title: Frequency of going outdoors: a predictor of functional and psychosocial change among ambulatory frail elders living at home.
abstract: BACKGROUND
  This study investigated the relationship between the frequency of going outdoors among ambulatory frail elders living at home and subsequent functional and psychosocial changes.
  
  
  METHODS
  In this 9-month prospective cohort study, data were collected via questionnaire from 112 frail elderly persons living at home and their families. Functional and psychosocial status at baseline and follow-up regarding activities of daily living, functional capacity, depression, self-efficacy for daily activities, self-efficacy for health promotion, and social support, were compared among 3 groups defined by the frequency of going outdoors: 1) more than 4 times a week, 2) 1-3 times a week, 3) less than once a week. At baseline, elders going outdoors more often were less functionally impaired, more socially active, and scored less depressed than elders going outdoors less often.
  
  
  RESULTS
  There were significant differences in functional capacity (p=.0201) and intellectual activities (p=.0026) over time according to the frequency of going outdoors, even when controlling for baseline differences, and the scores of those who seldom went outdoors decreased rapidly. There were similar relationships between frequency of going outdoors and changes in self-efficacy for both daily activities (p=.0067) and for health promotion (p=.0245), with participants going outdoors most frequently improving significantly more.
  
  
  CONCLUSIONS
  These results suggest that the frequency of going outdoors may be a useful and simple indicator to predict changes in functional capacity, intellectual activity and self-efficacy.
authors.affiliation: Sepulveda VA GRECC, and UCLA School of Medicine, Los Angeles, CA, USA. ayukono-tky@umin.ac.jp
authors.forename: Ayumi
authors.initials: A
authors.lastname: Kono
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kai
authors.forename: Chiyoko
authors.initials: C
authors.lastname: Sakato
authors.forename: Laurence Z
authors.initials: LZ
authors.lastname: Rubenstein
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly / Q000523:psychology; D005853:Geriatrics; D006304:Health Status; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011998:Recreation; D011795:Surveys and Questionnaires