This study aimed to examine the feasibility of using global positioning system (GPS) watches to examine relationships between GPS-based life-space mobility (LSM) metrics and self-report LSM and health measures (physical, psychological, and cognitive function) among older adults. Thirty participants wore a Fitbit Surge for 3 days. Eight spatial and temporal LSM measures were derived from GPS data. About 90% of in-home movement speeds were zero, indicating the sedentary lifestyle, but they made some active out-of-home trips as the total distance traveled and size of movement area indicated. There was a significant difference in total distance traveled and 95th percentile of movement speed between mild cognitive and intact cognition groups. GPS-based higher proportion of out-of-home time was significantly associated with greater functional fitness. Greater GPS use hours were significantly associated with higher cognition. These findings suggest the potential of GPS watches to continuously monitor changes in functional health to inform prevention efforts.
AppelhansT.DetschF.ReudenbackC.WoellauerS.FortevaS.NaussT.PebesmaE.RussellK.SumnerM.DarleyJ.RoudierP.SchratzP.Environmental Informatics MarburgBusettoL. (2020). Mapview: Interactive viewing of spatial data in R. https://cran.r-project.org/web/packages/mapview/index.html
2.
BakerP. S.BodnerE. VAllmanR. M. (2003). Measuring life-space mobility in community-dwelling older adults. Journal of the American Geriatrics Society, 51(11), 1610–1614. https://doi.org/10.1046/j.1532-5415.2003.51512.x
3.
BoissyP.BlamoutierM.BrièreS.DuvalC. (2018). Quantification of free-living community mobility in healthy older adults using wearable sensors. Frontiers in Public Health, 6(216), 1–13. https://doi.org/10.3389/fpubh.2018.00216
4.
Centers for Disease Control and Prevention. (2015). Steadi - older adult fall prevention. https://www.cdc.gov/steadi/
5.
CesariM.KritchevskyS. B.PenninxB. W. H. J.NicklasB. J.SimonsickE. M.NewmanA. B.TylavskyF. A.BrachJ. S.SatterfieldS.BauerD. C.VisserM.RubinS. M.HarrisT. B.PahorM. (2005). Prognostic value of usual gait speed in well-functioning older people - Results from the health, aging and body composition study. Journal of the American Geriatrics Society, 53(10), 1675–1680. https://doi.org/10.1111/j.1532-5415.2005.53501.x
6.
ChungJ.DemirisG.ThompsonH. J. (2015). Instruments to assess mobility limitation in community-dwelling older adults: A systematic review. Journal of Aging and Physical Activity, 23(2), 298–313. https://doi.org/10.1123/japa.2013-0181
7.
CornwellE. Y.CagneyK. A. (2017). Aging in activity space: Results from smartphone-based GPS-tracking of urban seniors. Journals of Gerontology - Series B Psychological Sciences and Social Sciences, 72(5), 864–875. https://doi.org/10.1093/geronb/gbx063
8.
CzajaS. J.KallestrupP.HarveyP. D. (2020). Evaluation of a novel technology-based program designed to assess and train everyday skills in older adults. Innovation in Aging, 4(6), 1–10. https://doi.org/10.1093/geroni/igaa052
9.
De SilvaN. A.GregoryM. A.VenkateshanS. S.VerschoorC. P.KuspinarA. (2019). Examining the association between life-space mobility and cognitive function in older adults: A systematic review. Journal of Aging Research, 2019, 1-9. https://doi.org/10.1155/2019/3923574.
10.
DobkinB. H.DorschA. (2011). The promise of mHealth: Daily activity monitoring and outcome assessments by wearable sensors. Neurorehabilitation and Neural Repair, 25(9), 788–798. https://doi.org/10.1177/1545968311425908
11.
FillekesM. P.GiannouliE.KimE. K.ZijlstraW.WeibelR. (2019). Towards a comprehensive set of GPS-based indicators reflecting the multidimensional nature of daily mobility for applications in health and aging research. International Journal of Health Geographics, 18(1), 17. https://doi.org/10.1186/s12942-019-0181-0.
12.
FleinerT.HaussermannP.MelloneS.ZijlstraW. (2016). Sensor-based assessment of mobility-related behavior in dementia: Feasibility and relevance in a hospital context. International Psychogeriatrics, 28(10), 1687–1694. https://doi.org/10.1017/S1041610216001034
13.
GiannouliE.BockO.MelloneS.ZijlstraW. (2016). Mobility in old age: Capacity is not performance. BioMed Research International, 2016, 1-8. https://doi.org/10.1155/2016/3261567.
