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This study explores differences in the out-of-home behavior of community-dwelling older adults with different cognitive impairment. Three levels of complexity of out-of-home behavior were distinguished: (a) mostly automatized walking behavior (low complexity), (b) global out-of-home mobility (medium complexity), and (c) defined units of concrete out-of-home activities, particularly cognitively demanding activities (high complexity). A sample of 257 older adults aged 59 to 91 years (M = 72.9 years, SD = 6.4 years) included 35 persons with early-stage Alzheimer's disease (AD), 76 persons with mild cognitive impairment (MCI), and 146 cognitively healthy persons (CH). Mobility data were gathered by using a GPS tracking device as well as by questionnaire. Predicting cognitive impairment status by out-of-home behavior and a range of confounders by means of multinomial logistic regression revealed that only cognitively demanding activities showed at least a marginally significant difference between MCI and CH and were highly significant between AD and CH., (© The Author(s) 2012.)

Studies on the relationship between behavioral competence, such as the competence of exerting out-of-home behavior (OOHB), and well-being in older adults have rarely addressed cognitive status as a potentially moderating factor. We included 35 persons with early-stage dementia of the Alzheimer's type (DAT), 76 individuals with mild cognitive impairment (MCI) and 146 cognitively healthy (CH) study participants (grand mean age: M=72.9 years; SD=6.4 years). OOHB indicators were assessed based on a multi-method assessment strategy, using both GPS (global positioning system) tracking technology and structured self-reports. Environmental mastery and positive as well as negative affect served as well-being indicators and were assessed by established questionnaires. Three theoretically postulated OOHB dimensions of different complexity (out-of-home walking behavior, global out-of-home mobility, and out-of-home activities) were supported by confirmatory factor analysis (CFA). We also found in the DAT group that environmental mastery was substantially and positively related to less complex out-of-home walking behavior, which was not the case in MCI and CH individuals. In contrast, more complex out-of-home activities were associated with higher negative affect in the DAT as well as the MCI group, but not in CH persons. These findings point to the possibility that relationships between OOHB and well-being depend on the congruence between available cognitive resources and the complexity of the OOHB dimension considered., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Background: One of the more common behavioral manifestations of dementia-related disorders is severe problems with out-of-home mobility. Various efforts have been attempted to attain a better understanding of mobility behavior, but most studies are based on institutionalized patients and the assessment usually relies on reports of caregivers and institutional staff, using observational approaches, activity monitoring, or behavioral checklists. The current manuscript describes the research protocol of a project that measures mobility in Alzheimer's disease and related cognitive disorders in an innovative way, by taking advantage of advanced tracking technologies., Methods/design: Participants are 360 demented persons, mildly cognitively impaired persons, and unimpaired controls aged > or = 65 in Israel and Germany. Data regarding space-time activities will be collected via a GPS tracking kit for a period of 4 weeks in 3 waves (one year apart) with the same participants (using a repeated measures design). Participants will be interviewed by use of a battery of instruments prior to and following GPS data collection. Further, a family member will complete a questionnaire both before and after data tracking. Statistical analyses will strive to explain differences in mobility based on a wide range of socio-structural, clinical, affect-related and environmental variables. We will also assess the impact of the use of advanced tracking technology on the quality of life of dementia patients and care givers, as well as its potential as a diagnostic tool. Systematic assessment of ethical issues involved in the use of tracking technology will be an integral component of the project., Discussion: This project will be able to make a substantial contribution to basic as well as applied and clinical aspects in the area of mobility and cognitive impairment research. The innovative technologies applied in this study will allow for assessing a range of dimensions of out-of-home mobility, and provide better quality data.