Life-Space mobility and clinical outcomes in COPD

Iyer, Anand S; Wells, James M.; Bhatt, Surya P.; Kirkpatrick, deNay; Sawyer, Patricia; Brown, Cynthia J.; Allman, Richard M.; Bakitas, Marie

doi:10.2147/copd.s170887

Cited by 33 publications

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References 31 publications

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“…Appendix Table 2 summarizes the characteristics of the 17 longitudinal/prospective studies that have examined LSM as a predictor over time of health outcomes such as cognitive decline, health care utilization (physician visits, hospitalizations, and hospital readmissions), admission to nursing homes, incidence of falls, quality of life, and mortality 18 , 21 , 66 – 78 For example, Crowe et al 68 examined the relationship between LSA and subsequent change in cognitive function over four years in participants from the UAB Study of Aging. The authors found that greater life-space at baseline predicted less decline over the 4-year period, after controlling for all covariates.…”

Section: Resultsmentioning

confidence: 99%

“…In examining clinical exacerbations in patients with COPD leading to emergency room visits or requiring hospitalization, Iyer et al 18 found that those with restricted LSM had a significantly reduced score on the 6-minute walk test, more severe dyspnea, worse quality of life, and greater depressive symptoms after one year of enrollment. Lo et al, 73 studying neighborhood disadvantage and LSM as predictors of incident falls, found that every 10-point decrease in LSA score increased the risk for one or more falls at six months after baseline assessment.…”

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%

“…The LSA instrument has been found to predict morbidity, mortality, and healthcare utilization with greater accuracy than many standard measures. 18 – 21 …”

Section: Introductionmentioning

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: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The LSA instrument has been found to predict morbidity, mortality, and healthcare utilization with greater accuracy than many standard measures. 18 – 21 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Johnson¹,

Rodriguez²,

Snih³

2020

CIA

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“…Spirometry is mandatory for establishing a diagnosis of chronic obstructive pulmonary disease (COPD) but is not sufficient for a general clinical assessment and evaluation of potential treatment effects. Functional performance assessed at walk or bicycle exercise tests together with measurements of symptoms and healthrelated Quality of Life (QoL) provide valuable additional information about present disease status, as well as prediction of future risk of exacerbations and disease prognosis [1][2][3][4][5][6][7]. The standard bicycle exercise protocol for cardiopulmonary exercise testing (CPET) measures the endurance time of cycling during a standard endurance test, at a constant rate of 75% of the maximum exercise workload (W MAX ) [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

A new maximal bicycle test using a prediction algorithm developed from four large COPD studies

Eriksson

Radner

Peterson

et al. 2019

European Clinical Respiratory Journal

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Background: Maximum exercise workload (WMAX) is today assessed as the first part of Cardiopulmonary Exercise testing. The WMAX test exposes patients with COPD, often having cardiovascular comorbidity, to risks. Our research project was initiated with the final aim to eliminate the WMAX test and replace this test with a predicted value of WMAX, based on a prediction algorithm of WMAX derived from multicentre studies.Methods: Baseline data (WMAX, demography, lung function parameters) from 850 COPD patients from four multicentre studies were collected and standardized. A prediction algorithm was prepared using Random Forest modelling. Predicted values of WMAX were used in a new WMAX test, which used a linear increase in order to reach the predicted WMAX within 8 min. The new WMAX test was compared with the standard stepwise WMAX test in a pilot study including 15 patients with mild/moderate COPD.Results: The best prediction algorithm of WMAX included age, sex, height, weight, and six lung function parameters. FEV1 and DLCO were the most important predictors. The new WMAX test had a better correlation (R2 = 0.84) between predicted and measured WMAX than the standard WMAX test (R2 = 0.66), with slopes of 0.50 and 0.46, respectively. The results from the new WMAX test and the standard WMAX test correlated well.Conclusion: A prediction algorithm based on data from four large multicentre studies was used in a new WMAX test. The prediction algorithm provided reliable values of predicted WMAX. In comparison with the standard WMAX test, the new WMAX test provided similar overall results.

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Restricted life‐space mobility impacts physical but not mental quality of life in older cancer survivors

Taylor,

Bakitas,

Wells

et al. 2023

Cancer Medicine

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BackgroundOlder cancer survivors often value quality of life (QOL) over survival. Life‐space mobility (LSM), defined as the individual's spatial geographic mobility range, is an important QOL indicator in older adults with chronic illnesses; however, this relationship is unexplored in older cancer survivors.MethodsWe examined the longitudinal associations and causal relationships between LSM and QOL in 153 older cancer survivors (≥65 years) from the University of Alabama at Birmingham (UAB) Study of Aging. LSM was assessed using the UAB Life‐Space Assessment‐Composite score (LSA‐C), and QOL was assessed by the SF‐12 Mental Component Score (MCS12) and Physical Component Score (PCS12) at 0 (study entry), 6, 18, 36, 54, and 72 months. We examined the causal relationship between LSM and QOL using a cross‐lagged panel model (CLPM).ResultsThe cohort (n = 153) was 76 years old on average and predominantly White (58%), female (58%), and married (55%). Longitudinal analyses found LSM decreased over time (p < 0.0001), and this decrease was associated with decreased QOL (PCS12, p < 0.0001, MCS12, p < 0.0001). In the CLPM causal analysis, lower LSM resulted in worse PCS12 (p < 0.001), but not worse MSC12.ConclusionsRestricted LSM resulted in worse physical QOL over 72 months in a sample of 153 older cancer survivors. Developing and evaluating interventions to preserve greater LSM could be a promising approach to improving QOL.

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Life-Space mobility and clinical outcomes in COPD

Cited by 33 publications

References 31 publications

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

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

A new maximal bicycle test using a prediction algorithm developed from four large COPD studies

Restricted life‐space mobility impacts physical but not mental quality of life in older cancer survivors

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