Dataset Information

Assessing Older Adults' Daily Mobility: A Comparison of GPS-Derived and Self-Reported Mobility Indicators.

ABSTRACT: Interest in global positioning system (GPS)-based mobility assessment for health and aging research is growing, and with it the demand for validated GPS-based mobility indicators. Time out of home (TOH) and number of activity locations (#ALs) are two indicators that are often derived from GPS data, despite lacking consensus regarding thresholds to be used to extract those as well as limited knowledge about their validity. Using 7 days of GPS and diary data of 35 older adults, we make the following three main contributions. First, we perform a sensitivity analysis to investigate how using spatial and temporal thresholds to compute TOH and #ALs affects the agreement between self-reported and GPS-based indicators. Second, we show how daily self-reported and GPS-derived mobility indicators are compared. Third, we explore whether the type and duration of self-reported activity events are related to the degree of correspondence between reported and GPS event. Highest indicator agreement was found for temporal interpolation (Tmax) of up to 5 h for both indicators, a radius (Dmax) to delineate home between 100 and 200 m for TOH, and for #ALs a spatial extent (Dmax) between 125 and 200 m, and temporal extent (Tmin) between 5 and 6 min to define an activity location. High agreement between self-reported and GPS-based indicators is obtained for TOH and moderate agreement for #ALs. While reported event type and duration impact on whether a reported event has a matching GPS event, indoor and outdoor events are detected at equal proportions. This work will help future studies to choose optimal threshold settings and will provide knowledge about the validity of mobility indicators.

SUBMITTER: Fillekes MP

PROVIDER: S-EPMC6833043 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Assessing Older Adults' Daily Mobility: A Comparison of GPS-Derived and Self-Reported Mobility Indicators.

Fillekes Michelle Pasquale MP Kim Eun-Kyeong EK Trumpf Rieke R Zijlstra Wiebren W Giannouli Eleftheria E Weibel Robert R

Sensors (Basel, Switzerland) 20191019 20

Interest in global positioning system (GPS)-based mobility assessment for health and aging research is growing, and with it the demand for validated GPS-based mobility indicators. Time out of home (TOH) and number of activity locations (#ALs) are two indicators that are often derived from GPS data, despite lacking consensus regarding thresholds to be used to extract those as well as limited knowledge about their validity. Using 7 days of GPS and diary data of 35 older adults, we make the followi ...[more]

PMID: 31635100

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Project description:Background and objectivesIn 2010, Webber and colleagues conceptualized the interrelationships between mobility determinants, and researchers tested Webber's framework using data from developed countries. No studies have tested this model using data from developing nations (e.g., Nigeria). This study aimed to simultaneously explore the cognitive, environmental, financial, personal, physical, psychological, and social influences and their interaction effects on the mobility outcomes among community-dwelling older adults in Nigeria.Research design and methodsThis cross-sectional study recruited 227 older adults (mean age [standard deviation] = 66.6 [6.8] years). Performance-based mobility outcomes included gait speed, balance, and lower extremity strength, and were assessed using the Short Physical Performance Battery, whereas the self-reported mobility outcomes included inability to walk 0.5 km, 2 km, or climb a flight of stairs, assessed using the Manty Preclinical Mobility Limitation Scale. Regression analysis was used to determine the predictors of mobility outcomes.ResultsThe number of comorbidities (physical factor) negatively predicted all mobility outcomes, except the lower extremity strength. Age (personal factor) negatively predicted gait speed (β = -0.192), balance (β = -0.515), and lower extremity strength (β = -0.225), and a history of no exercise (physical factor) positively predicted inability to walk 0.5 km (B = 1.401), 2 km (B = 1.295). Interactions between determinants improved the model, explaining the most variations in all the mobility outcomes. Living arrangement is the only factor that consistently interacted with other variables to improve the regression model for all mobility outcomes, except balance and self-reported inability to walk 2 km.Discussion and implicationsInteractions between determinants explain the most variations in all mobility outcomes, highlighting the complexity of mobility. This finding highlighted that factors predicting self-reported and performance-based mobility outcomes might differ, but this should be confirmed with a large data set.

