WHAT IS THE MINIMUM CLINICALLY IMPORTANT DIFFERENCE FOR LIFE-SPACE?. (11th November 2018) - Kennedy, R
Abstract: The UAB Life-Space Assessment (LSA) is a practical measure of community mobility in older adults. Changes in life-space have been shown to precede several adverse health outcomes in older adults, including death, institutionalization, hospitalization, and cognitive impairment. However, the magnitude of change in the LSA that would be considered clinically significant has not been well established. We examined 412 participants from the UAB Study of Aging II who completed baseline interviews and at least two consecutive monthly follow-up interviews over the next 3 years. We used change in walking status, measured with the Katz Activities of Daily Living scale, as the reference for change in mobility. Participants classified as having no change, decline, or improvement in mobility over each 1-month follow-up. We used mixed effects models to compare the change in LSA by change in walking status. When participants reported no change in their walking status, they also had very little change in their LSA scores (mean decrease 0.527 points, 95% CI 0.233, 0.821). Decline in walking status was associated with a mean decrease in LSA scores of 2.931 points (95% CI 1.692, 4.171), while improvement in walking status was associated with a mean increase of 2.511 points (95% CI 1.257, 3.766). Based on these results, a change of 5 or more points on the LSA should be considered clinically meaningful. Future studies should incorporate this cutoff to assess interventions to improve mobility and lessen adverse consequences of low mobility.