Association of peripheral artery disease with life-space mobility restriction and mortality in community-dwelling older adults.

OBJECTIVE: Symptomatic peripheral artery disease (PAD) impairs walking, but data on the impact of PAD on community mobility is limited. Life-space mobility measures the distance, frequency, and assistance needed as older adults move through geographic areas extending from their bedroom (life-space mobility score: 0) to beyond their town (life-space mobility score: 120). We evaluated the association of PAD with longitudinal life-space mobility trajectory. METHODS: Participants were part of the University of Alabama at Birmingham Study of Aging, a longitudinal study of community-dwelling older adults who were observed from 2001 to 2009. We limited our analysis to those who survived at least 6 months (N = 981). PAD was based on self-report with verification by physician report and hospital records. Our primary outcome was life-space mobility score assessed every 6 months. A multilevel change model (mixed model) was used to determine the association between PAD and life-space mobility trajectory during a median 7.9 years of follow-up. RESULTS: Participants had a mean age of 75.7 (standard deviation, 6.7) years; 50.5% were female, and 50.4% were African American. PAD prevalence was 10.1%, and 57.1% of participants with PAD died. In participants with both PAD and life-space restriction, defined as life-space mobility score <60, we observed the highest mortality (73.1%). In a multivariable adjusted mixed effects model, participants with PAD had a more rapid decline in life-space mobility by -1.1 (95% confidence interval [CI], -1.9 to -0.24) points per year compared with those without PAD. At 5-year follow-up, model-adjusted mean life-space mobility was 48.1 (95% CI, 43.5-52.7) and 52.4 (95% CI, 50.9-53.8) among those with and without PAD, respectively, corresponding to a restriction in independent life-space mobility at the level of one's neighborhood. CONCLUSIONS: Life-space mobility is a novel patient-centered measure of community mobility, and PAD is associated with significant life-space mobility decline among community-dwelling older adults. Further study is needed to mechanistically confirm these findings and to determine whether better recognition and treatment of PAD alter the trajectory of life-space mobility.

A comparison of urban and non-urban African American older adults on health-related characteristics.

Although residential geographic health disparities have been noted in the previous literature, studies are specifically lacking on intra-group health comparisons of African American older adults by residential geography. The purpose of this study was to determine if health-related characteristics of African American older adults varied by residential geography. Socioeconomic demographics, medical conditions, primary care use, and self-ratings of general health, social activity, and physical activity were compared in a community-dwelling sample of 327 urban and non-urban African American older adults. Urban and non-urban African American older adults were compared on health-related factors. Compared to urban African American older adults, those in non-urban areas had lower incomes, lower self-ratings of general health, social activity, and physical activity, and a higher frequency of arthritis and gastroenterological and urological conditions. Despite poorer general health and medical conditions, non-urban African American older adults were less likely to visit the doctor when needed. Study findings suggest residential geography may be an underappreciated underlying contributing factor to inter-group health disparities between African American and white older adults and not race alone. Therefore, social workers in public health, health care, and clinical settings should be aware of the interaction between race and residential geography.

ED Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults.

The rise in ED utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to have a positive impact on the care of older adults. Symptoms have been associated with ED utilization; however, it remains unclear whether symptoms are the primary reason for ED utilization. The purpose of this study was to describe the self-reported symptoms of community-dwelling older adults prior to accessing the emergency department and to examine the differences in self-reported symptoms among those who did and did not utilize the emergency department. METHODS: A prospective longitudinal design was used. The sample included 403 community-dwelling older adults aged 75 years and older. Baseline in-home interviews were conducted followed by monthly telephone interviews over 15 months. RESULTS: Commonly reported symptoms at baseline included pain, feeling tired, and having shortness of breath. In univariate analysis, pain, shortness of breath, fair/poor well-being, and feeling tired were significantly correlated with ED utilization. In multivariable models, problems with balance and fair/poor well-being were significantly associated with ED utilization. DISCUSSION: Several symptoms were common among this cohort of older adults. However, no significant differences were found in the types of symptoms reported by older adults who utilized the emergency department compared with those who did not utilize the emergency department. Based on these findings, it appears that symptoms among community-dwelling older adults may not be the primary reason for ED utilization.

