Sponsor:
National Institute on Aging (R01-AG15062)

Description:
The first phase of the UAB Study of Aging (Mobility Among Older African Americans and Whites) was a prospective, observational study of a population based sample of 1000 community-dwelling Medicare beneficiaries, stratified by sex, race, and urban/rural residence to study potentially modifiable factors that predict life-space mobility trajectories. Participants were 65 years of age and older at baseline (1999-2001). Telephone follow-up interviews were conducted every six months through April 2009 for 8.5 years total follow-up. A second in-home visit, dietary recalls, and fasting blood specimens were completed at the 48 month interview.

Study of Aging II:
Late life, age 75 and older, is a time when adults are more likely to experience illness and hospitalizations, the development of new conditions, personal losses, memory problems, and be at risk for nutritional deficits. As a result, this period of life is associated with an increased risk for mobility loss and decreased social participation. The overall purpose of the UAB Study of Aging II is to study the impact of specific events such as surgical and non-surgical hospitalizations, emergency room visits, new non-skin cancer diagnoses, falling, driving cessation, and bereavement on life-space and factors which may modify any associated life-space change among community-dwelling adults age 75 years and older. This study will differentiate the causes of gradual and acute causes of changes in mobility and participation in society among community-dwelling older adults. By identifying potentially modifiable causes for decline in mobility after age 75, we will be able to develop interventions designed to enhance participation and quality of life for the burgeoning number of adults entering late life.

The outcome measure for both phases of the UAB Study of Aging is the UAB Life-Space Assessment (LSA), a composite measure of a person’s frequency of movement in geographically defined life-space zones extending from the room where one sleeps to beyond the town where one lives and whether or not assistance is required for that movement. As such, it reflects participation in the wider society in the month before the assessment. The LSA has been validated and shown to be reliable whether assessed face-to-face or over the phone.

To address the specific aims listed below, we have recruited a 419 community-dwelling adults aged 75 and older (42% male, 35% African American, and 41% rural). The in-home baseline assessment completed 2010-2011 will permit collection of nutritional and performance based assessments associated with life-space such as gait speed and cognitive screening tests. Telephone follow-up interviews at one-month intervals over a subsequent three-year period will be used to track life-space change, incident acute events, hypothesized effect-modifying factors, and adverse outcomes such as new ADL and IADL disability, nursing home placement and mortality.

  1. Assess the immediate magnitude of LSA changes associated with specific events commonly occurring among community-dwelling adults aged 75 years and older and follow changes in life-space after the occurrence of the events.
  2. Determine if life-space changes over one-month predict subsequent adverse outcomes.
  3. Examine the role of social support, symptom burden and post-event services and resources on changes in LSA.

The results of this study will be used to identify the distribution of life-space changes associated with specific events and help identify factors that moderate precipitous life-space mobility changes in community-dwelling adults aged 75 years and greater and will guide the development and testing of interventions to optimize life-space mobility in late life.

Papers (Published 2003-)

