title: Life-space assessment in urogynecology and gynecological oncology surgery patients: a measure of perioperative mobility and function.
abstract: OBJECTIVE
  To assess the effect of gynecological surgery on mobility and functional status in women aged 60 and older using Life-Space Assessment (LSA).
  
  
  METHODS
  Observational prospective cohort study.
  
  
  METHODS
  Academic outpatient urogynecology and gynecological oncology clinics.
  
  
  METHODS
  Women presenting for urogynecology (n=51) and gynecological oncology (n=51) surgery.
  
  
  METHODS
  LSA scores 6 weeks, 6 months, and 1 year after surgery. Information on participant demographics, preoperative diagnoses, surgical approach, and medical comorbidities was collected. Analyses used repeated measures.
  
  
  RESULTS
  Mean age was 71 +/- 7. Urogynecology participants started and maintained a higher LSA (P=.03) than oncology participants at all study intervals. Six weeks after surgery, urogynecology and oncology participants' mean decline was 13 points (95% confidence interval (CI)=4-21; P=.004) and 23 points (95% CI=13-33; P<.001), respectively. At 6 months, the urogynecology and oncology participants' scores increased by a mean of 9 points (95% CI=1-17; P=.03) and 13 points (95% CI=5-20; P=.001), respectively. No significant difference was found 1 year from baseline within each group or between groups in LSA scores. Income, depression, body mass index, and having an operative complication predicted a larger decline in life-space over time in both groups.
  
  
  CONCLUSIONS
  Gynecological surgical interventions in older women limit physical and functional ability at 6 weeks after surgery. The urogynecology and gynecological oncology cohorts returned to baseline levels by 6 months, which was sustained to 1 year.
authors.affiliation: Division of Women's Reproductive Healthcare, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
authors.forename: Chere M L
authors.initials: CM
authors.lastname: Stewart
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Wheeler
authors.forename: Alayne D
authors.initials: AD
authors.lastname: Markland
authors.forename: J Michael
authors.initials: JM
authors.lastname: Straughn
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D014571:Urologic Neoplasms / Q000601:surgery*