Association between neighborhood disadvantage and hypertension prevalence, awareness, treatment, and control in older adults: results from the University of Alabama at Birmingham Study of Aging.

OBJECTIVES: We evaluated the effect of neighborhood disadvantage (ND) on older adults' prevalence, awareness, treatment, and control of hypertension. METHODS: Data were from the University of Alabama at Birmingham Study of Aging, an observational study of 1000 community-dwelling Black and White Alabamians aged 65 years and older, in 1999 to 2001. We assessed hypertension prevalence, awareness, treatment, and control with blood pressure measurements and self-report data. We assessed ND with US Census data corresponding with participants' census tracts, created tertiles of ND, and fit models with generalized estimating equations via a logit link function with a binomial distribution. Adjusted models included variables assessing personal advantage and disadvantage, place-based factors, sociodemographics, comorbidities, and health behaviors. RESULTS: Living in mid-ND (adjusted odds ratio [AOR] = 1.6; 95% confidence interval [CI] = 1.2, 2.1) and high-ND tertiles (AOR = 1.8; 95% CI = 1.3, 2.3) was associated with higher hypertension prevalence, and living in high-ND tertiles was associated with lower odds of controlled hypertension (AOR = 0.6; 95% CI = 0.4, 0.6). In adjusted models, ND was not associated with hypertension awareness or treatment. CONCLUSIONS: These findings show that neighborhood environmental factors matter for hypertension outcomes and suggest the importance of ND for hypertension management in older adults.

The Impact of Veteran Status on Life-Space Mobility among Older Black and White Men in the Deep South.

OBJECTIVE: To examine life-space mobility over 8.5 years among older Black and White male veterans and non-veterans in the Deep South. DESIGN: A prospective longitudinal study of community-dwelling Black and White male adults aged >65 years (N=501; mean age=74.9; 50% Black and 50% White) enrolled in the University of Alabama at Birmingham (UAB) Study of Aging. Data from baseline in-home assessments with follow-up telephone assessments of life-space mobility completed every 6 months were used in linear mixed-effects modeling analyses to examine life-space mobility trajectories. MAIN OUTCOME MEASURES: Life-space mobility. RESULTS: In comparison to veterans, non-veterans were more likely to be Black, single, and live in rural areas. They also reported lower income and education. Veterans had higher baseline life-space (73.7 vs 64.9 for non-veterans; P<.001). Race-veteran subgroup analyses revealed significant differences in demographics, comorbidity, cognition, and physical function. Relative to Black veterans, there were significantly greater declines in life-space trajectories for White non-veterans (P=.009), but not for White veterans (P=.807) nor Black non-veterans (P=.633). Mortality at 8.5 years was 43.5% for veterans and 49.5% for non-veterans (P=.190) with no significant differences by race-veteran status. CONCLUSIONS: Veterans had significantly higher baseline life-space mobility. There were significantly greater declines in life-space trajectories for White non-veterans in comparison to other race-veteran subgroups. Black veterans and non-veterans did not have significantly different trajectories.

An Examination of Lower Extremity Function and its Correlates in Older African American and White Men.

