A GPS-Based Framework for Understanding Outdoor Mobility Patterns of Older Adults with Dementia: An Exploratory Study.

Introduction An active lifestyle may protect older adults from cognitive decline. Yet, due to the complex nature of outdoor environments, many people living with dementia experience decreased access to outdoor activities. In this context, conceptualizing and measuring outdoor mobility is of great significance. Using the global positioning system (GPS) provides an avenue for capturing the multi-dimensional nature of outdoor mobility. The objective of this study is to develop a comprehensive framework for comparing outdoor mobility patterns of cognitively intact older adults and older adults with dementia using passively collected GPS data. Methods A total of 7 people with dementia (PwD) and 8 cognitively intact controls (CTLs), aged 65 years or older, carried a GPS device when travelling outside their homes for 4 weeks. We applied a framework incorporating 12 GPS-based indicators to capture spatial, temporal, and semantic dimensions of outdoor mobility. Results Despite a small sample size, the application of our mobility framework identified several significant differences between the 2 groups. We found that PwD participated in more medical-related (Cliff's Delta = 0.71, 95% CI: 0.34-1) and fewer sport-related (Cliff's Delta = -0.78, 95% CI: -1 to -0.32) activities compared to the cognitively intact CTLs. Our results also suggested that longer duration of daily walking time (Cliff's Delta = 0.71, 95% CI: 0.148-1) and longer outdoor activities at night, after 8 p.m. (Hedges' g = 1.42, 95% CI: 0.85-1.09), are associated with cognitively intact individuals. Conclusion Based on the proposed framework incorporating 12 GPS-based indicators, we were able to identify several differences in outdoor mobility in PwD compared with cognitively intact CTLs.