Life-Space and Cognitive Decline in Older Adults in Different Social and Economic Contexts: Longitudinal Results from the IMIAS Study

Caldas, Vescia Vieira de Alencar; Fernandes, Juliana; Vafaei, Afshin; Gomes, Camila de Carvalho; Costa, José Vílton; Curcio, Carmen-Lucía; Guerra, Ricardo Oliveira

doi:10.1007/s10823-020-09406-8

Cited by 19 publications

(6 citation statements)

References 52 publications

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“…The inclusion criteria for participation in the study were: being at least 60 years of age; being a resident of the community in the municipality of Parnamirim/RN ; and being registered with the municipality's health services. The exclusion criteria were: neurological diseases; physical and/or visual impairment; cognitive deficit identified by 4 errors or more in the orientation domain of the Leganes Cognitive Test22,23; or did not complete the evaluation protocol.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic Accuracy of the Short Physical Performance Battery in Detecting Frailty and Prefrailty in Community-Dwelling Older Adults: Results From the PRO-EVA Study

Gonçalves

Ribeiro

Fernandes

et al. 2022

Journal of Geriatric Physical Therapy

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Background and Purpose: The Short Physical Performance Battery (SPPB) is widely used for older adults since it has a high level of validity, reliability, and responsiveness in measuring function in this population. However, only a few studies of diagnostic accuracy have assessed SPPB capacity in detecting frailty and prefrailty by estimating more detailed measurement properties. Thus, the present study aimed to evaluate the SPPB's diagnostic accuracy in detecting frailty and prefrailty, in addition to identifying cut-off points for walking time and chair stand time. Methods: This is a cross-sectional study composed of 786 community-dwelling older adults 60 years or older, in which sociodemographic and anthropometric data, frailty phenotype, and total SPPB score, as well as walking time and chair stand time, were assessed. Analysis of a receiver operating characteristic curve was performed to identify the cut-off point, sensitivity, and specificity in the total SPPB score, as well as the walking time and chair stand time for frailty and prefrailty screening. Accuracy and positive and negative predictive values were subsequently calculated. Results and Discussion: The cut-off points identified for the total SPPB score, walking time, and chair stand time were 9 points or less (accuracy of 72.6%), 5 seconds or less, and 13 seconds or less, respectively, for frailty screening and 11 points or less (accuracy of 58.7%), 4 seconds or less, and 10 seconds or less, respectively, for prefrailty screening. The walking time showed greater frailty discriminatory capacity compared with the chair stand time (effect size = 1.24 vs 0.64; sensitivity = 69% vs 59%; and specificity = 84% vs 75%). Conclusions: The total SPPB score has good diagnostic accuracy to discriminate between nonfrail and frail older adults using a cut-off point of 9 or less, being better to identify the true negatives (older adults who are not frail). Although the SPPB's diagnostic accuracy measures for detecting prefrailty were low to moderate, this instrument can help in screening prefrail older adults from the cutoff point of 11 or less in the total SPPB score. Identification of prefrail older adults enables implementing early treatment in this target audience and can prevent their advance to frailty.

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Section: Methodsmentioning

confidence: 99%

Diagnostic Accuracy of the Short Physical Performance Battery in Detecting Frailty and Prefrailty in Community-Dwelling Older Adults: Results From the PRO-EVA Study

Gonçalves

Ribeiro

Fernandes

et al. 2022

Journal of Geriatric Physical Therapy

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“…Thus, long-term prospective studies of cognitive and motor function in relation to life space are critical to exploring temporality and directionality. [9][10][11][12][13][14][15][16][17] In previous work, our group has reported a crosssectional association between cognitive and motor abilities with life space. 18 Further, we found an association between constricted life space and later cognitive decline, as well as risk for incident mild cognitive impairment (MCI) and Alzheimer's dementia.…”

Section: Introductionmentioning

confidence: 88%

“…Importantly, directionality is difficult to establish in cross‐sectional or even short‐term prospective studies. Thus, long‐term prospective studies of cognitive and motor function in relation to life space are critical to exploring temporality and directionality 9–17 …”

Section: Introductionmentioning

confidence: 99%

A prospective study of the association of cognitive and motor function with odds of life space constriction in older adults