OBJECTIVE: Maintaining functional status and reducing/eliminating health disparities in late life are key priorities. Older African Americans have been found to have worse lower extremity functioning than Whites, but little is known about potential differences in correlates between African American and White men. The goal of this investigation was to examine measures that could explain this racial difference and to identify race-specific correlates of lower extremity function. METHODS: Data were analyzed for a sample of community-dwelling men. Linear regression models examined demographics, medical conditions, health behaviors, and perceived discrimination and mental health as correlates of an objective measure of lower extremity function, the Short Physical Performance Battery (SPPB). Scores on the SPPB have a potential range of 0 to 12 with higher scores corresponding to better functioning. RESULTS: The mean age of all men was 74.9 years (SD=6.5), and the sample was 50% African American and 53% rural. African American men had scores on the SPPB that were significantly lower than White men after adjusting for age, rural residence, marital status, education, and income difficulty (P<.01). Racial differences in cognitive functioning accounted for approximately 41% of the race effect on physical function. Additional models stratified by race revealed a pattern of similar correlates of the SPPB among African American and White men. CONCLUSIONS: The results of this investigation can be helpful for researchers and clinicians to aid in identifying older men who are at-risk for poor lower extremity function and in planning targeted interventions to help reduce disparities.

The interprofessional clinical experience: interprofessional education in the nursing home.

The interprofessional clinical experience (ICE) was designed to introduce trainees to the roles of different healthcare professionals, provide an opportunity to participate in an interprofessional team, and familiarize trainees with caring for older adults in the nursing home setting. Healthcare trainees from seven professions (dentistry, medicine, nursing, nutrition, occupational therapy, optometry and social work) participated in ICE. This program consisted of individual patient interviews followed by a team meeting to develop a comprehensive care plan. To evaluate the impact of ICE on attitudinal change, the UCLA Geriatric Attitudes Scale and a post-experience assessment were used. The post-experience assessment evaluated the trainees' perception of potential team members' roles and attitudes about interprofessional team care of the older adult. Attitudes toward interprofessional teamwork and the older adult were generally positive. ICE is a novel program that allows trainees across healthcare professions to experience interprofessional teamwork in the nursing home setting.

Advancing geriatric education: development of an interprofessional program for health care faculty.

To improve the health care of older adults, a faculty development program was created to enhance geriatric knowledge. The University of Alabama at Birmingham (UAB) Geriatric Education Center leadership instituted a one-year, 36-hour curriculum focusing on older adults with complex health care needs. Content areas were chosen from the Institute of Medicine Transforming Health Care Quality report and a local needs assessment. Potential preceptors were identified and participant recruitment efforts began by contacting UAB department chairs of health care disciplines. This article describes the development of the program and its implementation over three cohorts of faculty scholars (n = 41) representing 13 disciplines, from nine institutions of higher learning. Formative and summative evaluation showed program success in terms of positive faculty reports of the program, information gained, and expressed intent by each scholar to apply learned content to teaching and/or clinical practice. This article describes the initial framework and strategies guiding the development of a thriving interprofessional geriatric education program.

Community mobility among older adults with reduced kidney function: a study of life-space.

BACKGROUND: Life-Space Assessment captures community mobility and social participation and quantifies the distance, frequency, and independence obtained as an older adult moves through his or her environment. Reduced estimated glomerular filtration rate (eGFR) is associated with decline in activities of daily living among older adults, but less is known about the association of eGFR with restrictions in mobility. STUDY DESIGN: Prospective observational cohort study. SETTING & PARTICIPANTS: Community-dwelling Medicare beneficiaries from the University of Alabama at Birmingham Study of Aging who had serum creatinine measured during a baseline in-home study visit and completed at least one telephone follow-up (N = 390). PREDICTOR: eGFR ≥ 60, 45-59, and <45 mL/min/1.73 m(2). OUTCOME: Life-space mobility trajectory. MEASUREMENTS: Life-space mobility was evaluated by telephone every 6 months for up to 4.5 years using the previously validated Life-Space Assessment. Scores using this tool range from 0-120 (higher scores indicate greater mobility). RESULTS: Mean age of the 390 participants was 77.6 ± 5.8 (SD) years, 41% were African American, 50.5% were women; 30.0% had eGFR of 45-59 mL/min/1.73 m(2), and 20.2% had eGFR < 45 mL/min/1.73 m(2). Age-, race-, and sex-adjusted mean baseline life-space mobility scores were 64.8(95% CI, 62.0-67.6), 63.8 (95% CI, 60.3-67.4), and 58.3 (95% CI, 53.8-62.7) among those with eGFR categories ≥ 60, 45-59, and <45 mL/min/1.73 m(2), respectively. Compared with those with eGFRs ≥ 60 mL/min/1.73 m(2), a more rapid decline in life-space mobility was found among those with eGFRs < 45 mL/min/1.73 m(2), though this did not reach statistical significance (P=0.06); a similar effect was not seen among those with eGFRs of 45-59 mL/min/1.73 m(2) (P=0.3). LIMITATIONS: Urinary albumin or longitudinal measures of eGFR were not available. CONCLUSIONS: eGFR < 45 mL/min/1.73 m(2) was associated with a trend toward a more rapid decline in life-space mobility among community-dwelling older adults. Findings should be confirmed in a larger population.

