Dataset Information

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

ABSTRACT:

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.

SUBMITTER: Saraiva MD

PROVIDER: S-EPMC7678592 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

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

Saraiva M D MD Apolinario D D Avelino-Silva T J TJ de Assis Moura Tavares C C Gattás-Vernaglia I F IF Marques Fernandes C C Rabelo L M LM Tavares Fernandes Yamaguti S S Karnakis T T Kalil-Filho R R Jacob-Filho W W Romero Aliberti M J MJ

The journal of nutrition, health & aging.. 20210101 4

<h4>Background</h4>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.<h4>Objective</h4>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.<h4>Design</h4>Multicenter prospective cohort study based on structured telephone interviews.<h4>Setting</h4>Four geriatric outpatient c ...[more]

PMID: 33786560

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Project description:BackgroundThe relation of gait quality to real-life mobility among older adults is poorly understood. This study examined the association between gait quality, consisting of step variability, smoothness, regularity, symmetry, and gait speed, and the Life-Space Assessment (LSA).MethodIn community-dwelling older adults (N = 232, age 77.5 ± 6.6, 65% females), gait quality was derived from (i) an instrumented walkway: gait speed, variability, and walk ratio and (ii) accelerometer: signal variability, smoothness, regularity, symmetry, and time-frequency spatiotemporal variables during 6-minute walk. In addition to collecting LSA scores, cognitive functioning, walking confidence, and falls were recorded. Spearman correlations (speed as covariate) and random forest regression were used to assess associations between gait quality and LSA, and Gaussian mixture modeling (GMM) was used to cluster participants.ResultsSpearman correlations of ρ p = .11 (signal amplitude variability mediolateral [ML] axis), ρ p = .15 and ρ p = -.13 (symmetry anterior-posterior-vertical [AP-V] and ML-AP axes, respectively), ρ p = .16 (power V), and ρ = .26 (speed), all p <.05 and marginally related, ρ p = -.12 (regularity V), ρ p = .11 (smoothness AP), and ρ p = -.11 (step-time variability), all p <.1, were obtained. The cross-validated random forest model indicated good-fit LSA prediction error of 17.77; gait and cognition were greater contributors than age and gender. GMM indicated 2 clusters. Group 1 (n = 189) had better gait quality than group 2 (n = 43): greater smoothness AP (2.94 ± 0.75 vs 2.30 ± 0.71); greater similarity AP-V (.58 ± .13 vs .40 ± .19); lower regularity V (0.83 ± 0.08 vs 0.87 ± 0.10); greater power V (1.86 ± 0.18 vs 0.97 ± 1.84); greater speed (1.09 ± 0.16 vs 1.00 ± 0.16 m/s); lower step-time coefficient of variation (3.70 ± 1.09 vs 5.09 ± 2.37), and better LSA (76 ± 18 vs 67 ± 18), padjusted < .004.ConclusionsGait quality measures taken in the clinic are associated with real-life mobility in the community.

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Project description:BackgroundLife-Space Assessment captures community mobility and social participation and quantifies the distance, frequency, and independence obtained as an older adult moves through his or her environment. Reduced estimated glomerular filtration rate (eGFR) is associated with decline in activities of daily living among older adults, but less is known about the association of eGFR with restrictions in mobility.Study designProspective observational cohort study.Setting & participantsCommunity-dwelling Medicare beneficiaries from the University of Alabama at Birmingham Study of Aging who had serum creatinine measured during a baseline in-home study visit and completed at least one telephone follow-up (N = 390).PredictoreGFR ≥ 60, 45-59, and <45 mL/min/1.73 m(2).OutcomeLife-space mobility trajectory.MeasurementsLife-space mobility was evaluated by telephone every 6 months for up to 4.5 years using the previously validated Life-Space Assessment. Scores using this tool range from 0-120 (higher scores indicate greater mobility).ResultsMean age of the 390 participants was 77.6 ± 5.8 (SD) years, 41% were African American, 50.5% were women; 30.0% had eGFR of 45-59 mL/min/1.73 m(2), and 20.2% had eGFR < 45 mL/min/1.73 m(2). Age-, race-, and sex-adjusted mean baseline life-space mobility scores were 64.8(95% CI, 62.0-67.6), 63.8 (95% CI, 60.3-67.4), and 58.3 (95% CI, 53.8-62.7) among those with eGFR categories ≥ 60, 45-59, and <45 mL/min/1.73 m(2), respectively. Compared with those with eGFRs ≥ 60 mL/min/1.73 m(2), a more rapid decline in life-space mobility was found among those with eGFRs < 45 mL/min/1.73 m(2), though this did not reach statistical significance (P=0.06); a similar effect was not seen among those with eGFRs of 45-59 mL/min/1.73 m(2) (P=0.3).LimitationsUrinary albumin or longitudinal measures of eGFR were not available.ConclusionseGFR < 45 mL/min/1.73 m(2) was associated with a trend toward a more rapid decline in life-space mobility among community-dwelling older adults. Findings should be confirmed in a larger population.

Dataset Information

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

Background

Objective

Design

Setting

Participants

Measurements

Results

Conclusion

Publications

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

Similar Datasets

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