Individual and environmental factors underlying life space of older people – study protocol and design of a cohort study on life-space mobility in old age (LISPE)

BMC Public Health

Merja Rantakokko²  Susanne Iwarsson¹  Sarianna Sipilä²  Eeva-Maija Palonen²  Markku Kauppinen²  Li-Tang Tsai²  Milla Saajanaho²  Johanna Eronen²  Anne Viljanen²  Erja Portegijs²  Taina Rantanen² 

[1]Department of Health Sciences, Lund University, Lund, Sweden

[2]Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, P.O.Box 35, Jyväskylä, FI-40014, Finland

关键词: Cohort studies;    Aging;    Walking;    Physical activity;    Participation;    Environment;    Quality of life;    Mobility;    Life-space;   

Others  :  1162790
DOI  :  10.1186/1471-2458-12-1018

 received in 2012-11-14, accepted in 2012-11-19,  发布年份 2012

【 摘 要 】

Background

A 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.

Design

This 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.

Discussion

Our 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.

【 授权许可】

   
2012 Rantanen et al. licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Satariano WA, Guralnik JM, Jackson RJ, Marottoli RA, Phelan EA, Prohaska TR: Mobility and aging: New directions for public health action. Am J Public Health 2012, 102:1508-1515.
• [2]Cohen-Mansfield J, Shmotkin D, Hazan H: Homebound older persons: prevalence, characteristics, and longitudinal predictors. Arch Gerontol Geriatr 2012, 54:55-60.
• [3]Nagi SZ: An epidemiology of disability among adults in the United States. Milbank Mem Fund Q Health Soc 1976, 54:439-467.
• [4]Verbrugge LM, Jette AM: The disablement process. Soc Sci Med 1994, 38:1-14.
• [5]Lawton MP, Nahemow L: Ecology and aging process. In The psychology of adult development and aging. Edited by Eisdorfer C, Lawton MP. Washington DC: American Psychological Association; 1973:619-674.
• [6]Viljanen A, Kaprio J, Pyykko I, Sorri M, Koskenvuo M, Rantanen T: Hearing acuity as a predictor of walking difficulties in older women. J Am Geriatr Soc 2009, 57:2282-2286.
• [7]Viljanen A, Kaprio J, Pyykko I, Sorri M, Pajala S, Kauppinen M, Koskenvuo M, Rantanen T: Hearing as a predictor of falls and postural balance in older female twins. J Gerontol A Biol Sci Med Sci 2009, 64:312-317.
• [8]Kulmala J, Viljanen A, Sipila S, Pajala S, Parssinen O, Kauppinen M, Koskenvuo M, Kaprio J, Rantanen T: Poor vision accompanied with other sensory impairments as a predictor of falls in older women. Age Ageing 2009, 38:162-167.
• [9]Peel NM: Epidemiology of falls in older age. Can J Aging 2011, 15:1-13.
• [10]Mänty M, Heinonen A, Viljanen A, Pajala S, Koskenvuo M, Kaprio J, Rantanen T: Outdoor and indoor falls as predictors of mobility limitation in older women. Age Ageing 2009, 38:757-761.
• [11]Shumway-Cook A, Patla A, Stewart A, Ferrucci L, Ciol MA, Guralnik JM: Environmental components of mobility disability in community-living older persons. J Am Geriatr Soc 2003, 51:393-398.
• [12]Balfour JL, Kaplan GA: Neighborhood environment and loss of physical function in older adults: evidence from the alameda county study. Am J Epidemiol 2002, 155:507-515.
• [13]Rantakokko M, Iwarsson S, Mänty M, Leinonen R, Rantanen T: Perceived barriers in the outdoor environment and development of walking difficulties in older people. Age Ageing 2012, 41:118-121.
• [14]Wahl HW, Fange A, Oswald F, Gitlin LN, Iwarsson S: The home environment and disability-related outcomes in aging individuals: what is the empirical evidence? Gerontologist 2009, 49:355-367.
• [15]Clarke P, Nieuwenhuijsen ER: Environments for healthy ageing: a critical review. Maturitas 2009, 64:14-19.
• [16]Baker PS, Bodner EV, Allman RM: Measuring life-space mobility in community-dwelling older adults. J Am Geriatr Soc 2003, 51:1610-1614.
• [17]Ward RA, Kilburn H: Community access and satisfaction: racial differences in later life. Int J Aging Hum Dev 1983, 16:209-219.
• [18]Tinetti ME, Ginter SF: The nursing home life-space diameter. A measure of extent and frequency of mobility among nursing home residents. J Am Geriatr Soc 1990, 38:1311-1315.
• [19]Peel C, Sawyer Baker P, Roth DL, Brown CJ, Brodner EV, Allman RM: Assessing mobility in older adults: the UAB study of aging life-space assessment. Phys Ther 2005, 85:1008-1119.
