Mobility Is a Key Predictor of Change in Well-Being Among Older Adults Who Experience Falls: Evidence From the Vancouver Falls Prevention Clinic Cohort

Jennifer C Davis; John R Best; Stirling Bryan; Linda C Li; Chun Liang Hsu; Caitlin Gomez; Kelly Vertes; Teresa Liu-Ambrose

doi:10.1016/j.apmr.2015.02.033

Mobility Is a Key Predictor of Change in Well-Being Among Older Adults Who Experience Falls: Evidence From the Vancouver Falls Prevention Clinic Cohort

Arch Phys Med Rehabil. 2015 Sep;96(9):1634-40. doi: 10.1016/j.apmr.2015.02.033. Epub 2015 Apr 8.

Authors

Jennifer C Davis¹, John R Best², Stirling Bryan³, Linda C Li⁴, Chun Liang Hsu⁵, Caitlin Gomez⁶, Kelly Vertes⁶, Teresa Liu-Ambrose⁷

Affiliations

¹ Center for Clinical Epidemiology and Evaluation, University of British Columbia, and Vancouver Coastal Health Research Institute, Vancouver, BC, Canada; Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, BC, Canada.
² Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, BC, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada; Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
³ Center for Clinical Epidemiology and Evaluation, University of British Columbia, and Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
⁴ Arthritis Research Center of Canada, Richmond, BC, Canada.
⁵ Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, BC, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
⁶ Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada; Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
⁷ Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, BC, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada; Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada. Electronic address: teresa.ambrose@ubc.ca.

Abstract

Objective: To determine the factors that predict change in well-being over time in older men and women presenting to the falls prevention clinic.

Design: Prospective cohort study.

Setting: Falls prevention clinic.

Participants: Community-dwelling older adults who were referred to the clinic after sustaining a fall (between N=244 and N=255, depending on the analysis).

Interventions: Not applicable.

Main outcome measures: The ICEpop CAPability measure for Older people, a measure of well-being or quality of life, was administered at baseline, 6 months, and 12 months. We constructed linear mixed models to determine whether baseline predictor variables were related to baseline well-being and/or changes in well-being over time. In addition, we included interactions with sex to investigate the difference between men and women. Baseline predictors included 2 measures of mobility--Short Performance Physical Battery and timed Up and Go test--and a measure of global cognitive function--Montreal Cognitive Assessment.

Results: All 3 predictors were associated with well-being at baseline (P<.05). Furthermore, both the Short Performance Physical Battery and the timed Up and Go test interacted with sex (P<.05) to predict changes in well-being over time. Follow-up analyses suggested that better mobility was protective against decline in well-being in men but was generally unrelated to changes in well-being in women.

Conclusions: We found that 2 valid and reliable measures of mobility interacted with sex to predict changes in well-being over time. This is a critical research area to develop in order to appropriately tailor future intervention strategies targeting well-being in older fallers, a population at high risk of functional decline.

Trial registration: ClinicalTrials.gov NCT01022866.

Keywords: Accidental falls; Frail older adults; Quality of life; Rehabilitation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Accidental Falls / prevention & control*
Age Factors
Aged
Aged, 80 and over
Cognition
Educational Status
Female
Humans
Longitudinal Studies
Male
Mobility Limitation*
Postural Balance
Prospective Studies
Quality of Life*
Reproducibility of Results
Residence Characteristics
Risk Factors
Sex Factors

Associated data

ClinicalTrials.gov/NCT01022866

Abstract

Publication types

MeSH terms

Associated data

Grant support