adults have limited experience with these devices, which are not designed with them in mind. We conducted a demonstration project to explore how seven older adult assisted and independent living residents interacted with digital assistants over four months. We conducted monthly semi-structured telephone interviews and pre/post questionnaires. Participants desired to use their devices to communicate with others, and for a range of health activities, including nutrition tracking, medication management, and health information searching. However, numerous usability barriers emerged. Some participants perceived their device as a social companion. These findings indicate that older adults are willing to use digital assistants for various activities that may enhance independence, although instructional and training materials are needed to support their use.

Social Engagement After Nursing Home Admission: Racial and Ethnic Disparities and Risk Factors

2015 ◽  
Vol 36 (11) ◽  
pp. 1306-1326 ◽  
Author(s):  
Donna Bliss ◽  
Susan Harms ◽  
Lynn E. Eberly ◽  
Kay Savik ◽  
Olga Gurvich ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Social Engagement ◽  
Significant Risk ◽  
Ethnic Disparities ◽  
Well Being ◽  
Nursing Home Admission ◽  
Racial And Ethnic Disparities ◽  
Multi Level ◽  
Racial Ethnic

Older adults admitted to nursing homes (NHs) are at risk for low social engagement, which has associations with medical, psychological, and social well-being. Minorities may be at a disadvantage for social engagement because of their racial or ethnic group identity. This study assessed whether there were racial/ethnic disparities in social engagement among older adults ( N = 15,927) at 1 year after their NH admission using multi-level predictors. No racial or ethnic-based disparities in social engagement were found; hence, an analysis of risk factors at NH admission that predicted low social engagement at 1 year for all residents was conducted. Significant risk factors for low social engagement were low social engagement at admission, deficits in activities in daily living and cognition, problems with vision and communication, and residing in an NH in an urban community. Results highlight the importance of initiating interventions to increase social engagement at the time of NH admission.

Abstract 15730: Ankle-Brachial Index and Physical Function in Community-Based Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kunihiro Matsushita ◽  
Shoshana Ballew ◽  
Yingying Sang ◽  
Corey Kalbaugh ◽  
Laura Loehr ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Independent Living ◽  
Ankle Brachial Index ◽  
Poor Performance ◽  
Community Dwelling ◽  
Atherosclerosis Risk In Communities ◽  
Logistic Regression Models ◽  
History Of ◽  
The Impact

Background: Lower extremity peripheral artery disease (PAD), commonly defined by an ankle-brachial index (ABI) <0.9, increases mortality risk and also reduces physical function. All prior studies of the impact of PAD on objectively measured physical function have been in restricted populations with known PAD or physical inactivity, leaving uncertainty regarding its impact in the community. Methods: We studied 5,351 ARIC participants (age 71-90 years during 2011-2013) who underwent the assessment of ABI and the Short Physical Performance Battery (SPPB, 0-12 scale), a summary measure of physical function based on three domains (4-meter walk velocity, timed chair stands, and standing balance). Logistic regression models examined the association of ABI with poor physical function (SPPB score <6), adjusting for potential confounders including a history of other cardiovascular diseases. Results: There were 463 participants (8.2%) with ABI <0.9 and 506 participants (9.0%) with ABI ≥1.3, a potential manifestation of PAD reflecting noncompressible pedal arteries. Both ABI <0.9 and ≥1.3 were significantly and independently associated with higher odds of having poor physical function compared to those with a normal ABI (1.1-1.2). The 469 participants (8.8%) with a “borderline” low ABI (0.9-1.0) also demonstrated significantly poor physical function. Low ABI was significantly associated with poor performance in every SPPB domain, whereas none were statistically significant for high ABI. The results were largely consistent among those without a history of stroke or heart failure. Conclusion: In our population of community-dwelling older adults, ~25% had low, borderline low, or high ABI suggestive of PAD and demonstrated poorer physical function compared to those with normal ABI. Since physical function is a key element for independent living in older adults and several therapeutic options for PAD exist, our findings may have broad and important implications.

scholarly journals Comparing GPS-Based Community Mobility Measures with Self-report Assessments in Older Adults with Parkinson’s Disease

2020 ◽  
Vol 75 (12) ◽  
pp. 2361-2370 ◽  
Author(s):  
Lynn Zhu ◽  
Christian Duval ◽  
Patrick Boissy ◽  
Manuel Montero-Odasso ◽  
Guangyong Zou ◽  
...  
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Convergent Validity ◽  
Intraclass Correlation ◽  
Self Report ◽  
Measurement Unit ◽  
Life Space ◽  
Community Mobility ◽  
Trip Frequency

Abstract Background Real-life community mobility (CM) measures for older adults, especially those with Parkinson’s disease (PD), are important tools when helping individuals maintain optimal function and quality of life. This is one of the first studies to compare an objective global positioning system (GPS) sensor and subjective self-report CM measures in an older clinical population. Methods Over 14 days, 54 people in Ontario, Canada with early to mid-stage PD (mean age = 67.5 ± 6.3 years; 47 men; 46 retired) wore a wireless inertial measurement unit with GPS (WIMU-GPS), and completed the Life Space Assessment and mobility diaries. We assessed the convergent validity, reliability and agreement on mobility outcomes using Spearman’s correlation, intraclass correlation coefficient, and Bland-Altman analyses, respectively. Results Convergent validity was attained by the WIMU-GPS for trip frequency (rs = .69, 95% confidence interval [CI] = 0.52–0.81) and duration outside (rs = .43, 95% CI = 0.18–0.62), but not for life space size (rs = .39, 95% CI = 0.14–0.60). The Life Space Assessment exhibited floor and ceiling effects. Moderate agreements were observed between WIMU-GPS and diary for trip frequency and duration (intraclass correlation coefficients = 0.71, 95% CI = 0.51–0.82; 0.67, 95% CI = 0.42–0.82, respectively). Disagreement was more common among nonretired individuals. Conclusions WIMU-GPS could replace diaries for trip frequency and duration assessments in older adults with PD. Both assessments are best used for retired persons. However, the Life Space Assessment may not reflect actual mobility.

Environmental mastery and depression in older adults in residential care

2011 ◽  
Vol 31 (5) ◽  
pp. 870-884 ◽  
Author(s):  
TESS KNIGHT ◽  
TANYA ELLEN DAVISON ◽  
MARITA PATRICIA MCCABE ◽  
DAVID MELLOR
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Residential Care ◽  
Independent Living ◽  
Nursing Home Care ◽  
Factors Affecting ◽  
Supported Living ◽  
Environmental Mastery ◽  
Explained Variance ◽  
Over Time

ABSTRACTThis study investigated the association between environmental mastery and depression in a sample of 96 older adults (aged 64–98 years) in residential care. The participants completed a scale that assessed depression along with measures for risk factors for depression such as functional capacity, self-evaluated physical health, bereavement experiences and environmental mastery. The results showed that 49 per cent of the variance in participants' scores in depression could be attributed to their self-reported level of environmental mastery. Given the complexity of depression and the likelihood of reduced environmental mastery among older adults in residential care, the construct was further assessed as a mediating variable between the risk factors and depression. With environmental mastery taken as such, the explained variance in depression increased to 56 per cent. It was concluded that environmental mastery may be one of the more important factors affecting the mental health of older adults living in residential care and that strategies for increasing the residents' environmental mastery are important to their psychological wellbeing. The discussion notes that among the questions needing further investigation are whether older adults who experience high environmental mastery make the transition from community living to residential nursing home care more successfully than others, and whether perceived mastery diminishes over time or occurs at the point of transition from community independent living to dependent supported living.

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