title: Is frailty associated with life-space mobility and perceived autonomy in participation outdoors? A longitudinal study.
abstract: essential aspects of independence in community mobility among older people concern the control over where, when and how to participate (perceived autonomy), and actual mobility (life-space mobility; frequency, distance and need of assistance). We studied relationships between frailty and life-space mobility and perceived autonomy in participation outdoors among community-dwelling 75-90 years old people.
  
  
  
  longitudinal analyses of the 'Life-space mobility in old age' cohort study (n = 753). Life-space mobility (Life-Space Assessment, range 0-120) and perceived autonomy in participation outdoors (Impact on Participation and Autonomy subscale 'autonomy outdoors', range 0-20) were assessed at baseline and 2 years later. Baseline frailty indicators were unintentional weight loss (self-report), weakness (5 times chair rise), exhaustion (self-report), slowness (2.44 m walk) and low physical activity (self-report).
  
  
  
  in total, 53% had no frailty, 43% pre-frailty (1-2 frailty indicators) and 4% frailty (≥3 indicators). Generalised estimation equation models showed that life-space mobility was lower among those with frailty and pre-frailty compared with those without frailty and, in addition, declined at a faster pace. Perceived autonomy in participation outdoors was more restricted among those with frailty and pre-frailty compared with those without frailty, but the rate of decline did not differ.
  
  
  
  frailty was associated with more restricted life-space mobility and poorer perceived autonomy in the decision-making concerning community mobility. Over the follow-up, frailty predicted a steeper decline in life-space mobility but not in perceived autonomy. Further study is warranted to determine whether compensation strategies or changes in the valuation of activities underlie this discrepancy.
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland.
authors.forename: Erja
authors.initials: E
authors.lastname: Portegijs
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland.
authors.forename: Merja
authors.initials: M
authors.lastname: Rantakokko
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Viljanen
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland.
authors.forename: Sarianna
authors.initials: S
authors.lastname: Sipilä
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland.
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D015444:Exercise; D005221:Fatigue / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005387:Finland; D016330:Frail Elderly / Q000523:psychology*; D000073496:Frailty / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D015577:Geriatric Assessment; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D051346:Mobility Limitation; D018908:Muscle Weakness / Q000503:physiopathology / Q000523:psychology; D026684:Personal Autonomy; D012307:Risk Factors; D058992:Social Participation / Q000523:psychology*; D015431:Weight Loss
keywords: ageing; disability; frailty; mobility limitation; older people; participation