• [20]World Health Organization: ICF: international classification of functioning, disability and health. Geneva: World Health Organization; 2002.
• [21]Auger C, Demers L, Gelinas I, Miller WC, Jutai JW, Noreau L: Life-space mobility of middle-aged and older adults at various stages of usage of power mobility devices. Arch Phys Med Rehabil 2010, 91:765-773.
• [22]The WHOQOL Group: Development of the world health organization WHOQOL-BREF quality of life assessment. Psychol Med 1998, 28:551-558.
• [23]Mänty M, Heinonen A, Leinonen R, Törmakangas T, Sakari-Rantala R, Hirvensalo M, von Bonsdorff MB, Rantanen T: Construct and predictive validity of a self-reported measure of preclinical mobility limitation. Arch Phys Med Rehabil 2007, 88:1108-1113.
• [24]Leinonen R, Heikkinen E, Hirvensalo M, Lintunen T, Rasinaho M, Sakari-Rantala R, Kallinen M, Koski J, Mottonen S, Kannas S, Huovinen P, Rantanen T: Customer-oriented counseling for physical activity in older people: study protocol and selected baseline results of a randomized-controlled trial (ISRCTN 07330512). Scand J Med Sci Sports 2007, 17:156-164.
• [25]Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB: A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994, 49:M85-M94.
• [26]Mänty M, Sihvonen S, Hulkko T, Lounamaa A: Iäkkäiden henkilöiden kaatumistapaturmat. Opas kaatumisten ja murtumien ehkäisyyn. Helsinki: Publications of the National Public Health Institute B; 2007:29.
• [27]Grimby G: Physical activity and muscle training in the elderly. Acta Med Scand Suppl 1986, 711:233-237.
• [28]Rasinaho M, Hirvensalo M, Leinonen R, Lintunen T, Rantanen T: Motives for and barriers to physical activity among older adults with mobility limitations. J Aging Phys Act 2007, 15:90-102.
• [29]Rantakokko M, Mänty M, Iwarsson S, Törmakangas T, Leinonen R, Heikkinen E, Rantanen T: Fear of moving outdoors and development of outdoor walking difficulty in older people. J Am Geriatr Soc 2009, 57:634-640.
• [30]Rantakokko M, Iwarsson S, Hirvensalo M, Leinonen R, Heikkinen E, Rantanen T: Unmet physical activity need in old age. J Am Geriatr Soc 2010, 58:707-712.
• [31]Carlsson G, Schilling O, Slaug B, Fänge A, Ståhl A, Nygren C, Iwarsson S: Towards a screening tool for housing accessibility problems: a reduced version of the housing enabler. J Appl Gerontol 2009, 28:59-80.
• [32]Pynnönen K, Törmakangas T, Heikkinen RL, Rantanen T, Lyyra TM: Does social activity decrease risk for institutionalization and mortality in older people? J Gerontol B Psychol Sci Soc Sci 2012, 67:765-774.
• [33]Cardol M, de Haan RJ, de Jong BA, van den Bos GA, de Groot IJ: Psychometric properties of the impact on participation and autonomy questionnaire. Arch Phys Med Rehabil 2001, 82:210-216.
• [34]Kanelisto K, Salminen A: IPA-kyselylomake valinnoista ja osallistumisesta jokapäiväisessä elämässä: toimintakyvyn itsearviointimenetelmä aikuisille, joilla on fyysisiä toimintarajoitteita. Helsinki: Kelan tutkimusosasto; 2011.
• [35]Laukkanen P, Karppi P, Heikkinen E, Kauppinen M: Coping with activities of daily living in different care settings. Age Ageing 2001, 30:489-494.
• [36]Lyyra TM, Lyyra AL, Lumme-Sandt K, Tiikkainen P, Heikkinen RL: Social relations in older adults: secular trends and longitudinal changes over a 16-year follow-up. Arch Gerontol Geriatr 2010, 51:133-138.
• [37]Tiikkainen P, Heikkinen RL: Associations between loneliness, depressive symptoms and perceived togetherness in older people. Aging Ment Health 2005, 9:526-534.
• [38]Pohjolainen P, Heikkinen E, Lyyra AL, Helin S, Tyrkkö K: Socio-economic status, health and life-style in two elderly cohorts in jyväskylä. Scand J Soc Med Suppl 1997, 52:1-65.
• [39]Subramanian SV, Huijts T, Avendano M: Self-reported health assessments in the 2002 world health survey: How do they correlate with education? Bull World Health Organ 2010, 88:131-138.
• [40]Ritchie CS, Locher JL, Roth DL, McVie T, Sawyer P, Allman R: Unintentional weight loss predicts decline in activities of daily living function and life-space mobility over 4 years among community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2008, 63:67-75.
• [41]Folstein MF, Folstein SE, McHugh PR: Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975, 12:189-198.
