Does Living with Parkinson's Disease Affect Life-Space Mobility? A Multiple-Methods Study

  • Author / Creator
    Ryder-Burbidge, Charlotte
  • BACKGROUND: Parkinson’s disease (PD) is a progressive, neurodegenerative disorder characterized by resting tremors, instability, slowness of movement and rigidity, generally accompanied by non-motor symptoms such as mood disturbance, fatigue, constipation, incontinence and sleep disorders. Any one of these symptoms can affect an individual’s capacity for home and community mobility but does not independently determine mobility performance. The objectives of this multiple-methods study were to identify a diverse set of explanatory factors that contributed to a model life-space mobility in people with PD and determine facilitators and barriers to mobility in a sample of this population.

    METHODS: We recruited 227 individuals with (n = 113) and without (n = 114) PD, who were comparable in age, from the community to complete a cross-sectional survey regarding mobility. The primary outcome was the life-space mobility composite score (LSA-C), which ranges from 0-120 (University of Alabama Birmingham Life-Space Assessment). Higher LSA-C represents more mobility in the home and community based on the frequency, distance, and independence of trips. Explanatory variables included demographics, lifestyle behaviours, driving status, self-reported health status, social participation and characteristics of the built environment. Descriptive statistics were used to describe and compare patterns of life-space mobility between participants with and without PD. Multivariable linear regression was used to identify factors that explained life-space mobility. Ten participants with PD participated in a semi-structured interview about facilitators and barriers to mobility. Guided by a comprehensive framework for mobility in older adults, transcripts were content analyzed.

    RESULTS: Mean LSA-C was lower for people with PD (life-space mobility composite score 64.2, SD = 25.8) in comparison to people without PD (70.3, SD=23.1; mean difference = 6 points, 95% CI: -0.4, 12.5). Participants with PD employed assistive mobility devices in higher proportions than participants without PD to reach the same life-space levels. Among people with PD, not driving, receiving caregiving and not having extra money in the house were associated with reduced life-space mobility. Social participation was the only factor associated with increased life-space mobility in the multivariable model. Data from qualitative interviews supported quantitative findings regarding the facilitating influence of driving, having social support and participating in the community. Interviewees identified additional barriers to mobility, which included PD-related anxiety and certain characteristics of the built environment such as being in crowded and confined spaces.

    CONCLUSIONS: People with PD reach similar levels of life-space compared to their counterparts without PD, but more commonly use an assistive mobility device to do so. We provide evidence that a diverse set of factors related to the individual, and social and built environments are associated with life-space mobility among people with PD.

    IMPLICATIONS: Clinicians and policy-makers should consider personal, social and environmental factors when developing interventions to improve the life-space mobility of the PD population.

  • Subjects / Keywords
  • Graduation date
    Fall 2020
  • Type of Item
  • Degree
    Master of Science
  • DOI
  • License
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