Dementia Care

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54 Australian Journal of Dementia Care October/November 2016 Vol 5 No 5
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Anne-Nicole Casey is a Dementia
Collaborative Research Centre: Assessment
and Better Care (DCRC: ABC) and Centre for
Healthy Brain Ageing (CHeBA), UNSW Australia
PhD candidate and lead researcher on the
FRIEND study; Janet Mitchell is a DCRC: ABC
and CHeBA PhD candidate, leading the
SOCIAL study. Contact the authors at:
and
.
Many people may relate to the
feeling that being able to leave the
house and be out and doing
things is a sign that life is good. The great
news is that we have the science to back
up this feeling.
Researchers have studied ‘lifespace’ –
the geographical area in which you live
and conduct your activities – since the
1970s. This measure records how often
people moved about in different areas of
their homes, neighbourhoods and further
afield. The research has shown that there
are key relationships between lifespace,
and a person’s well-being, physical
health and cognitive functioning. While
these relationships seem important, they
are not yet fully understood.
Now, there are new ways of
monitoring lifespace using smartphones
and this is helping us to figure out the
needs and experiences of people living
with mild cognitive impairment (people
having some changes to their memory
and thinking, but normal functioning)
and dementia.
Measuring lifespace
Lifespace was initially conceived as a
way of describing how often people left
their bedroom in residential care settings,
and its use revealed that the locations in
which they spent time were an indicator
of health and well-being.
The concept has quickly expanded
from there and has been studied in
ageing populations across the world.
These large studies indicated that
lifespace not only gave insights into
current functioning and well-being, but
was also a powerful predictor of future
outcomes. Even when statistically
controlling for the effect of poor health,
reduced independence, cognitive
functioning and frailty, people who had a
lower lifespace were significantly more
likely to have poorer health outcomes
and need residential care in the future
than those with a greater lifespace.
For people who already had a
cognitive impairment, those with a
smaller lifespace have a more rapid
deterioration of their cognition in the
future compared with those with larger
lifespaces.
Although we don’t know precisely
how lifespace and health and well-being
interact, this area clearly needs further
study. Something that has been hindering
study is that lifespace has been measured
either by staff observing a person’s
movements in a facility or by the person
recalling their activity over the past week
or two. Neither of these options is ideal
for monitoring the activity levels of
people living in the community and
particularly those who have difficulty
recalling the details.
Smartphones may provide a solution
for this. GPS (Global Positioning
System)-based location tracking, which is
present on all standard smartphones,
DCRC SPEC I AL I SSUE : THE B I G P I CTURE I N DEMENT I A RESEARCH
Measuring the importance
of getting out and about
A Sydney study is using a new ‘lifespace’ app to explore community
mobility and challenges for people with dementia. The results will be
used to develop interventions that improve community access and
engagement. Jacki Liddle, David Ireland, Fleur Harrison,
Louise Gustafsson, Sandy Brauer, Robyn Lamont, Theresa
Scott, Nancy Pachana , Perminder Sachdev, Kristan Kang and
Henry Brodaty report
The research has
shown that there are
key relationships
between lifespace, and
a person’s well-being,
physical health and
cognitive functioning.
While these
relationships seem
important, they are not
yet fully understood