  1. Baker, P.S., Bodner, E.V., and Allman, R.M., 2003. Measuring life-space mobility in community-dwelling older adults. J. Am. Geriatr. Soc., 51:1610-1614. doi:10.1046/j.1532-5415.2003.51512.x
  2. Parker, M., Roff, L.L., Klemmack, D.L., Koenig, H.G., Baker, P.S., and Allman, R.M., 2003. Religiosity and mental health in southern, community-dwelling older adults. Aging Mental Hlth., 7(5), 390-397. DOI: 10.1080/1360786031000150667
  3. Crowther, M.R., Baker, P. S., Larimore, W.L., Koenig, H.G., Parker, M.W., 2003. Spiritual and emotional well-being: emotional tasks associated with elder care. J. Geriatr Care Management, 13(1): 15-21.
  4. Fuller, G.F., Baker, P.S., Larimore, W.L., Parker, M.W., Allman, R.M., and Martin, J.A., 2003. Helping families establish a medical care plan for an elderly parent. J. Geriatr Care Management, 13(1): 22-28.
  5. Roff, L.L, Klemmack, D.L, Parker, M.W., Koenig, C.G., Crowther, M., Baker, P., Allman, R.M. 2004. Depression and religiosity in African American and White community-dwelling older adults. J Human Behav. Soc. Environ. 10: 175-189.
  6. Allman, R.M., Sawyer Baker, P., Maisiak, R.M., Sims, R.V., and Roseman, J.M., 2004. Racial similarities and differences in predictors of mobility change over eighteen months. J Gen Intern Med. 19: 1118-1126. doi:10.1111/j.1525-1497.2004.30239.x.
  7. Roff, L.L., Klemmack, D.L., Koenig, H.G., Parker, M., Sawyer Baker, P., and Allman, R.M. 2005. Religiosity, smoking, exercise, and obesity among southern, community-dwelling older adults. 2005. J Appl Gerontol. 24: 337-354.
  8. Locher, J.L., Ritchie, C.S., Roth, D.L., Sawyer Baker, P., Bodner, E.V., and Allman, R.M., 2005. Social isolation, support, capital and nutritional risk in an older sample: ethnic and gender differences. Soc Sci Med. 60: 747-761. doi:10.1016/j.socscimed.2004.06.023
  9. Goode, P.S., Burgio, K.L., Halli, A.D., Jones, R.W., Richter, H.E., Redden, D.T., Baker, P.S., Allman, R.M. 2005. Prevalence and correlates of fecal incontinence in community-dwelling older adults. J Am Geriatr Soc. 53:629-635. doi:10.1111/j.1532-5415.2005.53211.x
  10. Peel, C., Sawyer Baker, P., Roth, D.L., Brown, C.J., Bodner, E.V., Allman, R.M. 2005. Assessing mobility in older adults: The UAB Study of Aging life-space assessment. Physical Therapy 85(10): 1008–1019.
  11. Williams, B. R., Sawyer Baker, P., Allman, R.M. 2005. Nonspousal family loss among community-dwelling older adults. Omega 51: 125-142.
  12. Allman, R.M., Sawyer, P., Roseman, J.M. 2006. The UAB Study of Aging: background and prospects for insights into life-space mobility among older African-Americans and Whites in rural and urban settings. Aging Health, 2(3): 417-428.
  13. Sawyer, P., Bodner, E.V., Ritchie, C.S., Allman, R.M. 2006. Pain and pain medication use in community-dwelling older adults. Am J Geriatr Pharmacotherap 4:316-324. doi:10.1016/j.amjopharm.2006.12.005.
  14. Roff, L.L., Klemmack, D.L., Simon, C., Cho, G.W., Parker, M.W., Koenig, C.G., Sawyer Baker, P., Allman, R.M. 2006. Functional limitations and religious service attendance among African American and White elders. Hlth Soc Work 31:246-255.
  15. Makhija, S.K., Gilbert, G.H., Boykin, M.J., Litaker, M.S., Allman, R.M., Sawyer Baker, P., Locher, J.L., Ritchie, C.S. 2006. The relationship between sociodemographic factors and oral health-related quality of life in dentate and edentulous community-dwelling older adults. J Am Geriatr Soc 54:1701-1712. doi:10.1111/j.1532-5415.2006.00923.x