Zammit,

Yu,

Buchman

et al. 2023

J American Geriatrics Society

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BackgroundMany studies indicate that smaller life space is related to worse cognitive and motor function. It is plausible that cognitive and motor function also predict life space constriction, thus long‐term, prospective studies are needed of cognitive and motor function as predictors of life space.MethodsA total of 1246 participants of the Rush Memory and Aging Project, who reported initial maximal life space and at least one follow‐up assessment were included in this prospective study, with up to 19 years follow‐up. The outcome of interest was the Modified version of the Life Space Questionnaire; which we categorized into large (beyond community), medium (neighborhood/community), and small (home/yard) life space. Participants also had detailed composite measures of global cognition and motor function as predictors and available at the first life space assessment. Life space transitions over one‐year periods were modeled using multistate Markov modeling, including confounders and both predictors simultaneously.ResultsBetter cognitive and motor function were broadly associated with lower odds of life space constriction (Cognitive: Large ➔ medium: OR = 0.91, 95% CI 0.83–1.00; Large ➔ small: OR = 0.85, 95% CI 0.74–0.97; Medium ➔ small: OR = 1.01, 95% CI 0.82–1.22. Motor: large ➔ medium: OR = 0.76, 95% CI 0.69–0.83; large ➔ small: OR = 0.58, 95% CI 0.51–0.67; medium ➔ small: OR = 0.71, 95% CI = 0.57–0.87).ConclusionsCombined with previous literature that life space predicts function, these results support the notion of complex inter‐relations of cognitive function, motor function, and life space.

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“…3 Homebound older adults rarely or never leave home due to environmental, physical, psychological, cognitive, economic, and/or social reasons. This is associated with advanced age, [4][5][6] having more comorbidities, 4,7 greater functional impairment, 5,6 cognitive decline, 8 and high rates of depression and anxiety. 7 Homebound older adults have a greater overall use of emergency department visits and hospitalizations than non-homebound older adults.…”

Section: Introductionmentioning

confidence: 99%

Homebound status among older adult home care recipients in Ontario, Canada

Lapointe‐Shaw

Jones

Ivers

et al. 2021

J American Geriatrics Society

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Background Homebound status is associated with an increased risk of morbidity and mortality in older adults, yet little is known about homebound older adults in Canada. Our objectives were to describe time trends in the prevalence of homebound status among community‐dwelling long‐term home care recipients and the characteristics associated with homebound status. Methods This was a retrospective cross‐sectional and cohort study using linked health administrative data in Canada's most populous province, Ontario. We included adults aged 65 years and older who received at least one long‐term home care assessment from 2006 to 2017 (N = 666,514). Homebound individuals were those who exited the home an average of 0–1 days/week over the previous 30 days; not homebound comparators exited the home 2–7 days per week. We compared baseline characteristics between groups and estimated the association between these characteristics and homebound status at baseline and over time. Results From 2006 to 2017, the annual proportion of long‐term home care recipients who were homebound increased from 48% to 65%. At first assessment, 50% of the cohort (331,836 of 666,514) were homebound. Among those with a 4–12 month repeat assessment, homebound status persisted over time for 80%, and developed anew in 24%. Dependency on others for locomotion, use of an assistive device, poor access to dwelling, older age, and female sex were most strongly associated with homebound status at baseline, as well as its development and persistence over time. Conclusions We found that half of Ontario older adult long‐stay home care clients were homebound at the time of their first assessment, and that the prevalence of homebound status among home care recipients rose steadily from 2006 to 2017. This informs further research and policy development to ensure the adequacy of supports for older homebound persons.

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Life-Space and Cognitive Decline in Older Adults in Different Social and Economic Contexts: Longitudinal Results from the IMIAS Study

Cited by 19 publications

References 52 publications

Diagnostic Accuracy of the Short Physical Performance Battery in Detecting Frailty and Prefrailty in Community-Dwelling Older Adults: Results From the PRO-EVA Study

Diagnostic Accuracy of the Short Physical Performance Battery in Detecting Frailty and Prefrailty in Community-Dwelling Older Adults: Results From the PRO-EVA Study

A prospective study of the association of cognitive and motor function with odds of life space constriction in older adults

Homebound status among older adult home care recipients in Ontario, Canada

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