Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2015

Open Access 01-12-2015 | Research Article

Mobility predicts change in older adults’ health-related quality of life: evidence from a Vancouver falls prevention prospective cohort study

Authors: Jennifer C. Davis, Stirling Bryan, John R. Best, Linda C. Li, Chun Liang Hsu, Caitlin Gomez, Kelly A. Vertes, Teresa Liu-Ambrose

Published in: Health and Quality of Life Outcomes | Issue 1/2015

Login to get access

Abstract

Background

Older adults with mobility impairments are prone to reduced health related quality of life (HRQoL) is highly associated with mobility impairments. The consequences of falls have detrimental impact on mobility. Hence, ascertaining factors explaining variation among individuals’ quality of life is critical for promoting healthy ageing, particularly among older fallers. Hence, the primary objective of our study was to identify key factors that explain variation in HRQoL among community dwelling older adults at risk of falls.

Methods

We conducted a longitudinal analysis of a 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 148 to 286 depending on the analysis). We constructed linear mixed models where assessment month (0, 6, 12) was entered as a within-subjects repeated measure, the intercept was specified as a random effect, and predictors and covariates were entered as between-subjects fixed effects. We also included the predictors by sex and predictor by sex by time interaction terms in order to investigate sex differences in the relations between the predictor variable and the outcome variable, the EQ-5D.

Results

Our primary analysis demonstrated a significant mobility (assessed using the Short Performance Physical Battery and the Timed Up and Go) by time interaction (p < 0.05) and mobility by time by sex interaction (p < 0.05). The sensitivity analyses demonstrated some heterogeneity of these findings using an imputed and a complete case analysis.

