| dc.description.abstract | Introduction: Mobility in the elderly is the ability to move from home environment
to beyond the community where they live. Preservation of mobility is considered
essential for active aging, being closely linked to health status and quality of life.
The Life-space Mobility (LSM) restriction of community-dwelling elderly can
predict the need for future health care. Contextual factors such as life history,
social, environmental and personal aspects are considered determinants for the
maintenance of the living space in the elderly. Objectives: To know through a systematic review about contextual aspects that
interfere or modify the LSM, and to identify the associations between Life-Space
Assessment (LSA) and Life course adversities in old age in five populations with
different epidemiological contexts. Methods: A systematic review was performed according to PROSPERO protocol
CRD42017064552, previously published. A cross-sectional study, lined up to
cohort, was conducted with a sample of 1995 elderly individuals living in 5 distinct
sites with different epidemiological profiles (Kingston and Saint Hyacinthe in
Canada, Tirana in Albania, Manizales in Colombia and Natal-RN in Brazil). The
Life Space Assessment (LSA) were analyzed through multivariate analysis
(multiple linear regression), adjusted for variables of physical health, mental
health, social support and adversities in the course of life. Data were analyzed
using SPSS 20.0; bivariate analyses and multiple linear regression between LSA
total score and independents variables were performed, the confidence intervals
was considerate 95% and the p-value of less than 0.05 was considered
statistically significant. Results: The systematic review identified 3484 studies, only 41 were considered
by inclusion criteria, and classified with better methodological quality. The
literature highlights associations between life space mobility and environmental
contextual factors (products / technology and physical characteristics of the
environment) and personal (sociodemographic characteristics, life experience,
individual psychological characteristics, health and quality of life perception, and
mortality index). The cross-sectional study identified that life-space mobility was significantly related to contextual aspects, such as: social support (β = 0.041, pvalue = 0.035), community barriers (β = -0,128, p-value = 0.000), perception of
safety (β = 0.093, p-value = 0.000) and social capital (β = 0.045, p-value = 0.026).
In addition, we highlight that the total LSA score is inversely related to adulthood
adversities (β = -0.114, p-value= 0.000) and directly related to old age adversities
(β = 0.073, p-value= 0.001), but there was no association with childhood
adversities (economic adversities: p-value = 0.607 and social adversities: p-value
= 0.899). Conclusion: Low life space mobility rates are related to environmental and
personal contextual factors. We identified that life space mobility is influenced by
adulthood and old age adversities, but not by childhood adversities. Positive
contextual factors such as social support and a favorable environment, as well
as old age adversities (insufficient income and living alone) can be motivating
aspects of better life space mobility. The adversities in adulthood as low schooling
and semi-skilled manual occupation are predictors of mobility restriction in older
people. | |