A robust depolymerization route for polysiloxanes.

A versatile, robust, and stable tetrabutylammonium difluorotriphenylsilicate (TBAT) catalyst has been deployed for efficient depolymerization of silicones. This catalyst is soluble in a variety of organic solvents and is stable up to 170 °C, enabling a wide range of reaction conditions under which F--catalysed siloxane bond cleavage can be initiated. This effort offers significant advancement overcoming the traditional limitations of silicone depolymerization, such as high catalyst loading, storage and handling, and few viable reaction media.

Measuring symptoms in community-dwelling older adults: the psychometric properties of a brief symptom screen.

BACKGROUND: With aging, the probability of experiencing multiple chronic conditions has increased, along with symptoms associated with these conditions. Symptoms form a central component of illness burden, and distress. To date, most symptom measures have focused on a particular disease population. OBJECTIVE: We aimed to develop and evaluate a simple symptom screen using data obtained from a representative sample of community-dwelling older adults. METHODS: Psychometric analyses were conducted on 10 self-reported dichotomous symptom indicators collected during in-person interviews from a sample of 1000 community-dwelling older adults. Symptoms included shortness of breath, feeling tired or fatigued, problems with balance or dizziness, perceived weakness in legs, constipation, daily pain, stiffness, poor appetite, anxiety, and anhedonia. RESULTS: Over one third of the individuals (37.4%) had 5 or more concurrent symptoms. Stiffness and feeling tired were the most common symptoms. Confirmatory factor analyses were performed on the 10 symptoms for single factor and bifactor (physical and affective) models of symptom reporting. Goodness-of-fit indices indicated better fit for the bifactor model (χdf=10=89.6; P<0.001), but the practical significance of the improvement in fit was negligible. Differential item functioning analyses showed some differences of relatively high magnitude in location parameters by race; however, because the differential item functioning was in different directions, the impact on the overall measure was most likely lessened. CONCLUSIONS: Among community-dwelling older adults, a large proportion experienced multiple co-occurring symptoms. This Brief Symptom Screen can be used to quickly measure the overall symptom load in older adult populations, including those with multiple chronic conditions.

Functional status, life-space mobility, and quality of life: a longitudinal mediation analysis.

PURPOSE: Using the Wilson-Cleary model of patient outcomes as a conceptual framework, the impact of functional status on health-related quality of life (HRQoL) among older adults was examined, including tests of the mediation provided by life-space mobility. METHODS: Participants were enrollees in a population-based, longitudinal study of mobility among community-dwelling older adults. Data from four waves of the study equally spaced approximately 18 months apart (baseline, 18, 36, and 54 months) were used for participants who survived at least 1 year beyond the 54-month assessment (n = 677). Autoregressive mediation models using longitudinal data and cross-sectional mediation models using baseline data were evaluated and compared using structural equation modeling. RESULTS: The longitudinal autoregressive models supported the mediating role of life-space mobility and suggested that this effect is larger for the mental component summary score than the physical component summary score of the SF-12. Evidence for a reciprocal relationship over time between functional status, measured by ADL difficulty, and life-space mobility was suggested by modification indices; these model elaborations did not alter the substantive meaning of the mediation effects. Mediated effect estimates from longitudinal autoregressive models were generally larger than those from cross-sectional models, suggesting that mediating relationships would have been missed or were potentially underestimated in cross-sectional models. CONCLUSIONS: These results support a mediating role for life-space mobility in the relationship between functional status and HRQoL. Functional status limitations might cause diminished HRQoL in part by limiting mobility. Mobility limitations may precede functional status limitations in addition to being a consequence thereof.

