JMIR Publications

ABSTRACT

Background:

Life Space Mobility (LSM) refers to the movement of people over time and the areas through which they move to achieve lifegoals of health, employment, security and participation for Active Aging.

Objective:

The Elderly Activity Life-Space Envelopes (EASE) program is a large interdisciplinary mixed-methods LSM study in older adults 50 years and above. The overarching aims were to discover why, where and when seniors travel and how they get to their destinations.

Methods:

In this paper, we focus on the methodology of the main quantitative phase. This community-based study comprised an in-person multidomain geriatric assessment (MDGA) with physical performance measures, followed by a 14-day travel diary. For the MDGA, we structurally underpinned important population health constructs including the WHO-ICF, Frailty and Intrinsic Capacity. We also described home meso-environments by incorporating authoritative open-source environmental attributes. These facilitated the categorization of LSM determinants into Health, Social and Environmental domains. The LSM outcomes include self-reported and objective Geographical Information Science (GIS) LSM measures. We further developed a suite of GIS LSM outcomes in alignment with our overarching aims. Quota sampling based on age groups, housing typology and frailty status were applied. A customized, smartphone-based digital travel diary was designed, and barometric sensors were enabled to capture 3-dimensional LSM in capable smartphones.

Results:

We recruited 1131 seniors with an average age of 63.8 (7.6) years. The large majority (1062, 95%) successfully documented their travel diary on their smartphones with the rest on paper-based travel diaries. For the digital data, a total of 88,166 node points were recorded. There were 76,741 trips and 106,323 trip legs documented through the e-travel diary platform. Valid vertical LSM data was obtained in 228 participants. The majority (75%) lived in public apartments and 29% were pre-frail or frail.

Conclusions:

We provide a practical, feasible yet comprehensive protocol integrating LSM within important population health themes. Also, the development of an objective, systematic outcomes framework will form the basis for future LSM studies in the field. We aim to analyze interactions between LSM outcomes, explore its diverse determinants and identify senior travel phenotypes. We hope to develop interdisciplinary policy-driven interventions to ultimately improve the quality of life in older adults.