Conclusions

Mobility may be an important predictor of changes in HRQoL over time. As such, mobility is a critical factor to target for future intervention strategies aimed at maintaining or improving HRQoL in late life.
Literature
1.
go back to reference Bilotta C, Bowling A, Nicolini P, Case A, Pina G, Rossi SV, et al. Older People’s Quality of Life (OPQOL) scores and adverse health outcomes at a one-year follow-up. A prospective cohort study on older outpatients living in the community in Italy. Health Qual Life Outcomes. 2011;9:72.PubMedCentralPubMedCrossRef Bilotta C, Bowling A, Nicolini P, Case A, Pina G, Rossi SV, et al. Older People’s Quality of Life (OPQOL) scores and adverse health outcomes at a one-year follow-up. A prospective cohort study on older outpatients living in the community in Italy. Health Qual Life Outcomes. 2011;9:72.PubMedCentralPubMedCrossRef
2.
go back to reference Masel MC, Graham JE, Reistetter TA, Markides KS, Ottenbacher KJ. Frailty and health related quality of life in older Mexican Americans. Health Qual Life Outcomes. 2009;7:70.PubMedCentralPubMedCrossRef Masel MC, Graham JE, Reistetter TA, Markides KS, Ottenbacher KJ. Frailty and health related quality of life in older Mexican Americans. Health Qual Life Outcomes. 2009;7:70.PubMedCentralPubMedCrossRef
3.
go back to reference Masel MC, Ostir GV, Ottenbacher KJ. Frailty, mortality, and health-related quality of life in older Mexican Americans. J Am Geriatr Soc. 2010;58:2149–53.PubMedCentralPubMedCrossRef Masel MC, Ostir GV, Ottenbacher KJ. Frailty, mortality, and health-related quality of life in older Mexican Americans. J Am Geriatr Soc. 2010;58:2149–53.PubMedCentralPubMedCrossRef
4.
go back to reference Puts MT, Shekary N, Widdershoven G, Heldens J, Lips P, Deeg DJ. What does quality of life mean to older frail and non-frail community-dwelling adults in the Netherlands? Qual Life Res. 2007;16:263–77.PubMedCrossRef Puts MT, Shekary N, Widdershoven G, Heldens J, Lips P, Deeg DJ. What does quality of life mean to older frail and non-frail community-dwelling adults in the Netherlands? Qual Life Res. 2007;16:263–77.PubMedCrossRef
5.
go back to reference Zaninotto P, Falaschetti E, Sacker A. Age trajectories of quality of life among older adults: results from the English Longitudinal Study of Ageing. Qual Life Res. 2009;18:1301–9.PubMedCrossRef Zaninotto P, Falaschetti E, Sacker A. Age trajectories of quality of life among older adults: results from the English Longitudinal Study of Ageing. Qual Life Res. 2009;18:1301–9.PubMedCrossRef
6.
go back to reference Stubbs B, Binnekade T, Eggermont L, Sepehry AA, Patchay S, Schofield P. Pain and the risk for falls in community-dwelling older adults: systematic review and meta-analysis. Arch Phys Med Rehabil. 2014;95:175–87. e179.PubMedCrossRef Stubbs B, Binnekade T, Eggermont L, Sepehry AA, Patchay S, Schofield P. Pain and the risk for falls in community-dwelling older adults: systematic review and meta-analysis. Arch Phys Med Rehabil. 2014;95:175–87. e179.PubMedCrossRef
7.
go back to reference Stubbs B, Schofield P, Patchay S. Mobility limitations and fall-related factors contribute to the reduced health-related quality of life in older adults with chronic musculoskeletal pain. Pain Pract. 2014. doi:10.1111/papr.12264.PubMed Stubbs B, Schofield P, Patchay S. Mobility limitations and fall-related factors contribute to the reduced health-related quality of life in older adults with chronic musculoskeletal pain. Pain Pract. 2014. doi:10.​1111/​papr.​12264.PubMed
8.
go back to reference Movsas B, Moughan J, Sarna L, Langer C, Werner-Wasik M, Nicolaou N, et al. Quality of life supersedes the classic prognosticators for long-term survival in locally advanced non-small-cell lung cancer: an analysis of RTOG 9801. J Clin Oncol. 2009;27:5816–22.PubMedCentralPubMedCrossRef Movsas B, Moughan J, Sarna L, Langer C, Werner-Wasik M, Nicolaou N, et al. Quality of life supersedes the classic prognosticators for long-term survival in locally advanced non-small-cell lung cancer: an analysis of RTOG 9801. J Clin Oncol. 2009;27:5816–22.PubMedCentralPubMedCrossRef
9.
go back to reference Pedersen SS, Martens EJ, Denollet J, Appels A. Poor health-related quality of life is a predictor of early, but not late, cardiac events after percutaneous coronary intervention. Psychosomatics. 2007;48:331–7.PubMedCrossRef Pedersen SS, Martens EJ, Denollet J, Appels A. Poor health-related quality of life is a predictor of early, but not late, cardiac events after percutaneous coronary intervention. Psychosomatics. 2007;48:331–7.PubMedCrossRef
10.
go back to reference Tsai YC, Hung CC, Hwang SJ, Wang SL, Hsiao SM, Lin MY, et al. Quality of life predicts risks of end-stage renal disease and mortality in patients with chronic kidney disease. Nephrol Dial Transplant. 2010;25:1621–6.PubMedCrossRef Tsai YC, Hung CC, Hwang SJ, Wang SL, Hsiao SM, Lin MY, et al. Quality of life predicts risks of end-stage renal disease and mortality in patients with chronic kidney disease. Nephrol Dial Transplant. 2010;25:1621–6.PubMedCrossRef
