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