Creation of an interprofessional clinical experience for healthcare professions trainees in a nursing home setting.

Successful interprofessional teams are essential when caring for older adults with multiple complex medical conditions that require ongoing management from a variety of disciplines across healthcare settings. To successfully integrate interprofessional education into the healthcare professions curriculum, the most effective learning experiences should utilize adult learning principles, reflect real-life practice, and allow for interaction among trainees representing a variety of health professions. Interprofessional clinical experiences are essential to prepare future healthcare professionals to provide quality patient care and understand the best methods for utilizing members of the healthcare team to provide that care. To meet this need, the University of Alabama at Birmingham Geriatric Education Center has developed an Interprofessional Clinical Experience (ICE) to expose future healthcare providers to an applied training experience with older adults in the nursing home setting. This paper outlines how this program was developed, methods used for program evaluation, and how the outcome data influenced program revisions.

Predicting the trajectories of depressive symptoms among southern community-dwelling older adults: the role of religiosity.

BACKGROUND: This study examined the effects of religiosity on the trajectories of depressive symptoms in a sample of community-dwelling older adults over a four-year period in a Southern state in the U.S. METHODS: Data from the University of Alabama at Birmingham (UAB) Study of Aging were analyzed using a hierarchical linear modeling (HLM) method. This study involved 1000 participants aged 65 and above (M age = 75 at baseline, SD = 5.97) and data were collected annually from 1999 to 2003. The Geriatric Depression Scale measured depressive symptoms; the Duke University Religion Index measured religious service attendance, prayer, and intrinsic religiosity; and control variables included sociodemographics, health, and social and economic factors. RESULTS: The HLM analysis indicated a curvilinear trajectory of depressive symptoms over time. At baseline, participants who attended religious services more frequently tended to report fewer depressive symptoms. Participants with the highest levels of intrinsic religiosity at baseline experienced a steady decline in the number of depressive symptoms over the four-year period, while those with lower levels of intrinsic religiosity experienced a short-term decline followed by an increase in the number of depressive symptoms. IMPLICATIONS: In addition to facilitating access to health, social support and financial resources for older adults, service professionals might consider culturally appropriate, patient-centered interventions that boost the salutary effects of intrinsic religiosity on depressive symptoms.

Visual acuity's association with levels of leisure-time physical activity in community-dwelling older adults.

Little is known about the effect of reduced vision on physical activity in older adults. This study evaluates the association of visual acuity level, self-reported vision, and ocular disease conditions with leisure-time physical activity and calculated caloric expenditure. A cross-sectional study of 911 subjects 65 yr and older from the University of Alabama at Birmingham Study of Aging (SOA) cohort was conducted evaluating the association of vision-related variables to weekly kilocalorie expenditure calculated from the 17-item Leisure Time Physical Activity Questionnaire. Ordinal logistic regression was used to evaluate possible associations while controlling for potential confounders. In multivariate analyses, each lower step in visual acuity below 20/50 was significantly associated with reduced odds of having a higher level of physical activity, OR 0.81, 95% CI 0.67, 0.97. Reduced visual acuity appears to be independently associated with lower levels of physical activity among community-dwelling adults.

Wearing the garment of widowhood: variations in time since spousal loss among community-dwelling older adults.