11.
go back to reference Chang NT, Chi LY, Yang NP, Chou P. The impact of falls and fear of falling on health-related quality of life in Taiwanese elderly. J Community Health Nurs. 2010;27:84–95.PubMedCrossRef Chang NT, Chi LY, Yang NP, Chou P. The impact of falls and fear of falling on health-related quality of life in Taiwanese elderly. J Community Health Nurs. 2010;27:84–95.PubMedCrossRef
12.
go back to reference Murray C, Lopez A. Global and regional descriptive epidemiology of disability: incidence, prevalence, health expectancies, and years lived with disability. In: Murray C, Lopez A, editors. The global burden of disease. Boston: The Harvard School of Public Health; 1996. p. 201–46. Murray C, Lopez A. Global and regional descriptive epidemiology of disability: incidence, prevalence, health expectancies, and years lived with disability. In: Murray C, Lopez A, editors. The global burden of disease. Boston: The Harvard School of Public Health; 1996. p. 201–46.
13.
go back to reference Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–7.PubMedCrossRef Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–7.PubMedCrossRef
14.
go back to reference Pluijm S, Smit J, Tromp E, Stel V, Deeg D, Bouter L, et al. A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study. Osteoporosis International. 2006;17:417–25.PubMedCrossRef Pluijm S, Smit J, Tromp E, Stel V, Deeg D, Bouter L, et al. A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study. Osteoporosis International. 2006;17:417–25.PubMedCrossRef
15.
go back to reference Formiga F, Navarro M, Duaso E, Chivite D, Ruiz D, Perez-Castejon JM, et al. Factors associated with hip fracture-related falls among patients with a history of recurrent falling. Bone. 2008;43:941–4.PubMedCrossRef Formiga F, Navarro M, Duaso E, Chivite D, Ruiz D, Perez-Castejon JM, et al. Factors associated with hip fracture-related falls among patients with a history of recurrent falling. Bone. 2008;43:941–4.PubMedCrossRef
16.
go back to reference Rockwood K, Stolee P, McDowell I. Factors associated with institutionalization of older people in Canada: testing a multifactorial definition of frailty. Journal of the American Geriatrics Society. 1996;44:578–82.PubMedCrossRef Rockwood K, Stolee P, McDowell I. Factors associated with institutionalization of older people in Canada: testing a multifactorial definition of frailty. Journal of the American Geriatrics Society. 1996;44:578–82.PubMedCrossRef
17.
go back to reference Dai B, Ware WB, Giuliani CA. A structural equation model relating physical function, pain, impaired mobility (IM), and falls in older adults. Arch Gerontol Geriatr. 2012;55:645–52.PubMedCrossRef Dai B, Ware WB, Giuliani CA. A structural equation model relating physical function, pain, impaired mobility (IM), and falls in older adults. Arch Gerontol Geriatr. 2012;55:645–52.PubMedCrossRef
18.
go back to reference Fagerstrom C, Borglin G. Mobility, functional ability and health-related quality of life among people of 60 years or older. Aging Clin Exp Res. 2010;22:387–94.PubMedCrossRef Fagerstrom C, Borglin G. Mobility, functional ability and health-related quality of life among people of 60 years or older. Aging Clin Exp Res. 2010;22:387–94.PubMedCrossRef
19.
go back to reference Davis JC, Marra CA, Najafzadeh M, Liu-Ambrose T. The independent contribution of executive functions to health related quality of life in older women. BMC Geriatr. 2010;10:16.PubMedCentralPubMedCrossRef Davis JC, Marra CA, Najafzadeh M, Liu-Ambrose T. The independent contribution of executive functions to health related quality of life in older women. BMC Geriatr. 2010;10:16.PubMedCentralPubMedCrossRef
20.
go back to reference Davis JC, Marra CA, Liu-Ambrose TY. Falls-related self-efficacy is independently associated with quality-adjusted life years in older women. Age Ageing. 2011;40:340–6.PubMedCentralPubMedCrossRef Davis JC, Marra CA, Liu-Ambrose TY. Falls-related self-efficacy is independently associated with quality-adjusted life years in older women. Age Ageing. 2011;40:340–6.PubMedCentralPubMedCrossRef
21.
go back to reference Heydarnejad S, Dehkordi AH. The effect of an exercise program on the health-quality of life in older adults. A randomized controlled trial. Dan Med Bull. 2010;57:A4113.PubMed Heydarnejad S, Dehkordi AH. The effect of an exercise program on the health-quality of life in older adults. A randomized controlled trial. Dan Med Bull. 2010;57:A4113.PubMed
22.
