Life-space mobility declines associated with incident falls and fractures

J Am Geriatr Soc. 2014 May;62(5):919-23. doi: 10.1111/jgs.12787. Epub 2014 Apr 14.


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 (Geriatric Depression Scale), cognitive function (Mini-Mental State Examination), 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.

Keywords: falls; injury; life-space; mobility.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Activities of Daily Living*
  • Aged
  • Alabama / epidemiology
  • Depression / complications
  • Female
  • Follow-Up Studies
  • Fractures, Bone / epidemiology*
  • Fractures, Bone / etiology
  • Geriatric Assessment / methods*
  • Humans
  • Incidence
  • Male
  • Mobility Limitation*
  • Neuropsychological Tests
  • Prospective Studies
  • Rural Population
  • Survival Rate / trends
  • Time Factors