7 The NHLSD separated a patient’s living area into four spaces: their room, outside the room but within the unit, outside the unit but within the facility, and outside the facility it measured movement over a two-week period was validated in 398 residents of 3 nursing homes in New Haven, Connecticut and the test-retest reliability was 0.92. The Nursing Home Life-Space Diameter (NHLSD) instrument, published in 1990 by Tinetti and Ginter, focused on institutionalized patients in a long-term care setting. The LSM concept has proven so accessible that it formed the foundation of a comprehensive framework used to address research questions related to mobility in older adults. While the life-space diary did not gain widespread use in research, the concept proved accessible and adaptable in later, newer instruments. Inquiring about patient’s recent restrictions in movement was not new to clinicians, but systematically recording it in a comparable format was. The original goal of the instrument was to measure an individual’s geospatial movements over an interval of time. In 1985, May, Nayak, and Isaacs published the “The life-space diary, a measure of mobility in old people at home.” 6 This measure marks the introduction of LSM, both as a concept and as the first instrument used to quantify it. 4 Life-space mobility (LSM), an emerging concept that allows this assessment, assesses functional, environmental, and social factors that affect how people live their day-to-day lives.

4 These determinants have raised the profile of assessing mobility among older adults beyond the traditional measures of assessing activities of daily living (ADLs), instrumental activities of daily living (IADLs), and walking ability, all focusing on a single specific activity rather than capturing the full continuum of mobility in older adults. 2, 3 Mobility is determined by cognitive and physical function, psychosocial factors, environmental factors, and transportation. 1 Mobility in older adults is critical to aging successfully since it is essential to maintain independence and autonomy. As we age, the ability to maintain mobility becomes even more important, affecting the health and quality of life. Physical mobility affects all aspects of daily life and is a crucial part of independent living. Keywords: life-space mobility, LSA, LSM, mobility, older adults These studies showed that LSM instruments can accurately predict morbidity, mortality, and healthcare use. Areas of research included physical function, cognitive function, sensory impairment, mental health, falls, frailty, comorbidities, healthcare use, mortality, and social/environmental factors. Seventy-nine articles were identified: 36 that employed a cross-sectional design and 22 that employed a longitudinal/prospective design to examine LSM as outcome variable 17 longitudinal/prospective design articles that examined LSM as primary independent variable 3 review articles and 1 systematic review. Studies for this review were obtained with an organized search format and were included if they were published in the past 20 years, written in English, published in peer-reviewed literature, and included LSM as an independent or outcome variable. In response to the increased volume of publications with clinical applicability to those working in geriatric health or conducting population-based research in older adults, we conducted a narrative review: a) to provide a summary of the articles that have assessed validation of the University of Alabama at Birmingham LSA instrument, the most widely used instrument to assess LSM in older adults and b) to provide a summary of the research articles that have examined LSM as independent or outcome variable. There has been exponential growth in the use of instruments measuring LSM in studies of older adults since the concept was introduced in 1985. Several instruments have been developed to measure LSM, such as the University of Alabama at Birmingham Life-Space Assessment (LSA) or the Nursing Home Life-Space Diameter instrument. LSM is gaining traction in the research of geriatric population health. Jason Johnson, 1 Martin A Rodriguez, 2 Soham Al Snih 1– 3ġDivision of Rehabilitation Sciences/School of Health Professions, The University of Texas Medical Branch, Galveston, TX, USA 2Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, USA 3Division of Geriatrics/Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, USAĭivision of Rehabilitation Sciences/School of Health Professions, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0170, USAĪbstract: Life-space mobility (LSM) is a concept for assessing patterns of functional mobility over time.

Elderly mobility scale pdf