title: Caregiving burden and out-of-home mobility of cognitively impaired care-recipients based on GPS tracking.
abstract: BACKGROUND
  Out-of-home mobility refers to the realization of trips outside the home, by foot or by other means of transportation. Although out-of-home mobility is important for the well-being of older people with cognitive impairment, its importance for their caregivers is not clear. This study aims to clarify the relationship between caregiving burden and out-of-home mobility of care-recipients using Global Positioning Systems (GPS) technology.
  
  
  METHODS
  Seventy-six dyads (care-recipients and caregivers) were recruited from a psychogeriatric center, where they underwent cognitive assessment, followed by psychosocial interviews at home. Care-recipients received GPS tracking kits to carry for a period of four weeks, whenever they left home. Mobility data and diagnostic and psychosocial data were examined in relation to caregiver burden.
  
  
  RESULTS
  The strongest predictors of burden were care-recipients' lower cognitive status and more time spent walking out-of-home. An interaction was found between cognitive status and time spent walking in relation to caregiver burden. The relationship between walking and burden was stronger among caregivers of care-recipients with dementia than caregivers of care-recipients with no cognitive impairment or mild cognitive impairment. Care-recipients' behavioral and emotional states were also positively related to caregiver burden.
  
  
  CONCLUSIONS
  The findings stress the importance of maintaining older persons' out-of-home mobility during cognitive decline.
authors.affiliation: Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel. shirlior@mscc.huji.ac.il
authors.forename: Shirli
authors.initials: S
authors.lastname: Werner
authors.forename: Gail K
authors.initials: GK
authors.lastname: Auslander
authors.forename: Noam
authors.initials: N
authors.lastname: Shoval
authors.forename: Tamar
authors.initials: T
authors.lastname: Gitlitz
authors.forename: Ruth
authors.initials: R
authors.lastname: Landau
authors.forename: Jeremia
authors.initials: J
authors.lastname: Heinik
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D003704:Dementia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D051341:Dependent Ambulation / Q000523:psychology*; D005260:Female; D040362:Geographic Information Systems; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D051346:Mobility Limitation; D010043:Outcome and Process Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D014187:Transportation of Patients / Q000379:methods*