Validation of the German version of the Life-Space Assessment LSA-D

Muemken, S. A.; Gellert, P.; Stollwerck, M.; O'Sullivan, J. L.; Kiselev, J.

Abstract Objectives To develop a German version of the original University of Alabama at Birmingham (UAB) Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its psychometric properties for urban and rural populations of older adults. Design Cross-sectional validation study. Setting Two study centres in urban and rural German outpatient hospital settings. Participants In total N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 (SD=5.4); 49% male). Primary and secondary outcome measures The final version of the translated LSA-D was related with questions about activities and instrumental activities of daily living (ADL/iADL; primary hypothesis), Timed-Up&Go-Test (TUG), self-rated health, balance confidence and history of falls, use of transportation, and sociodemographic factors to obtain construct validity. Secondary outcome measures of health included handgrip strength, screening of cognitive function and comorbidities. To assess conduct construct validity, correlations between LSA-D and all health measures were examined for total sample, urban and rural subsamples using bivariate regression and multiple adjusted regression models. Posthoc analyses included different LSA-D scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure. Results In the multiple adjusted model for the total sample, number of ADL/iADL limitations ({beta}=-.26; 95%CI=-.42/-.08), TUG ({beta}=-.37; 95%CI=-.68/-.14), living in shared living arrangements ({beta}=.22; 95%CI=.01/.44) and history of falls in the past 6 months ({beta}=-.22; 95%CI=-.41/-.05) showed significant associations with the LSA-D composite score, while living in urban area ({beta}=-.19; 95%CI=-.42/.03) and male gender ({beta}=.15; 95%CI=-.04/.35) were not significant. Conclusion The LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past four weeks in ambulant urban and rural settings. Trial registration number DRKS00019023