    See the following links for supplemental information about this paper:
  16. Martin, M.Y., Powell, M.P., Peel, C., Zhu, S., Allman, R.M., 2006. Leisure-time physical activity and health-care utilization in older adults. J. of Aging Physical Activity 14:392-410.
  17. Williams, B.R., Sawyer Baker, P., Allman, R.M., Roseman, J.M. 2006. The feminization of bereavement among community-dwelling older adults. J. Women Aging 18:3-18.
  18. Rahman, S., Sawyer Baker, P., Allman, R.M., Zamrini, E. 2007. Dietary factors and cognitive impairment in community-dwelling older adults. J. Nutr. Hlth. Aging 11: 49-54.
  19. Williams, B.R., Sawyer Baker, P., Allman, R.M., Roseman, J.M. 2007. Bereavement among African American and White older adults. J. of Aging Hlth. 19: 313-333. doi: 10.1177/0898264307299301
  20. Klemmack, D.L., Roff, L.L., Parker, M.W., Koenig, H.G., Sawyer Baker, P., Allman, R.M. 2007. A cluster analysis typology of religiousness/spirituality among older adults. Res. on Aging 29:163-183. doi: 10.1177/0164027506296757
  21. Sims, R.V., Ahmed, A., Sawyer, P., Allman, R.M. 2007. Self-reported health and driving cessation in community-dwelling older adults. J. Gerontol. A Biol. Sci. Med. Sci. 62: 89-793.
  22. Sawyer, P., Lillis, J.P., Bodner, E.V., Allman, R.M. 2007. Substantial daily pain among nursing home residents. J. Am. Med. Dir. Assoc. 8:158-165. doi:10.1016/j.jamda.2006.12.030.
  23. Schillerstrom, J.E., Sawyer Baker, P., Allman, R.M., Rungruang, B., Zamrini, E., Royall, D.R. 2007. Clock drawing phenotypes in community-dwelling African Americans and Caucasians: Results from the UAB Study of Aging. Neuroepidemiology 28:175-180. doi: 10.1159/000104095
  24. Makhija S.K., Gilbert G.H., Litaker M.S., Allman R.M., Sawyer P., Locher J.L., Ritchie C.S. 2007. Association between aspects of oral health-related quality of life and body mass index in community-dwelling older adults. J. Am. Geriatr. Soc. 55:1808-1816. doi:10.1111/j.1532-5415.2007.01391.x
  25. Markland, A.D., Goode, P.S., Burgio, K.L. Redden, D.T., Richter, H.E., Sawyer, P., Allman, R.M. 2007. Correlates of urinary, fecal, and dual incontinence among older, African- American and White men and women J. Am. Geriatr. Soc. 56 (2), 285–290 doi:10.1111/j.1532-5415.2007.01509.x
  26. Crowe, M., Clay O.J., Sawyer P., Crowther M.R., Allman R.M., 2008. Education and reading ability in relation to differences in cognitive screening between African American and Caucasian older adults. Int. J. Geriatr. Psychiatr. 23:222-223. doi:10.1002/gps.1902.
  27. Locher, J.L. Roth, D.L., Ritichie, C.S. Cox, K., Bodner, E.V., Sawyer, P., Allman, R.M. 2007. Body mass index, weight loss, and mortality in community-dwelling older adults. J. Gerontol. A Biol. Sci. Med. Sci. 62:1389-1392.
  28. Ritchie, C.S., Locher, J.L., Roth, D.L., McVie, T., Sawyer, P., Allman, R.M. 2008. Unintentional weight loss predicts decline in ADL function and life-space mobility over four years among community-dwelling older adults J. Gerontol. A Biol. Sci. Med. Sci. 63:67-75.
  29. Goode, P.S., Burgio K.L., Redden, D.T., Markland, A., Richter, H.E., Sawyer, P., Allman, R.M. 2008. Population-based study of incidence and predictors of urinary incontinence in African and White Older Adults. J. Urol. 179:1449-1453. doi:10.1016/j.juro.2007.11.069
  30. Crowe, M., Clay O.J., Sawyer P., Crowther M.R., Allman R.M., 2008. Education and reading ability in relation to differences in cognitive screening between African American and Caucasian older adults. Int. J. Geriatr. Psychiatr. 23:222-223. doi:10.1002/gps.1902.
  31. Park, N., Klemmack, D., Roff, L., Parker, M., Koenig, H., Baker, P., Allman, R. 2008. Religiousness and longitudinal trajectories in elders’ functional status. Research on Aging 279-298. doi:10.1177/0164027507313001.
  32. Williams, B.R., Sawyer, P., Roseman, J.M., Allman, R.M. 2008 Marital status and health:exploring pre-widowhood, Journal of Palliative Medicine. 11(6): 848-856. doi:10.1089/jpm.2007.0190.
  33. Crowe, M., Andel, R., Okonkwo, O.,Wadley, V., Sawyer, P., Allman, R.M. 2008. Life-space and cognitive decline in a community-based sample of African American and Caucasian older adults J. Gerontol. A Biol. Sci. Med. Sci. 63:1241-1245
  34. Brown, C.J., Roth, D.L., Allman, R.M., Sawyer, P., Ritchie, C.S. Roseman, J.M. Trajectories of life-space mobility after hospitalization. 2009. Ann Intern Med 150:372-378
  35. Makhija S.K., Gilbert G.H., Clay O.J., Matthews J.C., Sawyer P., Allman R.A. Oral health-related quality of life and life-space mobility in community-dwelling older adults 2010. J Am Geriatr Soc Accepted for publication

