title: Mobility and cognition are associated with wellbeing and health related quality of life among older adults: a cross-sectional analysis of the Vancouver Falls Prevention Cohort.
abstract: BACKGROUND
  Ascertaining individuals' quality of life and wellbeing is essential in public health and clinical research. The impact of these two pressing geriatric syndromes--impaired mobility and cognitive function--on wellbeing and quality of life is not well examined. Hence, our objective was to identify key clinically relevant outcome measures of mobility and cognitive function that explain variation in wellbeing and health related quality of life (HRQoL) among community dwelling older adults.
  
  
  METHODS
  We conducted a cross-sectional analysis of 229 participants presenting to the Vancouver Falls Prevention Clinic from June 2010 through October 2013. The linear regression models included two dependent variables: the ICECAP-O assessing wellbeing and the EQ-5D-3L assessing HRQoL. Key independent variables included the Short Performance Physical Battery (SPPB) and the Montreal Cognitive Assessment (MoCA). Covariates included Functional Comorbidity Index (FCI), sex and age. In the two multiple linear regression models, age was statistically controlled. Other covariates (i.e., sex and FCI) were included based on statistical significance (i.e., p < 0.05).
  
  
  RESULTS
  The SPPB was significantly associated with HRQoL and with wellbeing after adjusting for known covariates (p < 0.05, Unstandardized ß (Standard Error) 0.023 (0.006) for HRQoL and 0.016 (0.003) for wellbeing). The MoCA was significantly associated with wellbeing after adjusting for known covariates (p = 0.006), Unstandardized ß (Standard Error) 0.005 (0.002) but not with health related quality of life (p > 0.05).
  
  
  CONCLUSIONS
  We found that a measure of mobility and balance was associated with HRQoL and wellbeing. However, cognitive function was associated with wellbeing only. This study highlights the potential importance of considering wellbeing as an outcome measure if interventions are intended to have a broader impact than health alone.
authors.affiliation: Centre for Clinical Epidemiology and Evaluation, 828 West 10th Avenue, Vancouver, Canada. jennifer.davis@ubc.ca.|Vancouver Coastal Health Research Institute (VCHRI), Vancouver, BC, V6T 2B5, Canada. jennifer.davis@ubc.ca.|University of British Columbia, Vancouver, BC, V6T 2B5, Canada. jennifer.davis@ubc.ca.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Davis
authors.affiliation: Centre for Clinical Epidemiology and Evaluation, 828 West 10th Avenue, Vancouver, Canada. Stirling.Bryan@ubc.ca.|Vancouver Coastal Health Research Institute (VCHRI), Vancouver, BC, V6T 2B5, Canada. Stirling.Bryan@ubc.ca.|University of British Columbia, Vancouver, BC, V6T 2B5, Canada. Stirling.Bryan@ubc.ca.
authors.forename: Stirling
authors.initials: S
authors.lastname: Bryan
authors.affiliation: Department of Physical Therapy, 2177 Wesbrook Mall, Vancouver, Canada. lli@arthritisresearch.ca.|University of British Columbia, Vancouver, BC, V6T 2B5, Canada. lli@arthritisresearch.ca.|Arthritis Research Centre of Canada, 5591 No. 3 Road, Richmond, BC, V6X 2C7, Canada. lli@arthritisresearch.ca.
authors.forename: Linda C
authors.initials: LC
authors.lastname: Li
authors.affiliation: Department of Physical Therapy, 2177 Wesbrook Mall, Vancouver, Canada. john.best@ubc.ca.|University of British Columbia, Vancouver, BC, V6T 2B5, Canada. john.best@ubc.ca.|Aging, Mobility, and Cognitive Neuroscience Lab, 2211 Wesbrook Mall, Vancouver, Canada. john.best@ubc.ca.|Djavad Mowafaghian Centre for Brain Health, University of British Columbia & VCHRI, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada. john.best@ubc.ca.|Center for Hip Health and Mobility, 311-2647 Willow Street, Vancouver, BC, V5Z 1 M9, Canada. john.best@ubc.ca.
authors.forename: John R
authors.initials: JR
authors.lastname: Best
authors.affiliation: Department of Physical Therapy, 2177 Wesbrook Mall, Vancouver, Canada. liang.hsu@hiphealth.ca.|University of British Columbia, Vancouver, BC, V6T 2B5, Canada. liang.hsu@hiphealth.ca.|Aging, Mobility, and Cognitive Neuroscience Lab, 2211 Wesbrook Mall, Vancouver, Canada. liang.hsu@hiphealth.ca.|Djavad Mowafaghian Centre for Brain Health, University of British Columbia & VCHRI, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada. liang.hsu@hiphealth.ca.|Center for Hip Health and Mobility, 311-2647 Willow Street, Vancouver, BC, V5Z 1 M9, Canada. liang.hsu@hiphealth.ca.
authors.forename: Chun Liang
authors.initials: CL
authors.lastname: Hsu
authors.affiliation: University of British Columbia, Vancouver, BC, V6T 2B5, Canada. caitlin.gomez@hiphealth.ca.|Aging, Mobility, and Cognitive Neuroscience Lab, 2211 Wesbrook Mall, Vancouver, Canada. caitlin.gomez@hiphealth.ca.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Gomez
authors.affiliation: University of British Columbia, Vancouver, BC, V6T 2B5, Canada. kelly.vertes@hiphealth.ca.|Aging, Mobility, and Cognitive Neuroscience Lab, 2211 Wesbrook Mall, Vancouver, Canada. kelly.vertes@hiphealth.ca.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Vertes
authors.affiliation: Department of Physical Therapy, 2177 Wesbrook Mall, Vancouver, Canada. tlambrose@exchange.ubc.ca.|University of British Columbia, Vancouver, BC, V6T 2B5, Canada. tlambrose@exchange.ubc.ca.|Aging, Mobility, and Cognitive Neuroscience Lab, 2211 Wesbrook Mall, Vancouver, Canada. tlambrose@exchange.ubc.ca.|Djavad Mowafaghian Centre for Brain Health, University of British Columbia & VCHRI, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada. tlambrose@exchange.ubc.ca.|Center for Hip Health and Mobility, 311-2647 Willow Street, Vancouver, BC, V5Z 1 M9, Canada. tlambrose@exchange.ubc.ca.
authors.forename: Teresa
authors.initials: T
authors.lastname: Liu-Ambrose
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology; D002170:Canada; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D015999:Multivariate Analysis; D004856:Postural Balance; D011788:Quality of Life / Q000523:psychology*