Cynthia J. Brown, MD, MSPH; David L. Roth, PhD; Richard M. Allman, MD; Patricia Sawyer, PhD; Christine S. Ritchie, MD, MSPH; Jeffrey M. Roseman, MD, PhD, MPH
Brown CJ, Roth DL, Allman RM, Sawyer P, Ritchie CS, Roseman JM. Trajectories of Life-Space Mobility After Hospitalization. Ann Intern Med. 2009;150:372-378. doi: 10.7326/0003-4819-150-6-200903170-00005
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Published: Ann Intern Med. 2009;150(6):372-378.
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.
To assess effects of hospitalization on life space in older adults, and to compare life-space trajectories associated with surgical and nonsurgical hospitalizations.
Prospective observational study.
687 community-dwelling Medicare beneficiaries at least 65 years of age with surgical (n = 44), nonsurgical (n = 167), or no (n = 476) hospitalizations.
Life-Space Assessment (LSA) scores before and after hospitalization (range, 0 to 120; higher scores reflect greater mobility).
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]; PÂ = 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 Â < 0.001). Score recovery for participants with nonsurgical hospitalizations did not significantly differ from the null (average recovery, 0.7 points [CI, âˆ’0.6 to 1.9 points] per ln [week after discharge]).
Life space immediately before and after hospitalization was self-reported, often after hospital discharge.
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.
National Institute on Aging.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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