Life‐Space Assessment Predicts Hospital Readmission in Home‐Limited Adults

Fathi, Roya; Bacchetti, Peter; Haan, Mary N.; Houston, Thomas K.; Patel, Kanan; Ritchie, Christine S.

doi:10.1111/jgs.14739

Cited by 29 publications

(22 citation statements)

References 29 publications

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“…In a study examining whether LSA predicts hospital readmission in patients with COPD or congestive heart failure, Fathi et al 69 reported that unrestricted LSA scores at baseline were associated with greater risk of mobility decline post-discharge compared to restricted LSA at baseline, after controlling for all covariates. Also, restricted LSA before hospitalization was associated with a greater risk of hospital readmission within 90 days of discharge, after controlling for all covariates.…”

Section: Resultsmentioning

confidence: 99%

“…LSM has been found to be a predictor of cognitive decline over 4-years 68 and 5-years 77 of follow-up, 90-day hospital readmission, 69 exacerbations of COPD requiring emergency room and hospital admission, 18 , 84 falls over 8.5 years, 73 mortality, 21 , 72 , 74 , 75 quality of life, 75 , 85 and admission to a nursing home. 76 Findings of this narrative review has shown that LSM instruments can help investigators and clinicians to assess both the current and future mobility status of older adults.…”

Section: Discussionmentioning

confidence: 99%

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<p>Life-Space Mobility in the Elderly: Current Perspectives</p>

Johnson¹,

Rodriguez²,

Snih³

2020

CIA

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Life-space mobility (LSM) is a concept for assessing patterns of functional mobility over time. LSM is gaining traction in the research of geriatric population health. Several instruments have been developed to measure LSM, such as the University of Alabama at Birmingham Life-Space Assessment (LSA) or the Nursing Home Life-Space Diameter instrument. There has been exponential growth in the use of instruments measuring LSM in studies of older adults since the concept was introduced in 1985. In response to the increased volume of publications with clinical applicability to those working in geriatric health or conducting population-based research in older adults, we conducted a narrative review: a) to provide a summary of the articles that have assessed validation of the University of Alabama at Birmingham LSA instrument, the most widely used instrument to assess LSM in older adults; and b) to provide a summary of the research articles that have examined LSM as independent or outcome variable. Studies for this review were obtained with an organized search format and were included if they were published in the past 20 years, written in English, published in peer-reviewed literature, and included LSM as an independent or outcome variable. Seventy-nine articles were identified: 36 that employed a cross-sectional design and 22 that employed a longitudinal/prospective design to examine LSM as outcome variable; 17 longitudinal/prospective design articles that examined LSM as primary independent variable; 3 review articles; and 1 systematic review. Areas of research included physical function, cognitive function, sensory impairment, mental health, falls, frailty, comorbidities, healthcare use, mortality, and social/environmental factors. These studies showed that LSM instruments can accurately predict morbidity, mortality, and healthcare use.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

<p>Life-Space Mobility in the Elderly: Current Perspectives</p>

Johnson¹,

Rodriguez²,

Snih³

2020

CIA

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“…The LSA is a well-validated tool that measures how much a person moves in the community, maintains social relationships and roles, exploits community amenities, and participates in meaningful activities (12,13). LSA scores have been shown to predict multiple adverse outcomes (e.g., falls, nursing home admissions, mortality) in community-dwelling older adults (16)(17)(18)(19)(20)(21)(22). Previous studies have demonstrated that declining life-space mobility is associated with lower quality of life (23).…”

Section: The Impact Of Frailty On the Relationship Between Life-spacementioning

confidence: 99%

The Impact of Frailty on the Relationship between Life-Space Mobility and Quality of Life in Older Adults during the COVID-19 Pandemic

