title: Life-space mobility declines associated with incident falls and fractures.
abstract: OBJECTIVE
  To determine the effect of falls and fractures on life-space mobility in a cohort of community-dwelling older adults.
  
  
  METHODS
  Prospective, observational study with a baseline in-home assessment and 6-month telephone follow-up interviews over 4 years.
  
  
  METHODS
  Central Alabama.
  
  
  METHODS
  Community-dwelling adults aged 65 and older recruited from a random sample of Medicare beneficiaries stratified according to sex, race, and urban versus rural residence (N = 970).
  
  
  METHODS
  Sociodemographic factors, medical history, depressive symptoms (Geriatric Depression Scale), cognitive function (Mini-Mental State Examination), mobility-related symptoms, transportation difficulty, and healthcare use were assessed during a baseline in-home interview of participants. Life-space mobility and falls or injuries (including fractures) were assessed at the baseline interview and at 6-month intervals in follow-up telephone calls.
  
  
  RESULTS
  Four hundred fifty-four (47%) participants reported at least one fall during the 4-year follow-up. The life-space score fell 3.2 points from the beginning to the end of the 6-month interval during which a fall occurred, adjusting for other known predictors of decline in life-space mobility. The decrease in interval life-space score was progressively greater for a fall and an injury (-4.7 points), a fall and a fracture (-14.2 points), and a fall and a hip fracture (-23.6 points).
  
  
  CONCLUSIONS
  Falls, whether associated with an injury or not, were independently associated with a decrease in life-space mobility in the ensuing 6 months. Further studies are needed to determine reasons for life-space mobility decline in community-dwelling older adults with incident falls without any injuries.
authors.affiliation: Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Alexander X
authors.initials: AX
authors.lastname: Lo
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Brown
authors.forename: Patricia
authors.initials: P
authors.lastname: Sawyer
authors.forename: Richard E
authors.initials: RE
authors.lastname: Kennedy
authors.forename: Richard M
authors.initials: RM
authors.lastname: Allman
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D000407:Alabama / Q000453:epidemiology; D003863:Depression / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D051346:Mobility Limitation; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012424:Rural Population; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: falls; injury; life-space; mobility
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