title: Identification of Older People at Risk of ADL Disability Using the Life-Space Assessment: A Longitudinal Cohort Study.
abstract: Life-space mobility, assessed with the Life-Space Assessment (LSA), reflects an individual's mobility in terms of the spatial area, frequency, and need for assistance. The aims were to study associations between life-space mobility and disability status in activities of daily living (ADL), and to define cutoff scores for baseline LSA and LSA change over time identifying individuals who developed ADL inability during 2 years of follow-up. Robustness of the cutoff scores was tested accounting for potential confounders.
  
  
  
  Longitudinal analyses of the "Life-space mobility in old age" cohort study.
  
  
  
  Home-based interviews at baseline and phone interviews 2 years later.
  
  
  
  A total of 755 community-dwelling 75- to 90-year-old people living in Central Finland.
  
  
  
  LSA score (range 0-120) and ADL disability status (no difficulty, difficulty in ≥1 tasks, or inability in ≥1 tasks) were determined based on self-reports.
  
  
  
  Participants who developed difficulty or inability in ADL over time presented lower LSA scores at baseline and larger declines compared to those who remained without task difficulty or inability during the follow-up, respectively. Sensitivity and specificity analyses showed that baseline LSA ≤52.3 (0.86 and 0.74, respectively) and LSA decline of >11.7 (0.76 and 0.71, respectively) identified participants who developed ADL inability over the follow-up. Multinomial regression showed that, after adjustment for potential confounders, these cutoff scores increased the odds to develop new difficulty in ADL tasks, and the odds to develop ADL inability among those with baseline difficulty.
  
  
  
  Our results suggest that restrictions and declines in life-space mobility may be early signs of increasing vulnerability to disability in old age. These longitudinally defined cutoff points may help to find clinical applications for the LSA.
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Finland. Electronic address: 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 Jyvaskyla, Finland.
authors.forename: Merja
authors.initials: M
authors.lastname: Rantakokko
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Viljanen
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Finland.
authors.forename: Sarianna
authors.initials: S
authors.lastname: Sipilä
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Finland.
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D036301:Qualitative Research; D018570:Risk Assessment / Q000379:methods*
keywords: Mobility limitation; activities of daily living; aging; disability; frail; participation