Determination of the Minimal Important Change in the Life-Space Assessment

Background/ObjectivesThe University of Alabama at Birmingham (UAB) Life-Space Assessment (LSA) is a widely used measure of community mobility. To assist clinicians and researchers with assessing the significance of changes in scores, we determined the minimal important change associated with a change in health status. SettingHomes of community-dwelling older adults. ParticipantsA total of 419 African American and non-Hispanic white adults 75 years and older participating in the UAB Study of Aging II, a longitudinal epidemiological study across the state of Alabama. InterventionNone. MeasurementsLinear mixed models were used to compare change in LSA scores over 1-month intervals (N = 9712) between participants reporting improvement, no change, or decline in activities of daily living walking scores, accounting for the correlation among scores for the same participant over time. ResultsA decline in walking status was associated with a mean decrease in LSA scores of 2.93 points (95% confidence interval [CI] = 1.69-4.17 points), indicating lower mobility. An improvement in walking status was associated with a mean increase in LSA scores of 2.51 points (95% CI = 1.26-3.77 points), indicating higher mobility. ConclusionA change in LSA scores of five or more is clinically important, exceeding the 95% CI for the change in LSA associated with change in walking status. Changes exceeding this threshold should prompt further investigation by providers with a goal of preserving mobility. J Am Geriatr Soc 67:565-569, 2019.