Determination of the Minimal Important Change in the Life-Space Assessment.


Journal

Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062

Informations de publication

Date de publication:
03 2019
Historique:
received: 29 08 2018
revised: 26 10 2018
accepted: 29 10 2018
pubmed: 12 12 2018
medline: 19 3 2020
entrez: 12 12 2018
Statut: ppublish

Résumé

The University of Alabama at Birmingham (UAB) Life-Space Assessment (LSA) is a widely used measure of community mobility. To assist clinicians and researchers with assessing the significance of changes in scores, we determined the minimal important change associated with a change in health status. Homes of community-dwelling older adults. A total of 419 African American and non-Hispanic white adults 75 years and older participating in the UAB Study of Aging II, a longitudinal epidemiological study across the state of Alabama. None. Linear mixed models were used to compare change in LSA scores over 1-month intervals (N = 9712) between participants reporting improvement, no change, or decline in activities of daily living walking scores, accounting for the correlation among scores for the same participant over time. A decline in walking status was associated with a mean decrease in LSA scores of 2.93 points (95% confidence interval [CI] = 1.69-4.17 points), indicating lower mobility. An improvement in walking status was associated with a mean increase in LSA scores of 2.51 points (95% CI = 1.26-3.77 points), indicating higher mobility. A change in LSA scores of five or more is clinically important, exceeding the 95% CI for the change in LSA associated with change in walking status. Changes exceeding this threshold should prompt further investigation by providers with a goal of preserving mobility. J Am Geriatr Soc 67:565-569, 2019.

Sections du résumé

BACKGROUND/OBJECTIVES
The University of Alabama at Birmingham (UAB) Life-Space Assessment (LSA) is a widely used measure of community mobility. To assist clinicians and researchers with assessing the significance of changes in scores, we determined the minimal important change associated with a change in health status.
SETTING
Homes of community-dwelling older adults.
PARTICIPANTS
A total of 419 African American and non-Hispanic white adults 75 years and older participating in the UAB Study of Aging II, a longitudinal epidemiological study across the state of Alabama.
INTERVENTION
None.
MEASUREMENTS
Linear mixed models were used to compare change in LSA scores over 1-month intervals (N = 9712) between participants reporting improvement, no change, or decline in activities of daily living walking scores, accounting for the correlation among scores for the same participant over time.
RESULTS
A decline in walking status was associated with a mean decrease in LSA scores of 2.93 points (95% confidence interval [CI] = 1.69-4.17 points), indicating lower mobility. An improvement in walking status was associated with a mean increase in LSA scores of 2.51 points (95% CI = 1.26-3.77 points), indicating higher mobility.
CONCLUSION
A change in LSA scores of five or more is clinically important, exceeding the 95% CI for the change in LSA associated with change in walking status. Changes exceeding this threshold should prompt further investigation by providers with a goal of preserving mobility. J Am Geriatr Soc 67:565-569, 2019.

Identifiants

pubmed: 30536982
doi: 10.1111/jgs.15707
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

565-569

Subventions

Organisme : NIH HHS
ID : R01 AG15062
Pays : United States

Informations de copyright

© 2018 The American Geriatrics Society.

Auteurs

Richard E Kennedy (RE)

Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Comprehensive Center for Healthy Aging, Birmingham, Alabama.

Marzouq Almutairi (M)

Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama.

Courtney P Williams (CP)

Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.

Patricia Sawyer (P)

Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Comprehensive Center for Healthy Aging, Birmingham, Alabama.

Richard M Allman (RM)

Geriatrics and Extended Care, Veterans Health Administration, Washington, District of Columbia.

Cynthia J Brown (CJ)

Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Comprehensive Center for Healthy Aging, Birmingham, Alabama.
Birmingham/Atlanta Veterans Administration Geriatric Research, Education, and Clinical Center, Birmingham, Alabama.

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