Project description:BackgroundAge-associated increases in medical complexity, frailty, and cognitive impairment may compromise reliable reporting of medical history.ObjectiveTo evaluate the influence of increasing age and cognitive impairment on concordance between reported history of stroke and cerebral infarction, and reported history of diabetes and elevated hemoglobinA1c in community-dwelling older adults.MethodsThe association between participant-specific factors and accurate reporting of stroke or diabetes was evaluated using multivariable logistic regression in 1,401 participants enrolled in longitudinal studies of memory and aging, including 425 participants with dementia (30.3%). Stroke and diabetes were selected as index variables as gold standard measures of both were obtained in all participants: magnetic resonance neuroimaging for cerebral infarcts and hemoglobinA1c (≥6.5%) for diabetes.ResultsConcordance between reported history of stroke and imaging-confirmed cerebral infarction was low (sensitivity: 17.4%, 8/46; specificity: 97.9%, 799/816). Small infarcts were strongly associated with inaccurate reporting (OR = 265.8; 95% CI: 86.2, 819.4), suggesting that occult/silent infarcts contributed to discordant reporting. Reporting accuracy was higher concerning diabetes (sensitivity: 83.5%, 147/176; specificity: 96.2%, 1100/1143). A history of hypertension (OR = 2.3; 95% CI: 1.3, 4.2), higher hemoglobinA1c (OR = 1.9; 95% CI: 1.5, 2.4), and hemoglobinA1c compatible with impaired glucose tolerance (OR = 3.1; 95% CI 1.8, 5.3) associated with increased odds of discordant reporting. Cognitive impairment and increased age were not independently associated with reliable reporting.ConclusionFactors beyond advancing age and cognitive impairment appear to drive discordance in reported medical history in older participants. Objective testing for cerebral infarcts or diabetes should be performed when relevant to diagnostic or therapeutic decisions in clinical and research settings.

Project description:BackgroundGPS tracking is increasingly used in health and aging research to objectively and unobtrusively assess individuals' daily-life mobility. However, mobility is a complex concept and its thorough description based on GPS-derived mobility indicators remains challenging.MethodsWith the aim of reflecting the breadth of aspects incorporated in daily mobility, we propose a conceptual framework to classify GPS-derived mobility indicators based on their characteristic and analytical properties for application in health and aging research. In order to demonstrate how the classification framework can be applied, existing mobility indicators as used in existing studies are classified according to the proposed framework. Then, we propose and compute a set of selected mobility indicators based on real-life GPS data of 95 older adults that reflects diverse aspects of individuals' daily mobility. To explore latent dimensions that underlie the mobility indicators, we conduct a factor analysis.ResultsThe proposed framework enables a conceptual classification of mobility indicators based on the characteristic and analytical aspects they reflect. Characteristic aspects inform about the content of the mobility indicator and comprise categories related to space, time, movement scope, and attribute. Analytical aspects inform how a mobility indicator is aggregated with respect to temporal scale and statistical property. The proposed categories complement existing studies that often underrepresent mobility indicators involving timing, temporal distributions, and stop-move segmentations of movements. The factor analysis uncovers the following six dimensions required to obtain a comprehensive view of an older adult's daily mobility: extent of life space, quantity of out-of-home activities, time spent in active transport modes, stability of life space, elongation of life space, and timing of mobility.ConclusionThis research advocates incorporating GPS-based mobility indicators that reflect the multi-dimensional nature of individuals' daily mobility in future health- and aging-related research. This will foster a better understanding of what aspects of mobility are key to healthy aging.

Project description:Background and objectivesAlthough the association between self-reported and capacity-based mobility outcomes is prominently researched, the pathways through which self-reported measures affect capacity-based measures remains poorly understood. Therefore, our study examines the association between self-reported and capacity-based mobility measures and explores which mobility determinants mediate the association in Nigerian community-dwelling older adults.Research design and methodsThis cross-sectional study included 169 older adults [mean age (SD) = 67.7 (7.0)]. Capacity-based mobility outcomes included the Short Physical Performance Battery (SPPB), the 6-Minute Walk Test (6MWT), and the 10-Meter Walk Test (10mWT), whereas the self-reported mobility outcomes included the Lower Extremity Functional scale (LEFS), the Life Space Questionnaire (LSQ), and the Mänty Preclinical Mobility scale (inability to walk 2 km, 0.5 km, or climb a flight of stairs). Spearman's correlations were conducted to examine the relationship between self-reported and capacity-based mobility measures, whereas structural equation modeling was used to determine the mediators.ResultsThe correlation between SPPB and LEFS (rho = 0.284) and 0.5 km (rho = -0.251) were fair, whereas the correlation between SPPB and inability to walk 2 km (rho = -0.244) and inability to climb a flight of stairs (rho = -0.190) were poor. Similarly, correlations between 6MWT and the LEFS (rho = 0.286), inability to walk 2 km (rho = -0.269), and 0.5 km (rho = -0.303) were fair. The 6WMT was poorly correlated with inability to climb one flight of stairs (rho = -0.233). The LSQ was not correlated with SPPB or 10mWT. Age was the only significant mediator, whereas the number of chronic conditions and cognitive status were not.Discussion and implicationsThe correlation between self-reported and capacity-based mobility outcomes in older adults in Nigeria is lower than those in developed countries. Our analysis provides a foundation to explore mobility determinants that could be predictive mediators for mobility outcomes, making meaningful contributions to explaining mobility complexities.

Dataset Information

Assessing Older Adults' Daily Mobility: A Comparison of GPS-Derived and Self-Reported Mobility Indicators.

Publications

Assessing Older Adults' Daily Mobility: A Comparison of GPS-Derived and Self-Reported Mobility Indicators.

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