Mobility and cognition are associated with wellbeing and health related quality of life among older adults: a cross-sectional analysis of the Vancouver Falls Prevention Cohort.

BACKGROUND: Ascertaining individuals' quality of life and wellbeing is essential in public health and clinical research. The impact of these two pressing geriatric syndromes--impaired mobility and cognitive function--on wellbeing and quality of life is not well examined. Hence, our objective was to identify key clinically relevant outcome measures of mobility and cognitive function that explain variation in wellbeing and health related quality of life (HRQoL) among community dwelling older adults. METHODS: We conducted a cross-sectional analysis of 229 participants presenting to the Vancouver Falls Prevention Clinic from June 2010 through October 2013. The linear regression models included two dependent variables: the ICECAP-O assessing wellbeing and the EQ-5D-3L assessing HRQoL. Key independent variables included the Short Performance Physical Battery (SPPB) and the Montreal Cognitive Assessment (MoCA). Covariates included Functional Comorbidity Index (FCI), sex and age. In the two multiple linear regression models, age was statistically controlled. Other covariates (i.e., sex and FCI) were included based on statistical significance (i.e., p < 0.05). RESULTS: The SPPB was significantly associated with HRQoL and with wellbeing after adjusting for known covariates (p < 0.05, Unstandardized ß (Standard Error) 0.023 (0.006) for HRQoL and 0.016 (0.003) for wellbeing). The MoCA was significantly associated with wellbeing after adjusting for known covariates (p = 0.006), Unstandardized ß (Standard Error) 0.005 (0.002) but not with health related quality of life (p > 0.05). CONCLUSION: We found that a measure of mobility and balance was associated with HRQoL and wellbeing. However, cognitive function was associated with wellbeing only. This study highlights the potential importance of considering wellbeing as an outcome measure if interventions are intended to have a broader impact than health alone.

Mobility predicts change in older adults' health-related quality of life: evidence from a Vancouver falls prevention prospective cohort study.

BACKGROUND: Older adults with mobility impairments are prone to reduced health related quality of life (HRQoL) is highly associated with mobility impairments. The consequences of falls have detrimental impact on mobility. Hence, ascertaining factors explaining variation among individuals' quality of life is critical for promoting healthy ageing, particularly among older fallers. Hence, the primary objective of our study was to identify key factors that explain variation in HRQoL among community dwelling older adults at risk of falls. METHODS: We conducted a longitudinal analysis of a 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 148 to 286 depending on the analysis). We constructed linear mixed models where assessment month (0, 6, 12) was entered as a within-subjects repeated measure, the intercept was specified as a random effect, and predictors and covariates were entered as between-subjects fixed effects. We also included the predictors by sex and predictor by sex by time interaction terms in order to investigate sex differences in the relations between the predictor variable and the outcome variable, the EQ-5D. RESULTS: Our primary analysis demonstrated a significant mobility (assessed using the Short Performance Physical Battery and the Timed Up and Go) by time interaction (p < 0.05) and mobility by time by sex interaction (p < 0.05). The sensitivity analyses demonstrated some heterogeneity of these findings using an imputed and a complete case analysis. CONCLUSIONS: Mobility may be an important predictor of changes in HRQoL over time. As such, mobility is a critical factor to target for future intervention strategies aimed at maintaining or improving HRQoL in late life.

Learner-Controlled Self-Observation is Advantageous for Motor Skill Acquisition.

There were two main objectives of this research. First, we wanted to examine whether video feedback of the self (self-observation) was more effective for motor skill learning when the choice to view the video was provided to the learner (learner-controlled, LC) as opposed to an experimenter-controlled (EC) delivery. Secondly, we explored whether there were differences in the self-regulatory processes of self-efficacy and intrinsic motivation, as well as perceived choice between the LC and EC conditions. Two groups (LC and EC) of children (M age of 11.2 years; SD = 1.89) attempted to learn a progression of trampoline skills during a 2-day acquisition phase in which video self-observation was available. The second acquisition day was followed by a no self-observation retention test 1 day later. It was hypothesized that, during retention, the LC group would be more self-efficacious about their ability to progress through the trampoline skills, show greater intrinsic motivation and perceived choice, and go further in skill progression than the EC group. Analysis of the acquisition data showed the LC group had greater increases in self-efficacy as compared to the EC group. Results of the retention test showed that the participants in the LC group obtained higher scores on the intrinsic motivation and perceived choice measures and had higher skill progression scores as compared to the EC group. Regression analysis showed that group assignment and self-efficacy were significant predictors of the physical performance benefits noted in retention. These findings are discussed within Zimmerman's (2004) self-regulation of learning model.