    See the following links for supplemental information about this paper:

  36. Crowe, M., Sartori, A., Clay, O. J., Wadley, V. G., Andel, R., Wang, H. -X., Sawyer, P., & Allman, R. (2010). Diabetes and cognitive decline: Investigating the potential influence of factors related to health disparities. Journal of Aging and Health, 22, 292-306.
  37. Crowe, M., Allman, R. M., Triebel, K., Sawyer, P., & Martin, R. (2010). Normative performance on an executive clock drawing task (CLOX) in a community-dwelling sample of older adults. Archives of Clinical Neuropsychology, 25, 610-617.
  38. Sawyer, P., Allman, R.M. Nov 2010. Resilience in Mobility in the Context of Chronic Disease and Aging: Cross-Sectional and Prospective Findings from the UAB Study of Aging. In P.S. Fry & C. L. M. Keyes (Eds) New Frontiers of Resilient Aging, Life Strengths and Wellness in Late Life (pp. 310-339). New York Cambridge University Press.
  39. Allman,R.M., Sawyer, P., Crowther, M., Strothers II, H., Turner, T., Fouad, M. Predictors of 4-Year Retention Among African American and White Community Dwelling Participants in the UAB Study of Aging. 2011. May 2011 The Gerontologist. S1 (S46-S58)
  40. Clay O.J., Roth D.L., Safford M.M., Sawyer P.L., Allman R.M. Predictors of Overnight Hospital Admission in Older African American and Caucasian Medicare Beneficiaries 2011. J Gerontol A Biol Sci Med Sci. 2011 August;66A(8):910–916. doi:10.1093/gerona/glr082.
  41. Sun, F., Park, N.S., Roff, L.L., Klemmack, D. L., Parker, M., Koenig, H., Sawyer, P., Allman, R.M., January 2012 Predicting the Trajectories of Depressive Symptoms Among Southern Community-Dwelling Older Adults: The Role of Religiosity. Aging and Mental Health. 189-198. On-line available 10-28-11.
  42. Swanson, M., E.V. Bodner, Sawyer, P., Allman, R.M., Jan 2012. Reduced Visual Acuity is Associated with Lower Levels of Leisure Time Physical Activity Among Community Dwelling Older Adults. Journal of Aging and Physical Activity 20(1): 1-14. PMID:21945888
  43. Hannon III, L., Sawyer, P., Allman, R.M. April 2012. The Influence of Community and the Built Environment on Physical Activity. Journal of Aging and Health. 24(3): 384-406.
  44. Williams, B.R., Sawyer, P, Allman, R.M. April 2012. Wearing the Garment of Widowhood: Variations in Time Since Spousal Loss Among Community-Dwelling Older Adults. Journal of Women & Aging. 24 (2): 126-139.
  45. Crowe, M. Clay, O.J., Martin, R. C., Howard, V. J., Wadley, V. G., Sawyer, P, and Allman, R.M. April 2012. Indicators of childhood quality of education in relation to cognitive function in older adulthood. Journal of Gerontology: Medical Sciences. Epub

Opportunities for Faculty Involvement:
Data from this study are available for investigators to analyze for publications and for use as preliminary data for new grant applications.

Procedures for Requesting Data Sets

Primary Contact Person:

Patricia Sawyer, Ph.D.
(tel) (205) 975-5372
(fax) (205) 934-7354

or administration at ccha@uab.edu.

Leaders and Key Staff:

  • Cynthia Brown, M.D. (PI)
  • Julie Locher, Ph.D.
  • Richard Kennedy, M.D., Ph.D.