go back to reference Redondo-Sendino A, Guallar-Castillon P, Banegas JR, Rodriguez-Artalejo F. Gender differences in the utilization of health-care services among the older adult population of Spain. BMC Public Health. 2006;6:155.PubMedCentralPubMedCrossRef Redondo-Sendino A, Guallar-Castillon P, Banegas JR, Rodriguez-Artalejo F. Gender differences in the utilization of health-care services among the older adult population of Spain. BMC Public Health. 2006;6:155.PubMedCentralPubMedCrossRef
23.
go back to reference Lord S, Sherrington C, Menz H. A physiological profile approach for falls prevention. In: Falls in older people Risk factors and strategies for prevention. Cambridge: Cambridge University Press; 2001. p. 221–38. Lord S, Sherrington C, Menz H. A physiological profile approach for falls prevention. In: Falls in older people Risk factors and strategies for prevention. Cambridge: Cambridge University Press; 2001. p. 221–38.
24.
go back to reference Whitney JC, Lord SR, Close JC. Streamlining assessment and intervention in a falls clinic using the timed up and go test and physiological profile assessments. Age Ageing. 2005;34:567–71.PubMedCrossRef Whitney JC, Lord SR, Close JC. Streamlining assessment and intervention in a falls clinic using the timed up and go test and physiological profile assessments. Age Ageing. 2005;34:567–71.PubMedCrossRef
25.
go back to reference Gibson MJ, Andres RO, Isaacs B, Radebaugh T, Worm-Petersen J. The prevention of falls in later life. A report of the Kellogg International Work Group on the prevention of falls by the elderly. Danish Medical Bulletin. 1987;34:1–24. Gibson MJ, Andres RO, Isaacs B, Radebaugh T, Worm-Petersen J. The prevention of falls in later life. A report of the Kellogg International Work Group on the prevention of falls by the elderly. Danish Medical Bulletin. 1987;34:1–24.
26.
go back to reference Groll DL, To T, Bombardier C, Wright JG. The development of a comorbidity index with physical function as the outcome. J Clin Epidemiol. 2005;58:595–602.PubMedCrossRef Groll DL, To T, Bombardier C, Wright JG. The development of a comorbidity index with physical function as the outcome. J Clin Epidemiol. 2005;58:595–602.PubMedCrossRef
27.
go back to reference Yesavage JA. Geriatric depression scale. Psychopharmacol Bull. 1988;24:709–11.PubMed Yesavage JA. Geriatric depression scale. Psychopharmacol Bull. 1988;24:709–11.PubMed
28.
go back to reference Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17:37–49.PubMedCrossRef Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17:37–49.PubMedCrossRef
29.
go back to reference van Marwijk HW, Wallace P, de Bock GH, Hermans J, Kaptein AA, Mulder JD. Evaluation of the feasibility, reliability and diagnostic value of shortened versions of the geriatric depression scale. Br J Gen Pract. 1995;45:195–9.PubMedCentralPubMed van Marwijk HW, Wallace P, de Bock GH, Hermans J, Kaptein AA, Mulder JD. Evaluation of the feasibility, reliability and diagnostic value of shortened versions of the geriatric depression scale. Br J Gen Pract. 1995;45:195–9.PubMedCentralPubMed
30.
go back to reference Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995;332:556–61.PubMedCrossRef Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995;332:556–61.PubMedCrossRef
31.
go back to reference Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80:896–903.PubMed Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80:896–903.PubMed
33.
go back to reference Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther. 2003;83(3):237–52.PubMed Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther. 2003;83(3):237–52.PubMed
34.
go back to reference Lord S, Clark R, Webster I. Physiological factors associated with falls in an elderly population. Journal of American Geriatrics Society. 1991;39:1194–200.CrossRef Lord S, Clark R, Webster I. Physiological factors associated with falls in an elderly population. Journal of American Geriatrics Society. 1991;39:1194–200.CrossRef
35.
go back to reference Lord S, Ward J, Williams P, Anstey K. Physiological factors associated with falls in older community-dwelling women. Journal of American Geriatrics Society. 1994;42:1110–7.CrossRef Lord S, Ward J, Williams P, Anstey K. Physiological factors associated with falls in older community-dwelling women. Journal of American Geriatrics Society. 1994;42:1110–7.CrossRef
36.
go back to reference Delbaere K, Close JCT, Brodaty H, Sachdev P, Lord SR. Determinants of disparities between perceived and physiological risk o falling among elderly people: cohort study. British Medical Journal. 2010;341:c4165.PubMedCentralPubMedCrossRef Delbaere K, Close JCT, Brodaty H, Sachdev P, Lord SR. Determinants of disparities between perceived and physiological risk o falling among elderly people: cohort study. British Medical Journal. 2010;341:c4165.PubMedCentralPubMedCrossRef
37.
go back to reference Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.PubMedCrossRef Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.PubMedCrossRef
38.