We examine how the passage of time since spousal loss varies by social and demographic characteristics, using data from the University of Alabama at Birmingham Study of Aging. In multivariate analyses, African American race, female sex, lower income, and higher risk of social isolation had significant and independent associations with variation in time since spousal loss. African American women were at highest risk for long-term widowhood. Accurate characterizations of widowhood among community-dwelling older adults must consider variation in the length of time individuals are living as widowed persons and socioeconomic concomitants of long-term widowhood.

Heart failure is a risk factor for incident driving cessation among community-dwelling older adults: findings from a prospective population study.

BACKGROUND: Heart failure (HF) patients often depend on driving for access to specialty care. We analyzed a public-use copy of the Cardiovascular Health Study (CHS) data to determine if HF is a risk factor for driving cessation and to identify other risk factors for driving cessation among those with HF. METHODS AND RESULTS: Of the 5,383 community-dwelling drivers aged ≥65 years (mean age 73 years, 55% women, 13% African American), 839 had HF: 246 had baseline prevalent HF and 593 developed incident HF before driving cessation during 9 years of follow-up. Incident driving cessation occurred at rates of 3,980 and 3,709 per 10,000 person-years of follow-up for those with and without HF, respectively (unadjusted hazard ratio [HR] associated with HF as a time-varying variable: 2.13, 95% confidence interval [CI] 1.83-2.47; P < .001). This association remained unchanged after multivariable risk adjustment (HR 1.43, 95% CI 1.21-1.68; P < .001). Among the 839 older drivers with HF, independent predictors for incident driving cessation were age ≥75 years (HR 1.99, 95% CI 1.44-2.73; P < .001), female gender (HR 1.93, 95% CI 1.37-2.74; P < .001), difficulty walking half a mile (HR 1.47 (1.04-2.08); P = .028), vision problems (HR 1.47, 95% CI 1.07-2.02; P = .018), and stroke as a time-varying covariate (HR 1.96, 95% CI 1.38-2.79; P < .001). CONCLUSIONS: HF is an independent risk factor for incident driving cessation among community-dwelling older drivers. Several patient characteristics predicted driving cessation in older HF patients, which may be targets for interventions to prevent driving cessation among these patients.

Predictive validity of the classification schema for functional mobility tests in instrumental activities of daily living decline among older adults.

OBJECTIVE: To determine predictive validity for cut points of the Timed Up & Go (TUG) test and life-space assessment (LSA) on decline in instrumental activities of daily living (IADLs) among older adults. DESIGN: Cross-sectional and 1-year follow-up study. SETTING: Preventive health care services. PARTICIPANTS: In a cross-sectional study, 2404 older adults (65-100 y) were recruited to determine cut points for the TUG and LSA for IADLs limitation. For longitudinal analysis, 436 older adults (65-100 y) were followed over 1 year to explore the validity of a classification model using the cut points to predict incident IADLs decline. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The TUG, LSA, and Tokyo Metropolitan Institute of Gerontology index of IADLs measurement. RESULTS: The cut points associated with IADLs limitations for the TUG and LSA were 12 seconds and 56 points, respectively. Participants were classified into fast/high (most able; TUG <12 and LSA >56), fast/low, slow/high, and slow/low (vulnerable; TUG > or =12 and LSA < or =56) groups; there were 813 (34%), 385 (16%), 246 (10%), and 960 (40%) participants in each group, respectively. The proportions of participants with IADLs limitation in the most able, fast/low, slow/high, and vulnerable groups were 19%, 64%, 61%, and 89%, respectively. The vulnerable group included significantly more participants with IADLs limitation than any other group (P<.001). Compared with a most able group, the odds ratios of IADLs decline for the fast/low and vulnerable groups were 2.52 (95% confidence interval 1.15-5.53, P<.05) and 2.87 (95% confidence interval 1.38-5.96, P<.01), respectively. CONCLUSIONS: The combination of TUG and LSA identifies persons with future IADLs decline and has the potential to be used by community health care services to target individualized interventions.

Trajectories of life-space mobility after hospitalization.

