title: Self-reported hearing difficulties and changes in life-space mobility among community-dwelling older adults: a Two-year follow-Up study.
abstract: BACKGROUND
  Life-space mobility reflects individuals' actual mobility and engagement with society. Difficulty in hearing is common among older adults and can complicate participation in everyday activities, thus restricting life-space mobility. The aim of this study was to examine whether self-reported hearing predicts changes in life-space mobility among older adults.
  
  
  METHODS
  We conducted a prospective cohort study of community-dwelling older adults aged 75-90 years (n = 848). At-home face-to-face interviews at baseline and telephone follow-up were used. Participants responded to standardized questions on perceived hearing at baseline. Life-space mobility (the University of Alabama at Birmingham Life-Space Assessment, LSA, range 0-120) was assessed at baseline and one and two years thereafter. Generalized estimating equations were used to analyze the effect of hearing difficulties on changes in LSA scores.
  
  
  RESULTS
  At baseline, participants with major hearing difficulties had a significantly lower life-space mobility score than those without hearing difficulties (mean 54, 95 % CI 50-58 vs. 57, 95 % CI 53-61, p = .040). Over the 2-year follow-up, the life-space mobility score declined in all hearing categories in a similar rate (main effect of time p < .001, group x time p = .164). Participants with mild or major hearing difficulties at baseline had significantly higher odds for restricted life-space (LSA score < 60) at two years (OR 1.8, 95 % CI 1.0-3.2 and 2.0, 95 % CI 1.0-3.9, respectively) compared to those without hearing difficulties. The analyses were adjusted for chronic conditions, age, sex and cognitive functioning.
  
  
  CONCLUSIONS
  People with major hearing difficulties had lower life-space mobility scores at baseline but did not exhibit accelerated decline over the follow-up compared to those without hearing difficulties. Life-space mobility describes older people's possibilities for participating in out-of-home activities and access to community amenities, which are important building blocks of quality of life in old age. Early recognition of hearing difficulties may help prevent life-space restriction.
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland. hannele.polku@jyu.fi.
authors.forename: Hannele
authors.initials: H
authors.lastname: Polku
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland. tuija.m.mikkola@jyu.fi.
authors.forename: Tuija M
authors.initials: TM
authors.lastname: Mikkola
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland. merja.rantakokko@jyu.fi.
authors.forename: Merja
authors.initials: M
authors.lastname: Rantakokko
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland. erja.portegijs@jyu.fi.
authors.forename: Erja
authors.initials: E
authors.lastname: Portegijs
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland. timo.tormakangas@campus.jyu.fi.
authors.forename: Timo
authors.initials: T
authors.lastname: Törmäkangas
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland. taina.rantanen@jyu.fi.
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland. anne.viljanen@jyu.fi.
authors.forename: Anne
authors.initials: A
authors.lastname: Viljanen
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D057187:Independent Living / Q000523:psychology* / Q000639:trends; D007398:Interpersonal Relations; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D057566:Self Report; D013997:Time Factors