Life-Space Mobility Change Predicts 6-Month Mortality.
OBJECTIVE
To examine 6-month change in life-space mobility as a predictor of subsequent 6-month mortality in community-dwelling older adults.


METHODS
Prospective cohort study.


METHODS
Community-dwelling older adults from five Alabama counties in the University of Alabama at Birmingham (UAB) Study of Aging.


METHODS
A random sample of 1,000 Medicare beneficiaries, stratified according to sex, race, and rural or urban residence, recruited between November 1999 and February 2001, followed by a telephone interview every 6 months for the subsequent 8.5 years.


METHODS
Mortality data were determined from informant contacts and confirmed using the National Death Index and Social Security Death Index. Life-space was measured at each interview using the UAB Life-Space Assessment, a validated instrument for assessing community mobility. Eleven thousand eight hundred seventeen 6-month life-space change scores were calculated over 8.5 years of follow-up. Generalized linear mixed models were used to test predictors of mortality at subsequent 6-month intervals.


RESULTS
Three hundred fifty-four deaths occurred within 6 months of two sequential life-space assessments. Controlling for age, sex, race, rural or urban residence, and comorbidity, life-space score and life-space decline over the preceding 6-month interval predicted mortality. A 10-point decrease in life-space resulted in a 72% increase in odds of dying over the subsequent 6 months (odds ratio = 1.723, P < .001).


CONCLUSIONS
Life-space score at the beginning of a 6-month interval and change in life-space over 6 months were each associated with significant differences in subsequent 6-month mortality. Life-space assessment may assist clinicians in identifying older adults at risk of short-term mortality.
Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.|Comprehensive Center for Healthy Aging, Birmingham, Alabama.
Richard E
RE
Kennedy
Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.|Comprehensive Center for Healthy Aging, Birmingham, Alabama.
Patricia
P
Sawyer
Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Courtney P
CP
Williams
Comprehensive Center for Healthy Aging, Birmingham, Alabama.|Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Alexander X
AX
Lo
Division of Geriatrics, Department of Medicine, University of California at San Francisco, San Francisco, California.|Jewish Home San Francisco, San Francisco, California.
Christine S
CS
Ritchie
Division of Geriatric Medicine and Gerontology, Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland.
David L
DL
Roth
Geriatrics and Extended Care Services, Office of Patient Care Services, Veterans Health Administration, Washington, District of Columbia.
Richard M
RM
Allman
Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.|Comprehensive Center for Healthy Aging, Birmingham, Alabama.|Geriatric Research, Education, and Clinical Center, Birmingham/Atlanta Veterans Affairs, Birmingham, Alabama.
Cynthia J
CJ
Brown
D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000502:physiology; D000407:Alabama / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D009026:Mortality / Q000639:trends*; D011446:Prospective Studies; D012307:Risk Factors
comorbidity; life space; mobility; mortality; risk assessment