INCREASING LIFE-SPACE MOBILITY IN MULTIMORBID OLDER PERSONS WITH MOTOR AND COGNITIVE IMPAIRMENT

Abstract

Introduction: The study objective was to determine the effectiveness of a specific, standardized home‐based training to improve life‐space mobility (LSM) in community‐dwelling, multimorbid, older persons with cognitive impairment (CI) after discharge from geriatric rehabilitation, a high risk group for LSM restrictions and institutionalization. Methods: A double‐blinded, randomized, controlled trial including older persons with mild to moderate cognitive impairment (CI) was conducted by a 12‐weeks home‐based training intervention and 12‐weeks follow‐up period. The intervention group (IG) received supervised recommendations for a home‐based balance‐, strengthand walking‐ training including a tailored motivational strategy. The control group (CG) received supervised recommendations for lowintensity exercise while seated. LSM was evaluated by the validated Life‐Space Assessment in Persons with Cognitive Impairment (LSACI). Results: 118 older persons (age: 82.3 ± 6.0 years) with mild to moderate CI (Mini‐Mental State Examination: 23.3 ± 2.4) were included. Analyses of covariance (ANCOVAs), with baseline LSM as a covariate, revealed a training‐related significant increase in LSM as documented by the LSA‐CI composite score and 3 sub‐scores (change from baseline: p ≤ 0.001‐0.023, partial eta2: 0.06‐0.20), with female gender, low baseline LSM and increased physical activity during the intervention as significant predictors for increase in LSM. Training gains were sustained during follow‐up for the composite score and one of three sub‐scores (p ≤ 0.023‐0.026; eta2: je 0.06). Key conclusions: The training was feasible and sustainably improved LSM in multimorbid, older people with CI, thus representing a successful program for post ward rehabilitation to promote LSM in a high risk group for activity restriction and institutionalization.