go back to reference Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695–9.PubMedCrossRef Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695–9.PubMedCrossRef
39.
go back to reference Marra CA, Esdaile JM, Guh D, Kopec JA, Brazier JE, Koehler BE, et al. A comparison of four indirect methods of assessing utility values in rheumatoid arthritis. Med Care. 2004;42:1125–31.PubMedCrossRef Marra CA, Esdaile JM, Guh D, Kopec JA, Brazier JE, Koehler BE, et al. A comparison of four indirect methods of assessing utility values in rheumatoid arthritis. Med Care. 2004;42:1125–31.PubMedCrossRef
41.
go back to reference Oostenbrink JB, Al MJ. The analysis of incomplete cost data due to dropout. Health Econ. 2005;14:763–76.PubMedCrossRef Oostenbrink JB, Al MJ. The analysis of incomplete cost data due to dropout. Health Econ. 2005;14:763–76.PubMedCrossRef
42.
go back to reference Oostenbrink JB, Al MJ, Rutten-van Molken MP. Methods to analyse cost data of patients who withdraw in a clinical trial setting. Pharmacoeconomics. 2003;21:1103–12.PubMedCrossRef Oostenbrink JB, Al MJ, Rutten-van Molken MP. Methods to analyse cost data of patients who withdraw in a clinical trial setting. Pharmacoeconomics. 2003;21:1103–12.PubMedCrossRef
43.
go back to reference Briggs A, Clark T, Wolstenholme J, Clarke P. Missing… presumed at random: cost-analysis of incomplete data. Health Econ. 2003;12:377–92.PubMedCrossRef Briggs A, Clark T, Wolstenholme J, Clarke P. Missing… presumed at random: cost-analysis of incomplete data. Health Econ. 2003;12:377–92.PubMedCrossRef
44.
go back to reference Briggs AH, Gray AM. Handling uncertainty when performing economic evaluation of healthcare interventions. Health Technol Assess. 1999;3:1–134.PubMed Briggs AH, Gray AM. Handling uncertainty when performing economic evaluation of healthcare interventions. Health Technol Assess. 1999;3:1–134.PubMed
45.
go back to reference Satterthwaite FE. An approximate distribution of estimates of variance components. Biometrics Bulletin. 1946;2:110–4.PubMedCrossRef Satterthwaite FE. An approximate distribution of estimates of variance components. Biometrics Bulletin. 1946;2:110–4.PubMedCrossRef
46.
go back to reference Wolitzky-Taylor KB, Arch JJ, Rosenfield D, Craske MG. Moderators and non-specific predictors of treatment outcome for anxiety disorders: a comparison of cognitive behavioral therapy to acceptance and commitment therapy. Journal of Consulting and Clinical Psychology. 2012;80(5):786.PubMedCrossRef Wolitzky-Taylor KB, Arch JJ, Rosenfield D, Craske MG. Moderators and non-specific predictors of treatment outcome for anxiety disorders: a comparison of cognitive behavioral therapy to acceptance and commitment therapy. Journal of Consulting and Clinical Psychology. 2012;80(5):786.PubMedCrossRef
47.
go back to reference Fredriksen-Goldsen KI, Kim HJ, Shiu C, Goldsen J, Emlet CA. Successful aging among LGBT older adults: physical and mental health-related quality of life by age group. Gerontologist. 2015;55(1):154–68.PubMedCrossRef Fredriksen-Goldsen KI, Kim HJ, Shiu C, Goldsen J, Emlet CA. Successful aging among LGBT older adults: physical and mental health-related quality of life by age group. Gerontologist. 2015;55(1):154–68.PubMedCrossRef
48.
go back to reference Davis JC, Bryan S, McLeod R, Rogers J, Khan K, Liu-Ambrose T. Exploration of the association between quality of life, assessed by the EQ-5D and ICECAP-O, and falls risk, cognitive function and daily function, in older adults with mobility impairments. BMC Geriatr. 2012;12:65.PubMedCentralPubMedCrossRef Davis JC, Bryan S, McLeod R, Rogers J, Khan K, Liu-Ambrose T. Exploration of the association between quality of life, assessed by the EQ-5D and ICECAP-O, and falls risk, cognitive function and daily function, in older adults with mobility impairments. BMC Geriatr. 2012;12:65.PubMedCentralPubMedCrossRef
49.
go back to reference Oh B, Cho B, Choi HC, Son KY, Park SM, Chun S, et al. The influence of lower-extremity function in elderly individuals’ quality of life (QOL): an analysis of the correlation between SPPB and EQ-5D. Arch Gerontol Geriatr. 2014;58:278–82.PubMedCrossRef Oh B, Cho B, Choi HC, Son KY, Park SM, Chun S, et al. The influence of lower-extremity function in elderly individuals’ quality of life (QOL): an analysis of the correlation between SPPB and EQ-5D. Arch Gerontol Geriatr. 2014;58:278–82.PubMedCrossRef
Metadata
Title
Mobility predicts change in older adults’ health-related quality of life: evidence from a Vancouver falls prevention prospective cohort study
Authors
Jennifer C. Davis
Stirling Bryan
John R. Best
Linda C. Li
Chun Liang Hsu
Caitlin Gomez
Kelly A. Vertes
Teresa Liu-Ambrose
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2015
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-015-0299-0

Other articles of this Issue 1/2015

Health and Quality of Life Outcomes 1/2015 Go to the issue