• [42]Radloff LS: The CES-D scale: a self-reported scale for research in the general population. Applied Psychol Measurement 1977, 1:385-401.
• [43]Laitinen A, Koskinen S, Härkänen T, Reunanen A, Laatikainen L, Aromaa A: A nationwide population-based survey on visual acuity, near vision, and self-reported visual function in the adult population in Finland. Ophthalmology 2005, 112:2227-2237.
• [44]Viljanen A, Kulmala J, Rantakokko M, Koskenvuo M, Kaprio J, Rantanen T: Fear of falling and coexisting sensory difficulties as predictors of mobility decline in older women. J Gerontol A Biol Sci Med Sci 2012, 67:1230-1237.
• [45]Heistaro S: Methodology report: health 2000 survey. Helsinki: National Public Health Institute; 2008.
• [46]Little BR: Personal projects. A rationale and method for investigation. Environ Behav 1983, 15:273-309.
• [47]Preiser WFE, Ostroff E: Universal design handbook. New York: McGraw-Hill; 2001.
• [48]Iwarsson S, Slaug B, Haak M: Current developments of the housing enabler methodology. Br J Occup Ther 2012. in press
• [49]Iwarsson S, Slaug B: Housing enabler – A method for rating/screening and analysing accessibility problems in housing. Manual for the complete instrument and screening tool. Lund & Staffanstorp, Sweden: Veten & Skapen HB och Slaug Enabling Development; 2010.
• [50]Iwarsson S, Slaug B, Malmgren Fänge A: The housing enabler screening tool: feasibility and inter-rater reliability in a real-estate company practice context. J Appl Gerontol 2011, 31:641-660.
• [51]Iwarsson S, Slaug B: The housing enabler. An instrument for assessing and analysing accessibility problems in housing. Nävlinge and Staffanstorp: Veten & Skapen HB & Slaug Data Management; 2001.
• [52]Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW: Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963, 185:914-919.
• [53]Lawton MP, Brody EM: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969, 9:179-186.
• [54]Nosikov A, Gudex G: EUROHIS. Developing common instruments for health surveys. Amsterdam: WHO Regional Office for Europe, IOS Press; 2003.
• [55]Beekman ATF, Deeg DJ, van Limbeek J, Braam AW, de Vries MZ, van Tilburg W: Criterion validity of the center for epidemiologic studies depression scale (CES-D): results from a community-based sample of older subjects in the Netherlands. Psychol Med 1997, 27:231-235.
• [56]Radloff LS, Teri L: Use of the center for epidemiologic studies depression scale with older adults. Clinical Gerontologist: The J of Aging and Mental Health 1986, 5:119-136.
• [57]Hétu R, Getty L, Philibert L, Desilets F, Noble W, Stephens D: Mise au point d'un outil Clinique pour la mesure d'incapacités auditives et de handicaps. J Speech-Lang Path Audiol 1994, 18:83-95.
• [58]Noble W, Atherley G: The hearing measurement scale: a questionnaire for the assessment of auditory disability. J Audit Res 1970, 10:229-250.
• [59]Aromaa A, Koskinen S, and Kansanterveyslaitos: Health and functional capacity in Finland: baseline results of the health 2000 health examination survey. Helsinki: National Public Health Institute; 2004.
• [60]Hietanen A, Era P, Henrichsen J, Rosenhall U, Sorri M, Heikkinen E: Hearing among 75-year-old people in three Nordic localities: a comparative study. Int J Audiol 2005, 44:500-508.
• [61]Salmela-Aro K, Read S, Nurmi J, Koskenvuo M, Kaprio J, Rantanen T: Personal goals of older female twins.Genetic and environmental effects. Eur Psychol 2009, 14:160-167.
• [62]Lawton MP, Moss MS, Winter L, Hoffman C: Motivation in later life: personal projects and well-being. Psychol Aging 2002, 17:539-547.
• [63]Davis MG, Fox KR: Physical activity patterns assessed by accelerometry in older people. Eur J Appl Physiol 2007, 100:581-589.
• [64]United Nations, Economic and Social Commission for Asia and the Pacific: Guidelines on the application of new technology to population data collection and capture. http://www.unescap.org/stat/pop-it/pop-guide/index.asp webcite
• [65]von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP: STROBE initiative: the strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007, 370:1453-1457.
• [66]Hardy SE, Allore H, Studenski SA: Missing data: a special challenge in aging research. J Am Geriatr Soc 2009, 57:722-729.