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Life-Space Mobility Trajectories After Elective Surgery in Older Adults
Nai-Wen Ku1, Nelly Toledano1, Nicholas Legacy1
1Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
JAMA Network Open
|July 22, 2026
Summary
Older adults undergoing surgery often experience restricted life-space mobility (LSM) postoperatively, particularly women and those with frailty. Integrating LSM assessments into perioperative care can improve recovery and support strategies.
Area of Science:
- Geriatric Medicine
- Surgical Outcomes
- Rehabilitation Science
Background:
- The global population of frail older adults undergoing surgery is increasing.
- Life-space mobility (LSM) is a key indicator of physical and social recovery, linked to functional decline and quality of life.
Purpose of the Study:
- To investigate postoperative recovery using LSM in frail older adults.
- To identify factors associated with restricted mobility and hospital readmission after surgery.
Main Methods:
- A convergent mixed-methods exploratory cohort study involving 204 older adults (≥65 years) with frailty (CFS ≥3) undergoing major elective noncardiac surgery across 17 Canadian hospitals.
- LSM was measured pre-surgery and at 2 and 6 months post-surgery. Multivariable models identified factors associated with LSM trajectories, restricted mobility (LSM < 60), and readmission.
Main Results:
- Mean LSM improved from 2 to 6 months post-surgery, but 41.2% still had restricted mobility at 6 months.
- Restricted mobility was significantly associated with female sex (OR, 4.72), greater frailty (OR, 10.42), and need for caregiver support (OR, 5.43).
- Elevated-risk surgery was linked to 6-month hospital readmission (OR, 3.18).
Conclusions:
- Despite overall LSM recovery, a substantial proportion of frail older adults experience persistent mobility restrictions post-surgery.
- Female sex, higher frailty levels, and reliance on caregivers are key factors predicting poor recovery.
- Incorporating LSM into perioperative care planning can enhance functional recovery assessment and guide personalized support.
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