Associations Between Active Mobility Index and Disability |
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| Institution: | 1. Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA;2. Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA;3. Department of Economics, Farmer School of Business, Miami University, Oxford, OH, USA;4. Scripps Gerontology Center, Miami University, Oxford, OH, USA;5. Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA;6. Division of Geriatrics, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA;7. Geriatrics & Extended Care Data Analysis Center (GECDAC), Canandaigua VA Medical Center, Canandaigua, NY, USA;1. Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA;2. Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;3. MGH Institute of Health Professions, Boston, MA, USA;4. Meyers Primary Care Institute, Worcester, MA, USA;5. Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA;1. Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada;2. Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada;3. Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada;4. GERAS Centre for Aging Research, Hamilton, Ontario, Canada;5. Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada;1. Division of Geriatric Medicine, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA;2. Division of Palliative Care and Geriatric Medicine, Mongan Institute Center for Aging and Serious Illness, Massachusetts General Hospital, Boston, MA, USA;3. Harvard Medical School, Boston, MA, USA;4. University of Texas Southwestern Medical Center, Dallas, TX, USA;5. Baylor College of Medicine, Houston, TX, USA;6. Advisor to Improvers and Learners, Saint Paul, MN, USA;7. University of Pennsylvania Health System, Philadelphia, PA, USA;8. Connolly Hospital, Dublin, Ireland;1. Division of Community Internal Medicine, Mayo Clinic, Rochester, MN, USA;2. Division of Geriatric Medicine and Gerontology, Mayo Clinic, Rochester, MN, USA;3. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA;4. Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA;5. Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA;1. Tertiary Emergency Medical Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan;2. Tokyo Fire Department, Tokyo, Japan |
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| Abstract: | ObjectivesTo develop a questionnaire-based Active Mobility Index (AMI) to assess going-out behavior with physical and social activity among older adults, and to assess the criterion-related and predictive validity of the AMI.DesignProspective cohort study.Setting and ParticipantsGeneral community setting. Participants comprised 4432 older adults mean age: 75.9 ± 4.3 (70-96) years; 2100 men (47.4%)].MethodsAMI assessed life-space and activities in each life-space (distance from the respondent's home: <1 km, 1-10 km, or >10 km) according to physical or social activity during the past 1 month by noting frequency, purpose, type of transportation, interaction with others, and physical activity. Baseline characteristics and outcomes were compared by AMI score quartiles (highest: Q4). To examine the criterion-related validity of AMI, depressive symptoms, frailty, and cognitive function were assessed. During follow-up, incident disability was monitored by Long Term Care Insurance certification.ResultsLower scores (Q1-Q3 groups) were associated with more depressive symptoms, frailty, and cognitive impairment compared with the Q4 group (all P < .001). Multiple logistic regression analyses revealed significantly higher odds ratios in the Q1 group in all health adverse outcomes compared with the Q4 group depressive symptoms, odds ratio (OR) 3.94, 95% confidence interval (CI) 2.95-5.28; frailty, OR 3.20, 95% CI 2.31-4.44; cognitive impairment, OR 1.28, 95% CI 1.04-1.57]. Cox proportional hazards modeling indicated that the Q1 group had a higher risk of incident disability compared with the group (hazard ratio 1.53, 95% CI 1.24-1.88).Conclusions and ImplicationsAMI to assess life-space with physical and social activity among older people was associated with depressive symptoms, frailty, and cognitive impairment. Lower AMI scores were associated with higher incident disability risk. Further studies are needed to elucidate whether AMI is causally associated with incident adverse health outcomes. |
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| Keywords: | Frailty depression cognition |
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