Using GPS Technologies to Examine Community Mobility in Older Adults

• Published in: The journals of gerontology. Series A, Biological sciences and medical sciences Biological sciences and medical sciences, 2023-05, Vol.78 (5), p.811-820
• Main Authors: Crane, Breanna M, Moored, Kyle D, Rosso, Andrea L, Carlson, Michelle C
• Format: Article
• Language: English
• Subjects: Aged; Cognition; Cognitive ability; Editor's Choice; Executive Function; Gait; Geographic Information Systems; Global positioning systems; GPS; Humans; Independent Living; Mobility; Mobility Limitation; Older people; THE JOURNAL OF GERONTOLOGY: Medical Sciences; Walking
• ISSN: 1079-5006; 1758-535X
• DOI: 10.1093/gerona/glac185

Abstract Background Objective measures of community mobility are advantageous for capturing movement outside the home. Compared with subjective, self-reported techniques, global positioning system (GPS) technologies leverage passive, real-time location data to reduce recall bias and increase measurement precision. We developed methods to quantify community mobility among community-dwelling older adults and assessed how GPS-derived indicators relate to clinical measures of physical and cognitive performance. Methods Participants (n = 149; M ± standard deviation [SD] = 77.1 ± 6.5 years) from the program to improve mobility in aging (PRIMA) study, a physical therapy intervention to improve walking ability, carried a GPS device for 7 days. Community mobility was characterized by assessing activity space, shape, duration, and distance. Associations between GPS-derived indicators and cognition and physical function were evaluated using Spearman correlations. Results In adjusted models, a larger activity space, greater duration (eg, time out-of-home), and greater distance traveled from home were correlated with better 6-Minute Walk Test performance (ρ = 0.17–0.23, p’s < .05). A more circular activity shape was related to poorer performance on the Trail Making Test, Part A (ρ = 0.18, p < .05). More time out-of-home and a larger activity space were correlated with faster times on the Trail Making Test, Part B (ρ = −0.18 to −0.24, p’s < .05). Community mobility measures were not associated with global cognition, skilled walking, or usual gait speed. Conclusion GPS-derived community mobility indicators capture real-world activity among older adults and were correlated with clinical measures of executive function and walking endurance. These findings will guide the design of future interventions to promote community mobility.