Mobility in old age: Capacity and Performance

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This thesis addresses mobility capacity and mobility performance in old age and has three aims: to assess the predictive ability of mobility capacity measures for mobility performance; to determine predictors of real-life mobility; and to develop a step intervention approach aiming to enhance mobility of older adults by systematically addressing motor as well as cognitive components. A core finding is that laboratory-based assessments of mobility (and cognition) show weak associations with real-life mobility performance. This adds to the notion that capacity and performance are separate constructs, which in turn highlights the need for comprehensive assessments of mobility, covering also aspects of physical activity-related mobility and life-space mobility. In an attempt to compare the relative contribution of multidomain factors on real-life mobility, this thesis assessed potential determinants based on the mobility framework of Webber et al. and analyzed their predictive ability for physical activity-related mobility as well as life-space mobility. Compared to cognitive functioning, physical and psychological functioning seem to be more important for real-life mobility, which make them relevant targets for interventions aiming to enhance mobility. The last part of this thesis presents a novel concept for step interventions and discusses its potential effects on physical, cognitive and psychosocial functioning. A pilot study showed that this concept, delivered as a group-based exercise program, is safe and feasible for relatively healthy, community-dwelling older adults and therefore makes it a promising tool for the enhancement not only of mobility capacity but also for mobility performance. Future studies should assess additional/other multidomain factors in longitudinal study designs in order to deliver more robust results regarding the risk factors for mobility impairments. Furthermore, the effectiveness of the proposed intervention concept is to be tested via randomized controlled trials. The results of this thesis add to our understanding of mobility in older adults by highlighting its two distinct facets (capacity and performance), providing insights on its predictors and discussing relevant interventional approaches.
Original languageEnglish
Place of PublicationKöln
PublisherDeutsche Sporthochschule Köln
Number of pages120
Publication statusPublished - 2019

ID: 4694708

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