14.
GiannouliE.BockO.ZijlstraW. (2018). Cognitive functioning is more closely related to real-life mobility than to laboratory-based mobility parameters. European Journal of Ageing, 15(1), 57–65. https://doi.org/10.1007/s10433-017-0434-3
15.
HaradaK.LeeS.LeeS.BaeS.HaradaK.ShimadaH. (2018). Changes in objectively measured outdoor time and physical, psychological, and cognitive function among older adults with cognitive impairments. Archives of Gerontology and Geriatrics, 78, 190-195. https://doi.org/10.1016/j.archger.2018.06.003.
16.
HardingC.PattersonZ.Miranda-MorenoL.ZahabiS. (2012). Modeling the effect of land use on activity spaces. Transportation Research Record: Journal of the Transportation Research Board, 2323(1), 67–74. https://doi.org/10.3141/2323-08
17.
HillK. D.SchwarzJ. A.KalogeropoulosA. J.GibsonS. J. (1996). Fear of falling revisited. Archives of Physical Medicine and Rehabilitation, 77(10), 1025–1029.
18.
HirschJ. A.WintersM.ClarkeP.McKayH. (2014). Generating GPS activity spaces that shed light upon the mobility habits of older adults: A descriptive analysis. International Journal of Health Geographics, 13(1), 51. https://doi.org/10.1186/1476-072X-13-51
19.
JansenC. P.DiegelmannM.SchnabelE. L.WahlH. W.HauerK. (2017). Life-space and movement behavior in nursing home residents: Results of a new sensor-based assessment and associated factors. BMC Geriatrics, 17(1), 1–9. https://doi.org/10.1186/s12877-017-0430-7
20.
KasparR.OswaldF.WahlH.-W.VossE.WettsteinM. (2015). Daily mood and out-of-home mobility in older adults: Does cognitive impairment matter?Journal of Applied Gerontology, 34(1), 26–47. https://doi.org/10.1177/0733464812466290
21.
KatzS.DownsT. D.CashH. R.GrotzR. C. (1970). Progress in development of the index of ADL. Gerontologist, 10(1), 20–30.
22.
KayeJ.MattekN.DodgeH.BuracchioT.AustinD.HaglerS.PavelM.HayesT. (2012). One walk a year to 1000 within a year: Continuous in-home unobtrusive gait assessment of older adults. Gait & Posture, 35(2), 197–202. https://doi.org/10.1016/j.gaitpost.2011.09.006
23.
LoA. X.BrownC. J.SawyerP.KennedyR. E.AllmanR. M. (2014). Life-space mobility declines associated with incident falls and fractures. Journal of the American Geriatrics Society, 62(5), 919–923. https://doi.org/10.1111/jgs.12787
24.
MackeyD. C.CauleyJ. A.Barrett-ConnorE.SchousboeJ. T.CawthonP. M.CummingsS. R. (2014). Life-space mobility and mortality in older men: A prospective cohort study. Journal of the American Geriatrics Society, 62(7), 1288–1296. https://doi.org/10.1111/jgs.12892
25.
MahendranN.KuysS. S.DownieE.NgP.BrauerS. G. (2016). Are accelerometers and GPS devices valid, reliable and feasible tools for measurement of community ambulation after stroke?Brain Impairment, 17(2), 151–161. https://doi.org/10.1017/brimp.2016.13
26.
ManleyN. A.BayenE.BraleyT. L.MerrileesJ.ClarkA. M.ZylstraB.SchafferM.BayenA. M.PossinK. L.MillerB. L.SchenkA. K.BonaseraS. J. (2020). Long-term digital device-enabled monitoring of functional status: Implications for management of persons with Alzheimer’s disease. Alzheimer’s & Dementia (New York, N. Y.), 6(1), e12017. https://doi.org/10.1002/trc2.12017
27.
NagiS. Z. (1976). An epidemiology of disability among adults in the United States. The Milbank Memorial Fund Quarterly. Health and Society, 54(4), 439–467. http://www.jstor.org/stable/3349677
28.
NasreddineZ. S.PhillipsN. A.Be´dirianV.CharbonneauS.WhiteheadV.CollinI.CummingsJ. L.ChertkowH. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695–699. https://doi.org/10.1111/j.1532-5415.2005.53221.x
29.
PetersenJ.AustinD.KayeJ. A.PavelM.YahesT. L. (2014). Unobtrusive in-home detection of time spent out-of-home with applications to loneliness and physical activity. IEEE Journal of Biomedical and Health Informatics, 18(5), 1590–1596. https://doi.org/10.1021/nn300902w
30.
