Life-Space Mobility Trajectories After Elective Surgery in Older Adults.

Authors

Nai-Wen Ku, Nelly Toledano, Nicholas Legacy, Keying Xu, Duminda N Wijeysundera, Kristen R Haase, Eric Pitters, Fay Bennie, Anne Stephens, Gianni R Lorello, Kerry Kuluski, Daniel I McIsaac, Tyler R Chesney, Naveed Siddiqui, Karim S Ladha, C David Mazer, Noah Crampton, Stuart A McCluskey, Matteo Parotto, Lisa Del Giudice, Angela Jerath, Janet van Vlymen, Su-Yin MacDonell, Melinda Davis, Alexander J Gregory, Eric Jacobsohn, Katherine S McGilton, Emily Hladkowicz, Shabbir M H Alibhai, Martine Puts

Published in

JAMA network open. Volume 9. Issue 7. Pages e2624553. Jul 01, 2026. Epub Jul 01, 2026.

Abstract

The number of older adults living with frailty who undergo surgery is rapidly increasing worldwide. Life-space mobility (LSM) can capture physical and social dimensions of recovery and has been linked to functional decline and reduced quality of life.
To examine postoperative recovery using LSM among older adults living with frailty and to identify factors associated with restricted mobility and readmission.
This cohort study within the larger Functional Improvement Trajectories After Surgery study used a convergent mixed-methods exploratory design. Seventeen hospitals across Canada included older adults aged 65 years or older with a clinical frailty score (CFS) of 3 or more who underwent major elective noncardiac surgery from March 2021 to June 2023. Data were analyzed from September to October 2025.
Elective noncardiac surgery among older adults.
LSM (range 0-120, with higher scores indicating more mobility) was measured at 1 to 2 months and 6 months postoperatively, with retrospective presurgery LSM captured at 1 to 2 months. Multivariable linear mixed-effects models and multivariable mixed-effects logistic regression were used to identify factors associated with LSM trajectories, restricted mobility (ie, LSM < 60), and hospital readmission.
This study included 204 participants (mean [SD] age, 72.8 [5.6] years; 108 males [53%]). The mean (SD) LSM was 65.1 (26.7) presurgery, 56.6 (26.7) at 2 months postsurgery, and 64.9 (25.9) at 6 months postsurgery. Eighty participants (39.2%) had restricted mobility presurgery, 114 (56.4%) at 2 months postsurgery, and 84 (41.2%) at 6 months postsurgery. Restricted mobility was associated with being a woman (odds ratio [OR], 4.72; 95% CI, 2.27-9.84), greater frailty (OR, 10.42; 95% CI, 3.56-30.49), and concurrent need for support from formal or informal caregivers (OR, 5.43; 95% CI, 2.72-10.86). Elevated-risk surgery was associated with hospital readmission at 6 months (OR, 3.18; 95% CI, 1.48-7.25).
In this nested cohort study, mean LSM recovered by 6 months postsurgery, but 41% of older adults still had restricted mobility. Being a woman, having greater frailty, and needing support from caregivers were associated with poor recovery. Integrating life-space assessments into individualized perioperative care planning may enhance evaluation of functional recovery, inform shared decision-making, and guide support strategies.

PMID:
42485039
Bibliographic data and abstract were imported from PubMed on 22 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.