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

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Document Type: Article
Year of publication: 2021
The title of a journal, publication series: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Volume: 76
Issue number: 11
Page range: 1988-1996
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.

Dieser Datensatz wurde nicht während einer Tätigkeit an der Universität Mannheim veröffentlicht, dies ist eine Externe Publikation.

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