Trajectories of life-space mobility after hospitalization

Cynthia J. Brown, David L Roth, Richard M. Allman, Patricia Sawyer, Christine S. Ritchie, Jeffrey M. Roseman

Research output: Contribution to journalArticle

Abstract

Background: Life space is a measure of where a person goes, the frequency of going there, and the dependency in getting there. It may be a more accurate measure of mobility in older adults because it reflects participation in society as well as physical ability. Objective: To assess effects of hospitalization on life space in older adults, and to compare life-space trajectories associated with surgical and nonsurgical hospitalizations. Design: Prospective observational study. Setting: Central Alabama. Participants: 687 community-dwelling Medicare beneficiaries at least 65 years of age with surgical (n - 44), nonsurgical (n - 167), or no (n - 476) hospitalizations. Measurements: Life-Space Assessment (LSA) scores before and after hospitalization (range, 0 to 120; higher scores reflect greater mobility). Results: Mean age of participants was 74.6 years (SD, 6.3). Fifty percent were black, and 46% were male. Before hospitalization, adjusted LSA scores were similar in participants with surgical and nonsurgical admissions. Life-space assessment scores decreased in both groups immediately after hospitalization; however, participants with surgical hospitalizations had a greater decrease in scores (12.1 more points [95% CI, 3.6 to 20.7 points]; P - 0.005) than those with nonsurgical hospitalizations. However, participants with surgical hospitalizations recovered more rapidly over time (gain of 4.7 more points [CI, 2.0 to 7.4 points] per ln [week after discharge]; P<0.001). Score recovery for participants with nonsurgical hospitalizations did not significantly differ from the null (average recovery, 0.7 points [CI, - 0.6 to 1.9 points] per ln [week after discharge]). Limitation: Life space immediately before and after hospitalization was self-reported, often after hospital discharge. Conclusion: Hospitalization decreases life space in older adults. Surgical hospitalizations are associated with immediate marked life-space declines followed by rapid recovery, in contrast to nonsurgical hospitalizations, which are associated with more modest immediate declines and little evidence of recovery after several years of follow-up. Primary Funding Source: National Institute on Aging.

Original languageEnglish (US)
Pages (from-to)372-378
Number of pages7
JournalAnnals of Internal Medicine
Volume150
Issue number6
StatePublished - Mar 17 2009
Externally publishedYes

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Hospitalization
National Institute on Aging (U.S.)
Independent Living
Medicare
Observational Studies
Prospective Studies

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Brown, C. J., Roth, D. L., Allman, R. M., Sawyer, P., Ritchie, C. S., & Roseman, J. M. (2009). Trajectories of life-space mobility after hospitalization. Annals of Internal Medicine, 150(6), 372-378.

Trajectories of life-space mobility after hospitalization. / Brown, Cynthia J.; Roth, David L; Allman, Richard M.; Sawyer, Patricia; Ritchie, Christine S.; Roseman, Jeffrey M.

In: Annals of Internal Medicine, Vol. 150, No. 6, 17.03.2009, p. 372-378.

