Life-space mobility among home-living older adults with care needs and clinical depression-A cross-sectional analysis

While life-space mobility is key for wellbeing, social participation and access to health care, vulnerable older adults face physical and mental barriers that may restrict mobility. The present exploratory study examined associations between physical functional limitations, depressive symptoms, life-space mobility and outpatient health care utilization.

Cross-sectional data from 197 community-dwelling older adults with care needs and clinical depression was collected. Life-space assessment composite score (LS-C), instrumental activities of daily living scale (iADL), Geriatric Depression Scale (GDS-12) and outpatient health care utilization have been assessed. Multiple regression analyses were conducted.

Mean LS-C score was 31.8 (SD = 17.7, range: 0-92), indicating low mobility levels. Depressive symptoms (β = -0.21, p = 0.001) and iADL (β = 0.54, p < 0.001) were significantly related with life-space mobility, over and above age and living alone. An interaction effect between depressive symptoms and iADL was not significant (β = -0.07, 0.17, p = 0.26). Moreover, life-space mobility was positively associated with primary care (β = 0.19, p = 0.02) and mental health care utilization (β = 0.33, p < 0.001).

Life-space mobility appears to be largely restricted in home-living vulnerable older adults with clinically significant depression; and factors associated with these restrictions appear to be physical and mental. The interplay of depression, mobility and health care utilization and its potential for interventional approaches need further investigations. Present findings underline an urgent need for new health care services that allow mobility-impaired older patients to receive mental health outpatient treatment in their own home.

The trial was prospectively registered with the ISRCTN registry (Trial registration number: ISRCTN55646265, registered February 15, 2019).