Increasing life-space mobility in community-dwelling older persons with cognitive impairment following rehabilitation: A randomized controlled trial


Ullrich, Phoebe ; Werner, Christian ; Bongartz, Martin ; Eckert, Tobias ; Schönstein, Anton ; Kiss, Rainer ; Hauer, Klaus



DOI: https://doi.org/10.1093/gerona/glaa254
URL: https://academic.oup.com/biomedgerontology/advance...
Additional URL: https://pubmed.ncbi.nlm.nih.gov/33021670/
Document Type: Article
Year of publication Online: 2020
The title of a journal, publication series: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Volume: tba
Issue number: glaa254
Page range: tba
Place of publication: Oxford [u.a.]
Publishing house: Oxford University Press
ISSN: 1079-5006 , 1758-535X
Publication language: English
Institution: School of Social Sciences > Kognitive Psychologie mit Schwerp. Kognitives Altern (Kuhlmann 2015-)
Subject: 150 Psychology
Abstract: Background Community-dwelling older persons with cognitive impairment (CI) following discharge from geriatric rehabilitation are at high risk for losing life-space mobility (LSM). Interventions to improve their LSM are, however, still lacking. The study aim was to evaluate the effects of a CI-specific, home-based physical training and activity promotion program on LSM. Methods Older persons with mild-to-moderate CI (Mini-Mental State Examination [MMSE]: 17-26 points) discharged home from rehabilitation were included in this double-blinded, randomized, placebo-controlled trial with a 12-week intervention period and 12-week follow-up period. The intervention group (IG) received a CI-specific, home-based strength, balance and walking training supported by tailored motivational strategies. The control group (CG) received a placebo activity. LSM was evaluated by the Life-Space Assessment in Persons with Cognitive Impairment (LSA-CI), including a composite score for LSM and three sub-scores for maximal, equipment-assisted and independent life-space. Mixed-model repeated-measures analyses were used. Results One hundred eighteen participants (82.3±6.0 years) with CI (MMSE: 23.3±2.4) were randomized. After the intervention, the home-based training program resulted in a significant benefit in the LSA-CI composite scores (b=8.15; 95% confidence interval: 2.89-13.41; p=.003) and independent life-space sub-scores (b= 0.39; 95% confidence interval: 0.00-0.78; p=.048) in the IG (n=63) compared to CG (n=55). Other sub-scores and follow-up results were not significantly different. Conclusions The home-based training program improved LSM and independent life-space significantly in this vulnerable population. Effects were not sustained over the follow-up. The program may represent a model for improved transition from rehabilitation to the community to prevent high risk of LSM restriction.

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