Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults

Abstract

Objectives: To develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults.

Design: Cross-sectional validation study.

Setting: Two study centres in urban and rural German outpatient hospital settings.

Participants: In total, N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 years (SD=5.4); 49.4% men).

Primary and secondary outcome measures: The final version of the translated LSA-D was related to limitations in activities and instrumental activities of daily living (ADL/iADL) as primary outcome measure (primary hypothesis); and with sociodemographic factors, functional mobility, self-rated health, balance confidence and history of falls as secondary outcome measures to obtain construct validity. Further descriptive measurements of health included hand grip strength, screening of cognitive function, comorbidities and use of transportation. To assess construct validity, correlations between LSA-D and the primary and secondary outcome measures were examined for the total sample, and urban and rural subsamples using bivariate regression and multiple adjusted regression models. Descriptive analyses of LSA-D included different scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure.

Results: In the multiple adjusted model for the total sample, number of ADL/iADL limitations (beta=-0.26; 95% CI=-0.42 to -0.08), Timed Up and Go Test (beta=-0.37; 95% CI=-0.68 to -0.14), shared living arrangements (beta=0.22; 95% CI=0.01 to 0.44) and history of falls in the past 6 months (beta=-0.22; 95% CI=-0.41 to -0.05) showed significant associations with the LSA-D composite score, while living in urban area (beta=-0.19; 95% CI=-0.42 to 0.03) and male gender (beta=0.15; 95% CI=-0.04 to 0.35) were not significant.

Conclusion: The LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past 4 weeks in ambulant urban and rural settings.