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Life‐Space Mobility Declines Associated with Incident Falls and Fractures
Author(s) -
Lo Alexander X.,
Brown Cynthia J.,
Sawyer Patricia,
Kennedy Richard E.,
Allman Richard M.
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12787
Subject(s) - medicine , confidence interval , poison control , injury prevention , telephone interview , gerontology , prospective cohort study , suicide prevention , occupational safety and health , activities of daily living , demography , geriatrics , physical therapy , medical emergency , surgery , psychiatry , social science , pathology , sociology
Objectives To determine the effect of falls and fractures on life‐space mobility in a cohort of community‐dwelling older adults. Design Prospective, observational study with a baseline in‐home assessment and 6‐month telephone follow‐up interviews over 4 years. Setting Central Alabama. Participants Community‐dwelling adults aged 65 and older recruited from a random sample of Medicare beneficiaries stratified according to sex, race, and urban versus rural residence (N = 970). Measurements Sociodemographic factors, medical history, depressive symptoms ( G eriatric D epression S cale), cognitive function ( M ini‐ M ental S tate E xamination), mobility‐related symptoms, transportation difficulty, and healthcare use were assessed during a baseline in‐home interview of participants. Life‐space mobility and falls or injuries (including fractures) were assessed at the baseline interview and at 6‐month intervals in follow‐up telephone calls. Results Four hundred fifty‐four (47%) participants reported at least one fall during the 4‐year follow‐up. The life‐space score fell 3.2 points from the beginning to the end of the 6‐month interval during which a fall occurred, adjusting for other known predictors of decline in life‐space mobility. The decrease in interval life‐space score was progressively greater for a fall and an injury (−4.7 points), a fall and a fracture (−14.2 points), and a fall and a hip fracture (−23.6 points). Conclusion Falls, whether associated with an injury or not, were independently associated with a decrease in life‐space mobility in the ensuing 6 months. Further studies are needed to determine reasons for life‐space mobility decline in community‐dwelling older adults with incident falls without any injuries.