Comparing GPS-Based Community Mobility Measures with Self-report Assessments in Older Adults with Parkinson's Disease

Abstract

Background: Real-life community mobility (CM) measures for older adults, especially those with Parkinson's disease (PD), are important tools when helping individuals maintain optimal function and quality of life. This is one of the first studies to compare an objective global positioning system (GPS) sensor and subjective self-report CM measures in an older clinical population.

Methods: Over 14 days, 54 people in Ontario, Canada with early to mid-stage PD (mean age = 67.5 ± 6.3 years; 47 men; 46 retired) wore a wireless inertial measurement unit with GPS (WIMU-GPS), and completed the Life Space Assessment and mobility diaries. We assessed the convergent validity, reliability and agreement on mobility outcomes using Spearman's correlation, intraclass correlation coefficient, and Bland-Altman analyses, respectively.

Results: Convergent validity was attained by the WIMU-GPS for trip frequency (rs = .69, 95% confidence interval [CI] = 0.52-0.81) and duration outside (rs = .43, 95% CI = 0.18-0.62), but not for life space size (rs = .39, 95% CI = 0.14-0.60). The Life Space Assessment exhibited floor and ceiling effects. Moderate agreements were observed between WIMU-GPS and diary for trip frequency and duration (intraclass correlation coefficients = 0.71, 95% CI = 0.51-0.82; 0.67, 95% CI = 0.42-0.82, respectively). Disagreement was more common among nonretired individuals.

Conclusions: WIMU-GPS could replace diaries for trip frequency and duration assessments in older adults with PD. Both assessments are best used for retired persons. However, the Life Space Assessment may not reflect actual mobility.

Keywords: Functional performance; Geriatric assessment; Measurement comparison; Mobility assessment; Parkinson’s disease.

© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Figures

Figure 1.

Relationship between “daily duration” (a), “hourly frequency” (b), “life space size” (c) measured using WIMU-GPS and diary. Good convergent validity (r ≥ .4) was shown using Spearman correlation analysis for “daily duration” (a), “hourly frequency” (b), but not for “life space size” (c).

Figure 2.

Bland-Altman plots of agreement between log mean and log difference of WIMU-GPS and Diary measured “hourly frequency” (a) and “daily duration” (c). Majority of participants recorded higher WIMU-GPS “hourly frequency” (b) and “daily duration” (d) than the Diary (66.7% and 79.6%, respectively). All n = 54.