Life-space correlated with observed physical performance and self-reported function. It was stable over a 2-week period yet showed changes at 6 months.
Background and Purpose. The University of Alabama at Birmingham (UAB) Study of Aging Life-Space Assessment (LSA) is a relatively new instrument to measure mobility. The purpose of this report is to describe the relationships between LSA and traditional measures of physical function, sociodemographic characteristics, depression, and cognitive status. Subjects. Subjects were a stratified random sample of 998 Medicare beneficiaries aged ≥65 years. The sample was 50% African American, 50% male, and 50% from rural (versus urban) counties. Methods. In-home interviews were conducted. Mobility was measured using the LSA, which documents where and how often subjects travel and any assistance needed during the 4 weeks prior to the assessment. Basic activities of daily living (ADL) and instrumental activities of daily living (IADL), cognitive status, income level, presence of depressive symptoms, and transportation resources were determined. The Short Physical Performance Battery (SPPB) was used to assess physical performance. Results. Simple bivariate correlations indicated a significant relationship between LSA and all variables except residence (rural versus urban). In a regression model, physical function (ADL, IADL) and physical performance (SPPB) accounted for 45.5% of the variance in LSA scores. An additional 12.7% of the variance was explained by sociodemographic variables, and less than 1% was explained by cognition and depressive symptoms. Discussion and Conclusion. The LSA can be used to document patients' mobility within their home and community. The LSA scores are associated with a person's physical capacity and other factors that may limit mobility. These scores can be used in combination with other tests and measures to generate clinical hypotheses to explain mobility deficits and to plan appropriate interventions to address these deficits.
This study examines the relationships that exist between social isolation, support, and capital and nutritional risk in older black and white women and men. The paper reports on 1000 communitydwelling older adults aged 65 and older enrolled in the University of Alabama at Birmingham (UAB) Study of Aging, a longitudinal observational study of mobility among older black and white participants in the USA. Black women were at greatest nutritional risk; and black women and men were the groups most likely to be socially isolated and to possess the least amounts of social support and social capital. For all ethnic-gender groups, greater restriction in independent life-space (an indicator of social isolation) was associated with increased nutritional risk. For black women and white men, not having adequate transportation (also an indicator of social isolation) was associated with increased nutritional risk. Additionally, for black and white women and white men, lower income was associated with increased nutritional risk. For white women only, the perception of a low level of social support was associated with increased nutritional risk. For black men, not being married (an indicator of social support) and not attending religious services regularly, restricting activities for fear of being attacked, and perceived discrimination (indicators of social capital) were associated with increased nutritional risk. Black females had the greatest risk of poor nutritional
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Our study suggests that undernutrition, as measured by low BMI and unintentional weight loss, is a greater mortality threat to older adults than is obesity or intentional weight loss.
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