PortegijsE.RantakokkoM.MikkolaT. M.ViljanenA.RantanenT. (2014). Association between physical performance and sense of autonomy in outdoor activities and life-space mobility in community-dwelling older people. Journal of the American Geriatrics Society, 62(4), 615–621. https://doi.org/10.1111/jgs.12763
31.
PrinsR. G.PierikF.EtmanA.SterkenburgR. P.KamphuisC. B. M.van LentheF. J. (2014). How many walking and cycling trips made by elderly are beyond commonly used buffer sizes: Results from a GPS study. Health and Place, 27, 127–133. https://doi.org/10.1016/j.healthplace.2014.01.012
32.
RantakokkoM.PortegijsE.ViljanenA.IwarssonS.KauppinenM.RantanenT. (2016). Changes in life-space mobility and quality of life among community-dwelling older people: a 2-year follow-up study. Quality of Life Research, 25(5), 1189–1197. https://doi.org/10.1007/s11136-015-1137-x
RossoA. L.TaylorJ. A.TabbL. P.MichaelY. L. (2013). Mobility, disability, and social engagement in older adults. Journal of Aging and Health, 25(4), 617–637. https://doi.org/10.1177/0898264313482489
35.
StoneE.SkubicM.RantzM.AbbottC.MillerS. (2015). Average in-home gait speed: Investigation of a new metric for mobility and fall risk assessment of elders. Gait & Posture, 41(1), 57–62. https://doi.org/10.1016/j.gaitpost.2014.08.019
36.
StudenskiS.PereraS.WallaceD.ChandlerJ. M.DuncanP. W.RooneyE.FoxM.GuralnikJ. M. (2003). Physical performance measures in the clinical setting. Journal of the American Geriatrics Society, 51(3), 314–322. https://doi.org/10.1046/j.1532-5415.2003.51104.x
37.
TheouO.JakobiJ. M.VandervoortA. A.JonesG. R. (2012). A comparison of physical activity (PA) assessment tools across levels of frailty. Archives of Gerontology and Geriatrics, 54(3), e307–e314. https://doi.org/10.1016/j.archger.2011.12.005
38.
TungJ. Y.RoseR. V.GammadaE.LamI.RoyE. A.BlackS. E.PoupartP. (2014). Measuring life space in older adults with mild-to-moderate Alzheimer’s disease using mobile phone GPS. Gerontology, 60(2), 154–162. https://doi.org/10.1159/000355669
39.
WangF.StoneE.DaiW.BanerjeeT.GigerJ.KrampeJ.RantzM.SkubicM. (2009). Testing an in-home gait assessment tool for older adults. Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Minneapolis, MN, USA, 3–6 September 2009 (pp. 6147–6150). IEEE. https://doi.org/10.1109/IEMBS.2009.5333897
40.
WebberS. C.PorterM. M. (2009). Monitoring mobility in older adults using global positioning system (GPS) watches and accelerometers: A feasibility study. Journal of Aging & Physical Activity, 17(4), 455–467. https://doi.org/10.1123/japa.17.4.455
41.
WettsteinM.WahlH. W.DiehlM. K. (2014). A multidimensional view of out-of-home behaviors in cognitively unimpaired older adults: Examining differential effects of socio-demographic, cognitive, and health-related predictors. European Journal of Ageing, 11(2), 141–153. https://doi.org/10.1007/s10433-013-0292-6
42.
WettsteinM.WahlH.-W.ShovalN.AuslanderG.OswaldF.HeinikJ. (2015a). Identifying mobility types in cognitively heterogeneous older adults based on GPS-tracking. Journal of Applied Gerontology, 34(8), 1001–1027. https://doi.org/10.1177/0733464813512897
43.
WettsteinM.WahlH.-W.ShovalN.OswaldF.VossE.SeidlU.FrolichL.AuslanderG.HeinikJ.LandauR. (2015b). Out-of-home behavior and cognitive impairment in older adults: Findings of the SenTra Project. Journal of Applied Gerontology, 34(1), 3–25. https://doi.org/10.1177/0733464812459373
44.
YesavageJ. A.BrinkT. L.RoseT. L.LumO.HuangV.AdeyM.LeirerV. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49. https://doi.org/10.1016/0022-3956(82)90033-4
45.
ZeitlerE.BuysL. (2015). Mobility and out-of-home activities of older people living in suburban environments: “Because I’m a driver, I don’t have a problem.” Ageing and Society, 35(4), 785–808. https://doi.org/10.1017/S0144686X13001086
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
