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Observational Study
. 2014 May;62(5):919-23.
doi: 10.1111/jgs.12787. Epub 2014 Apr 14.

Life-space mobility declines associated with incident falls and fractures

Alexander X Lo  1 , Cynthia J Brown, Patricia Sawyer, Richard E Kennedy, Richard M Allman
Affiliations
Observational Study

Life-space mobility declines associated with incident falls and fractures

Alexander X Lo et al. J Am Geriatr Soc. 2014 May.

Abstract

Objectives: To determine the effect of falls and fractures on life-space mobility in a cohort of community-dwelling older adults.

Design: Prospective, observational study with a baseline in-home assessment and 6-month telephone follow-up interviews over 4 years.

Setting: Central Alabama.

Participants: Community-dwelling adults aged 65 and older recruited from a random sample of Medicare beneficiaries stratified according to sex, race, and urban versus rural residence (N = 970).

Measurements: Sociodemographic factors, medical history, depressive symptoms (Geriatric Depression Scale), cognitive function (Mini-Mental State Examination), mobility-related symptoms, transportation difficulty, and healthcare use were assessed during a baseline in-home interview of participants. Life-space mobility and falls or injuries (including fractures) were assessed at the baseline interview and at 6-month intervals in follow-up telephone calls.

Results: Four hundred fifty-four (47%) participants reported at least one fall during the 4-year follow-up. The life-space score fell 3.2 points from the beginning to the end of the 6-month interval during which a fall occurred, adjusting for other known predictors of decline in life-space mobility. The decrease in interval life-space score was progressively greater for a fall and an injury (-4.7 points), a fall and a fracture (-14.2 points), and a fall and a hip fracture (-23.6 points).

Conclusion: Falls, whether associated with an injury or not, were independently associated with a decrease in life-space mobility in the ensuing 6 months. Further studies are needed to determine reasons for life-space mobility decline in community-dwelling older adults with incident falls without any injuries.

Keywords: falls; injury; life-space; mobility.

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Conflict of interest statement

Conflict of interest:

Dr. Brown is supported by a Veterans Administration Rehabilitation Scientific Merit Award (E7036R). Dr. Lo is supported by the John A. Hartford Foundation.

Alexander X. Lo is supported by a grant from the John A. Hartford Foundation. Cynthia J. Brown is supported by a Veterans Administration Rehabilitation Scientific Merit Award (E7036R). Richard M. Allman, Cynthia J. Brown, Richard E. Kennedy and Patricia Sawyer were all support by grant number R01 AG16062 from NIA. Richard M. Allman was also supported by 5UL1 RR025777 from the NIH.

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