Research output: Contribution to journalArticle

Brown, CJ, Roth, DL, Allman, RM, Sawyer, P, Ritchie, CS & Roseman, JM 2009, 'Trajectories of life-space mobility after hospitalization', Annals of Internal Medicine, vol. 150, no. 6, pp. 372-378.
Brown CJ, Roth DL, Allman RM, Sawyer P, Ritchie CS, Roseman JM. Trajectories of life-space mobility after hospitalization. Annals of Internal Medicine. 2009 Mar 17;150(6):372-378.
Brown, Cynthia J. ; Roth, David L ; Allman, Richard M. ; Sawyer, Patricia ; Ritchie, Christine S. ; Roseman, Jeffrey M. / Trajectories of life-space mobility after hospitalization. In: Annals of Internal Medicine. 2009 ; Vol. 150, No. 6. pp. 372-378.
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abstract = "Background: Life space is a measure of where a person goes, the frequency of going there, and the dependency in getting there. It may be a more accurate measure of mobility in older adults because it reflects participation in society as well as physical ability. Objective: To assess effects of hospitalization on life space in older adults, and to compare life-space trajectories associated with surgical and nonsurgical hospitalizations. Design: Prospective observational study. Setting: Central Alabama. Participants: 687 community-dwelling Medicare beneficiaries at least 65 years of age with surgical (n - 44), nonsurgical (n - 167), or no (n - 476) hospitalizations. Measurements: Life-Space Assessment (LSA) scores before and after hospitalization (range, 0 to 120; higher scores reflect greater mobility). Results: Mean age of participants was 74.6 years (SD, 6.3). Fifty percent were black, and 46{\%} were male. Before hospitalization, adjusted LSA scores were similar in participants with surgical and nonsurgical admissions. Life-space assessment scores decreased in both groups immediately after hospitalization; however, participants with surgical hospitalizations had a greater decrease in scores (12.1 more points [95{\%} CI, 3.6 to 20.7 points]; P - 0.005) than those with nonsurgical hospitalizations. However, participants with surgical hospitalizations recovered more rapidly over time (gain of 4.7 more points [CI, 2.0 to 7.4 points] per ln [week after discharge]; P<0.001). Score recovery for participants with nonsurgical hospitalizations did not significantly differ from the null (average recovery, 0.7 points [CI, - 0.6 to 1.9 points] per ln [week after discharge]). Limitation: Life space immediately before and after hospitalization was self-reported, often after hospital discharge. Conclusion: Hospitalization decreases life space in older adults. Surgical hospitalizations are associated with immediate marked life-space declines followed by rapid recovery, in contrast to nonsurgical hospitalizations, which are associated with more modest immediate declines and little evidence of recovery after several years of follow-up. Primary Funding Source: National Institute on Aging.",
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N2 - Background: Life space is a measure of where a person goes, the frequency of going there, and the dependency in getting there. It may be a more accurate measure of mobility in older adults because it reflects participation in society as well as physical ability. Objective: To assess effects of hospitalization on life space in older adults, and to compare life-space trajectories associated with surgical and nonsurgical hospitalizations. Design: Prospective observational study. Setting: Central Alabama. Participants: 687 community-dwelling Medicare beneficiaries at least 65 years of age with surgical (n - 44), nonsurgical (n - 167), or no (n - 476) hospitalizations. Measurements: Life-Space Assessment (LSA) scores before and after hospitalization (range, 0 to 120; higher scores reflect greater mobility). Results: Mean age of participants was 74.6 years (SD, 6.3). Fifty percent were black, and 46% were male. Before hospitalization, adjusted LSA scores were similar in participants with surgical and nonsurgical admissions. Life-space assessment scores decreased in both groups immediately after hospitalization; however, participants with surgical hospitalizations had a greater decrease in scores (12.1 more points [95% CI, 3.6 to 20.7 points]; P - 0.005) than those with nonsurgical hospitalizations. However, participants with surgical hospitalizations recovered more rapidly over time (gain of 4.7 more points [CI, 2.0 to 7.4 points] per ln [week after discharge]; P<0.001). Score recovery for participants with nonsurgical hospitalizations did not significantly differ from the null (average recovery, 0.7 points [CI, - 0.6 to 1.9 points] per ln [week after discharge]). Limitation: Life space immediately before and after hospitalization was self-reported, often after hospital discharge. Conclusion: Hospitalization decreases life space in older adults. Surgical hospitalizations are associated with immediate marked life-space declines followed by rapid recovery, in contrast to nonsurgical hospitalizations, which are associated with more modest immediate declines and little evidence of recovery after several years of follow-up. Primary Funding Source: National Institute on Aging.

AB - Background: Life space is a measure of where a person goes, the frequency of going there, and the dependency in getting there. It may be a more accurate measure of mobility in older adults because it reflects participation in society as well as physical ability. Objective: To assess effects of hospitalization on life space in older adults, and to compare life-space trajectories associated with surgical and nonsurgical hospitalizations. Design: Prospective observational study. Setting: Central Alabama. Participants: 687 community-dwelling Medicare beneficiaries at least 65 years of age with surgical (n - 44), nonsurgical (n - 167), or no (n - 476) hospitalizations. Measurements: Life-Space Assessment (LSA) scores before and after hospitalization (range, 0 to 120; higher scores reflect greater mobility). Results: Mean age of participants was 74.6 years (SD, 6.3). Fifty percent were black, and 46% were male. Before hospitalization, adjusted LSA scores were similar in participants with surgical and nonsurgical admissions. Life-space assessment scores decreased in both groups immediately after hospitalization; however, participants with surgical hospitalizations had a greater decrease in scores (12.1 more points [95% CI, 3.6 to 20.7 points]; P - 0.005) than those with nonsurgical hospitalizations. However, participants with surgical hospitalizations recovered more rapidly over time (gain of 4.7 more points [CI, 2.0 to 7.4 points] per ln [week after discharge]; P<0.001). Score recovery for participants with nonsurgical hospitalizations did not significantly differ from the null (average recovery, 0.7 points [CI, - 0.6 to 1.9 points] per ln [week after discharge]). Limitation: Life space immediately before and after hospitalization was self-reported, often after hospital discharge. Conclusion: Hospitalization decreases life space in older adults. Surgical hospitalizations are associated with immediate marked life-space declines followed by rapid recovery, in contrast to nonsurgical hospitalizations, which are associated with more modest immediate declines and little evidence of recovery after several years of follow-up. Primary Funding Source: National Institute on Aging.

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