Saraiva

Apolinário

Avelino‐Silva

et al. 2021

The Journal of nutrition, health and aging

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Background: The COVID-19 pandemic has led to abrupt restrictions of life-space mobility. The impact of shelter-in-place orders on older adults' health and well-being is still unclear. Objective: To investigate the relationship between life-space mobility and quality of life (QoL) in older adults with and without frailty during the COVID-19 pandemic. Design: Multicenter prospective cohort study based on structured telephone interviews. Setting: Four geriatric outpatient clinics in the metropolitan area of Sao Paulo, Brazil. Participants: 557 community-dwelling adults aged 60 years and older. Measurements: The Life-Space Assessment was used to measure community mobility before and during the COVID-19 pandemic, and a previously validated decrease of ≥ 5 points defined restricted life-space mobility. Frailty was assessed through the FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight) scale. The impact of shelter-in-place orders on QoL was evaluated with the question «How is the COVID-19 pandemic affecting your QoL?», to which participants could respond «not at all», «to some extent», or «to a great extent». We used ordinal logistic regressions to investigate the relationship between restricted life-space mobility and impact on QoL, adjusting our analyses for demographics, frailty, comorbidities, cognition, functionality, loneliness, depression, and anxiety. We explored whether frailty modified the association between life-space mobility and impact on QoL. Results: Participants were on average 80±8 years old, 65% were women, and 33% were frail. The COVID-19 quarantine led to a restriction of community mobility in 79% of participants and affected the QoL for 77% of participants. We found that restricted life-space mobility was associated with impact on QoL in older adults during the pandemic, although frailty modified the magnitude of the association (P-value for interaction=0.03). Frail participants who experienced restricted life-space mobility had twice the odds of reporting an impact on QoL when compared with non-frail individuals, with respective adjusted odds ratios of 4.20 (95% CI=2.36-7.50) and 2.18 (95% CI=1.33-3.58). Conclusion: Older adults experienced substantial decreases in life-space mobility during the COVID-19 pandemic, and this unexpected change impacted their QoL. Providers should be particularly watchful for the consequences of abrupt life-space restrictions on frail individuals.

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“…Restricted life-space mobility is associated with various risk factors among older people, declining cognitive function 1) and quality of life 2) , hospital readmission 3) , nursing home admission 4) , and mortality 5) . Baker et al reported that life-space mobility can be evaluated using the Life-Space Assessment (LSA) tool 6) .…”

Section: Introductionmentioning

confidence: 99%

A 3-month multicomponent home-based rehabilitation program for older people with restricted life-space mobility: a pilot study

et al. 2021

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The purpose of this study was to verify the effects of a 3-month multicomponent homebased rehabilitation program developed on the basis of the reevaluation of older people with restricted life-space mobility. [Participants and Methods] The participants were residents in Japan aged ≥65 years who had Life-Space Assessment scores ≤52.3. Multicomponent home-based rehabilitation was conducted by physical and occupational therapists. Each visit included 40-60 min of combined exercise, practicing activities of daily living, improving the home environment, and caregiver support. The programs were developed in accordance with a flow diagram. The primary outcome was life-space mobility evaluated using the Life-Space Assessment score. [Results] Overall, 30 participants completed the intervention. The mean age of the participants was 82.4 ± 7.5 years. Three months after the intervention initiation, the Life-Space Assessment scores significantly improved from 12.0 to 30.5. The proportion of participants at maximal life-space level 5 (unlimited mobility) doubled from 16.7% at baseline to 33.3%. The functional independent measure score, fall efficacy scale score, and lower limb strength associated with standing up also significantly improved. We found no significant changes in the geriatric depression scale 5 and self-rated good health scores. [Conclusion] Multicomponent home-based rehabilitation can improve life-space mobility in older people with restricted life-space mobility.

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Life‐Space Assessment Predicts Hospital Readmission in Home‐Limited Adults

Abstract: Baseline restricted life-space was associated with greater risk of hospital readmission within 90 days after hospital discharge. These findings suggest a need to customize the management of individuals hospitalized with CHF or COPD based on baseline life-space level.

Cited by 29 publications

References 29 publications

<p>Life-Space Mobility in the Elderly: Current Perspectives</p>

<p>Life-Space Mobility in the Elderly: Current Perspectives</p>

The Impact of Frailty on the Relationship between Life-Space Mobility and Quality of Life in Older Adults during the COVID-19 Pandemic

A 3-month multicomponent home-based rehabilitation program for older people with restricted life-space mobility: a pilot study

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