BACKGROUND: Life space is a measure of where a person goes, the frequency of going there, and the dependency in getting there. It may be a more accurate measure of mobility in older adults because it reflects participation in society as well as physical ability. OBJECTIVE: To assess effects of hospitalization on life space in older adults, and to compare life-space trajectories associated with surgical and nonsurgical hospitalizations. DESIGN: Prospective observational study. SETTING: Central Alabama. PARTICIPANTS: 687 community-dwelling Medicare beneficiaries at least 65 years of age with surgical (n = 44), nonsurgical (n = 167), or no (n = 476) hospitalizations. MEASUREMENTS: Life-Space Assessment (LSA) scores before and after hospitalization (range, 0 to 120; higher scores reflect greater mobility). RESULTS: Mean age of participants was 74.6 years (SD, 6.3). Fifty percent were black, and 46% were male. Before hospitalization, adjusted LSA scores were similar in participants with surgical and nonsurgical admissions. Life-space assessment scores decreased in both groups immediately after hospitalization; however, participants with surgical hospitalizations had a greater decrease in scores (12.1 more points [95% CI, 3.6 to 20.7 points]; P = 0.005) than those with nonsurgical hospitalizations. However, participants with surgical hospitalizations recovered more rapidly over time (gain of 4.7 more points [CI, 2.0 to 7.4 points] per ln [week after discharge]; P < 0.001). Score recovery for participants with nonsurgical hospitalizations did not significantly differ from the null (average recovery, 0.7 points [CI, -0.6 to 1.9 points] per ln [week after discharge]). LIMITATION: Life space immediately before and after hospitalization was self-reported, often after hospital discharge. CONCLUSION: Hospitalization decreases life space in older adults. Surgical hospitalizations are associated with immediate marked life-space declines followed by rapid recovery, in contrast to nonsurgical hospitalizations, which are associated with more modest immediate declines and little evidence of recovery after several years of follow-up. PRIMARY FUNDING SOURCE: National Institute on Aging.

[Life-space of community-dwelling older adults using preventive health care services in Japan and the validity of composite scoring methods for assessment].

OBJECTIVE: Life-space is a spatial measure of mobility defined by the distance a person routinely travels to perform activities over a specific time period. Life-space assessment (LSA) has been widely applied, but measurement properties have not been investigated in a Japanese population. The purpose of this cross-sectional study was to describe distributions of maximal life-space and to clarify the validity of composite scores of an LSA scale among community-dwelling older adults using preventive health care services in Japan. METHODS: Surveys were conducted between November 2007 and February 2008 with a specially prepared Japanese LSA version. The sample was composed of 2,147 participants using preventive health care services provided by the Japanese long-term care insurance system, all being aged 65 and over, with adequate cognitive functions and living at home in the community (29.5% men, mean age +/- [SD] 79.4 +/- 6.9 years). First, the levels of life-space, based on how far a person had travelled on leaving his or her place of residence during the month preceding the assessment, were investigated. Second, LSA scores were calculated considering the degree of independence as well as frequencies for individuals at each level, then descriptive statistics were checked. Finally, it was tested whether the scores could be related to external criteria and functional or socio-psychological variables stated in previous studies. RESULTS: Sixty-four percent of individuals attained the highest level of life-space (i.e. outside town). The average of the composite scores was 51.4 +/- 25.2 points and the distribution was almost normal. The dispersion of the scores tended to be large. Values correlated with the hierarchical mobility level classification as an external criterion (0.539). As hypothesized, the scores were correlated with age (-0.296), functional mobility (time up and go test) (-0.387), and instrumental activities of daily living (0.533), and were discriminated by sex, depressive mood, and perceived health status, in the expected directions. CONCLUSIONS: The present study described the extent of life-space in older adults using preventive health care services in Japan, and provided preliminary support for criterion-related (concurrent) and construct validity of scores with the LSA Japanese version. The LSA composite scoring method may have advantages for detecting differences in life-space among individuals, as compared to simply using the maximal level attained.