BackgroundA crucial issue for the sustainability of societies is how to maintain health and functioning in older people. With increasing age, losses in vision, hearing, balance, mobility and cognitive capacity render older people particularly exposed to environmental barriers. A central building block of human functioning is walking. Walking difficulties may start to develop in midlife and become increasingly prevalent with age. Life-space mobility reflects actual mobility performance by taking into account the balance between older adults internal physiologic capacity and the external challenges they encounter in daily life. The aim of the Life-Space Mobility in Old Age (LISPE) project is to examine how home and neighborhood characteristics influence people’s health, functioning, disability, quality of life and life-space mobility in the context of aging. In addition, examine whether a person’s health and function influence life-space mobility.DesignThis paper describes the study protocol of the LISPE project, which is a 2-year prospective cohort study of community-dwelling older people aged 75 to 90 (n = 848). The data consists of a baseline survey including face-to-face interviews, objective observation of the home environment and a physical performance test in the participant’s home. All the baseline participants will be interviewed over the phone one and two years after baseline to collect data on life-space mobility, disability and participation restriction. Additional home interviews and environmental evaluations will be conducted for those who relocate during the study period. Data on mortality and health service use will be collected from national registers. In a substudy on walking activity and life space, 358 participants kept a 7-day diary and, in addition, 176 participants also wore an accelerometer.DiscussionOur study, which includes extensive data collection with a large sample, provides a unique opportunity to study topics of importance for aging societies. A novel approach is employed which enables us to study the interactions of environmental features and individual characteristics underlying the life-space of older people. Potentially, the results of this study will contribute to improvements in strategies to postpone or prevent progression to disability and loss of independence.

Mobility is important for community independence. With increasing age, underlying pathologies, genetic vulnerabilities, physiological and sensory impairments, and environmental barriers increase the risk for mobility decline. Understanding how mobility declines is paramount to finding ways to promote mobility in old age.

Fear of moving outdoors is common in older adults and increases the risk of developing self-reported difficulties in walking 0.5 km and 2 km. Knowledge about individual and environmental factors underlying fear of moving outdoors and finding ways to alleviate fear of moving outdoors are important for community planning and prevention of disability.

Objectives To study the relationship between physical performance and sense of autonomy in outdoor activities with life‐space mobility—the spatial area a person purposefully moves through in daily life—in community‐dwelling older people. Design Cross‐sectional analyses of baseline data of the Life‐Space Mobility in Old Age cohort study. Setting Structured interviews in participants' homes. Participants Community‐dwelling people aged 75 to 90 (N = 848). Measurements Sense of autonomy outdoors (Impact on Participation and Autonomy questionnaire subscale), life‐space mobility (Life‐Space Assessment; University of Alabama, Birmingham Study of Aging), and Short Physical Performance Battery. Results The median score for life‐space mobility was 64.0. In linear regression models, poorer physical performance and more‐limited sense of autonomy were independently associated with more restrictions in life‐space mobility, explaining approximately one‐third of the variation in life‐space mobility. Physical performance also had an indirect effect on life‐space mobility through sense of autonomy outdoors. Subgroup analyses of 5‐year age groups and sex revealed that the associations were somewhat stronger in women and the oldest age group. Conclusion Physical performance and sense of autonomy in outdoor activities explained a substantial portion of the variation in life‐space mobility in healthy older people, indicating that physical and psychosocial factors play a role in maintaining mobility in old age.

Changes in life-space mobility and quality of life among community-dwelling older people: a 2-year follow-up study Rantakokko, Merja; Portegijs, Erja; Viljanen, Anne; Iwarsson, Susanne; Kauppinen, Markku; Rantanen, Taina Rantakokko, M., Portegijs, E., Viljanen, A., Iwarsson, S., Kauppinen, M., & Rantanen, T. (2016). Changes in life-space mobility and quality of life among communitydwelling older people: a 2-year follow-up study. RESULTS:The mean life-space score at baseline was 63.9±SD 20.6 and mean QOL score 100.3±11.8. Over the follow-up, the QOL score decreased to 95.0±13.8 across the total study sample. The decrease in QOL score was somewhat higher among those whose life-space mobility score declined >10 points during the follow-up compared to those whose life-space remained stable or improved, even after adjustment for age, gender, number of chronic conditions, cognitive impairment, SPPB and education. CONCLUSIONS:Decline in life-space mobility is associated with decline in QOL. The results highlight the importance of ensuring continuous possibilities for out-of-home mobility in maintaining QOL among older people.