Mobility Is a Key Predictor of Change in Well-Being Among Older Adults Who Experience Falls: Evidence From the Vancouver Falls Prevention Clinic Cohort

Abstract

Objective: To determine the factors that predict change in well-being over time in older men and women presenting to the falls prevention clinic.

Design: Prospective cohort study.

Setting: Falls prevention clinic.

Participants: Community-dwelling older adults who were referred to the clinic after sustaining a fall (between N=244 and N=255, depending on the analysis).

Interventions: Not applicable.

Main outcome measures: The ICEpop CAPability measure for Older people, a measure of well-being or quality of life, was administered at baseline, 6 months, and 12 months. We constructed linear mixed models to determine whether baseline predictor variables were related to baseline well-being and/or changes in well-being over time. In addition, we included interactions with sex to investigate the difference between men and women. Baseline predictors included 2 measures of mobility--Short Performance Physical Battery and timed Up and Go test--and a measure of global cognitive function--Montreal Cognitive Assessment.

Results: All 3 predictors were associated with well-being at baseline (P<.05). Furthermore, both the Short Performance Physical Battery and the timed Up and Go test interacted with sex (P<.05) to predict changes in well-being over time. Follow-up analyses suggested that better mobility was protective against decline in well-being in men but was generally unrelated to changes in well-being in women.

Conclusions: We found that 2 valid and reliable measures of mobility interacted with sex to predict changes in well-being over time. This is a critical research area to develop in order to appropriately tailor future intervention strategies targeting well-being in older fallers, a population at high risk of functional decline.

Trial registration: ClinicalTrials.gov NCT01022866.

Keywords: Accidental falls; Frail older adults; Quality of life; Rehabilitation.

Conflict of interest statement

Conflict of Interest

The authors declare that they have no competing interests.

Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Figure 1a: SPPB by time by sex interaction over 12 months Figure 1b: TUG by time by sex interaction over 12 months

Figure 2

Figure 2a: Model-based estimated marginal means for low (−1 SD), average and high (+1 SD) SPPB scores for males. Figure 2b: Model-based estimated marginal means for low (−1 SD), average and high (+1 SD) SPPB scores for females.

Figure 3

Figure 3a: Model-based estimated marginal means for low (−1 SD), average and high (+1 SD) TUG scores for males. Figure 3b: Model-based estimated marginal means for low (−1 SD), average and high (+1 SD) TUG scores for females.