Accepted Manuscript Mobility is a key predictor of changes in wellbeing among older fallers: Evidence from the Vancouver Falls Prevention Cohort Jennifer C. Davis, John R. Best, Stirling Bryan, Linda C. Li, Chun Liang Hsu, Caitlin Gomez, Kelly Vertes, Teresa Liu-Ambrose PII:

S0003-9993(15)00292-0

DOI:

10.1016/j.apmr.2015.02.033

Reference:

YAPMR 56157

To appear in:

ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION

Received Date: 12 January 2015 Accepted Date: 24 February 2015

Please cite this article as: Davis JC, Best JR, Bryan S, Li LC, Hsu CL, Gomez C, Vertes K, Liu-Ambrose T, Mobility is a key predictor of changes in wellbeing among older fallers: Evidence from the Vancouver Falls Prevention Cohort, ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION (2015), doi: 10.1016/j.apmr.2015.02.033. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCEPTED MANUSCRIPT

Mobility is a key predictor of changes in wellbeing among older fallers: Evidence from the Vancouver Falls Prevention Cohort Jennifer C. Davis* a,d, John R. Best* d,e,f,g, Stirling Bryan a, Linda C Li b,c, Chun Liang Hsu d,e,f, Caitlin Gomez

* Jennifer a Centre

Kelly Vertes e,g, Teresa Liu-Ambrose d,e,f,g

C. Davis* a,d, John R. Best* d,e,f,g sharing first-authorship

RI PT

e,g,

for Clinical Epidemiology and Evaluation, 828 West 10th Avenue, University of British Columbia &

b Department

SC

Vancouver Coastal Health Research Institute (VCHRI), Vancouver, British Columbia, V6T 2B5, Canada of Physical Therapy, 2177 Wesbrook Mall, University of British Columbia, Vancouver, British

c Arthritis

M AN U

Columbia, V6T 2B5, Canada

Research Centre of Canada, 5591 No. 3 Road, Richmond BC, British Columbia, V6X 2C7,

Canada d

Aging, Mobility, and Cognitive Neuroscience Lab, 2211 Wesbrook Mall, University of British Columbia,

e Department

of Physical Therapy, 2177 Wesbrook Mall, University of British Columbia, Vancouver, British

Columbia, V6T 2B5, Canada

Research Center, 2211 Wesbrook Mall, University of British Columbia, Vancouver, British Columbia,

V6T 2B5, Canada

Center for Hip Health and Mobility, 311-2647 Willow Street, Vancouver, British Columbia, V5Z 1M9,

AC C

g

EP

f Brain

TE D

Vancouver, British Columbia, V6T 2B5, Canada

Canada

Funding: The Canadian Institute for Health Research Emerging Team Grant (CIHR, MOB-93373 to Karim Khan, TLA, LL) provided funding for this study. *Corresponding Author: Teresa Liu-Ambrose, PhD, PT, Tel: 1-604-875-4111 ext. 69059, Fax: 1-604-875-4762, Email: [email protected]

ACCEPTED MANUSCRIPT

Acknowledgement We thank the Vancouver Falls Prevention Cohort study participants. The Canadian Institute for Health Research Emerging Team Grant (CIHR, MOB-93373 to Karim Khan, TLA, LL) provided funding for this

RI PT

study. TLA is a Canada Research Chair in Physical Activity, Mobility, and Cognitive Neuroscience, a Michael Smith Foundation for Health Research (MSFHR) Scholar, a Canadian Institutes of Health Research (CIHR) New Investigator, and a Heart and Stroke Foundation of Canada’s Henry JM

SC

Barnett’s Scholarship recipient. JCD and JB are funded by a CIHR and MSFHR Postdoctoral Fellowship. LL is a MSFHR Scholar and a Canada Research Chair. CLS is a CIHR Doctoral Trainee.

M AN U

These funding agencies did not play a role in study design. We obtained approval for the Vancouver Falls Prevention Clinic Cohort study from UBC Clinical Ethics Review Board.

Conflict of Interest

TE D

Jennifer C. Davis, Stirling Bryan, John R. Best, Linda C Li, Chun Liang Hsu, Caitlin Gomez, Kelly Vertes and Teresa Liu-Ambrose declare that they have no competing interests.

EP

Author’s Contributions

TLA was principal investigator for the Vancouver Falls Prevention Clinic Cohort study. TLA and JCD

AC C

were responsible for study concept and design, acquisition of data, data analysis and interpretation, writing and reviewing of the manuscript. JCD and JB were responsible for data analysis. JCD, TLA, JB, SB, CLH, LL, CG, and KV drafted and revised the manuscript. JCD, JB, TLA and SB acquired and interpreted the data.

ACCEPTED MANUSCRIPT Mobility predicts wellbeing among older fallers 1

Mobility is a key predictor of changes in wellbeing among older fallers: Evidence from the

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Vancouver Falls Prevention Cohort ABSTRACT

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Objective: To determine the factors that predict change in wellbeing, over time among older men and

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women presenting to the Vancouver Falls Prevention Clinic.

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Design: 12-month prospective cohort study

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Setting: Vancouver Falls Prevention Clinic

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Participants: The study sample consisted of between 244 - 255 (depending on the analysis) community-

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dwelling older adults referred to the clinic after suffering a fall.

M AN U

SC

RI PT

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Main Outcome Measure: The ICECAP-O, a measure of wellbeing/quality of life, was administered at

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baseline, 6-months, and 12-months. We constructed linear mixed models to determine whether baseline

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predictor variables were related to baseline wellbeing and/or changes in wellbeing over time. Additionally,

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we included interactions with sex to investigate difference for males versus females. Baseline predictors

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included two measures of mobility (Short Performance Physical Battery (SPPB) and Timed Up and Go

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(TUG)) and a measure of global cognitive function (Montreal Cognitive Assessment (MoCA)).

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Results: All three predictors were associated with wellbeing at baseline (p