{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T16:26:48Z","timestamp":1784651208717,"version":"3.55.0"},"reference-count":44,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi231234-4\"><jats:title>Importance<\/jats:title><jats:p>Life space is a measure of the frequency, range, and independence of movement through the environment. There is increasing interest in life space as a holistic measure of function in older adults, but the association between change in life space and incident neurodegenerative disease is unknown.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi231234-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate the association between change in life space and cognitive decline or incident neurodegenerative disease over 7 years among community-dwelling older men.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi231234-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>In this cohort study, logistic regression analyses were used to examine the association of baseline and change in life space with change in cognition unadjusted and adjusted for demographics, cardiovascular risk factors, depression, gait speed, and physical activity. Mixed linear effects models were used to evaluate the association between change in life space and change in cognition. Men were recruited from 6 US sites to participate in a prospective, community-based cohort study of aging and followed-up from 2007 to 2014. Individuals with prevalent dementia or Parkinson disease (PD) at baseline were excluded. Data were analyzed from May 2022 to September 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi231234-7\"><jats:title>Exposure<\/jats:title><jats:p>Life space, assessed using the University of Alabama at Birmingham Life Space Assessment and divided into tertiles.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi231234-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Participants completed the Modified Mini-Mental State (3MS) Test, and Trail-Making Test Part B at baseline and 7 years later. At follow-up, participants were asked about a new physician diagnosis of dementia and PD.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi231234-9\"><jats:title>Results<\/jats:title><jats:p>A total of 1684 men (mean [SD] age, 77.1 [4.2] years) were recruited and over 7 years of follow-up, 80 men (4.8%) developed dementia and 23 men (1.4%) developed PD. Mean (SD) life space score was 92.9 (18.7) points and mean (SD) change was \u22129.9 (22.3) points over follow up. In the adjusted model, each 1-SD decrement in life space was associated with increased odds of dementia (odds ratio [OR], 1.59; 95% CI, 1.28-1.98) but not PD (OR, 1.48; 95% CI, 0.97-2.25). For each 1-SD decrement in life space, men worsened by 20.6 (95% CI, 19.8-21.1) seconds in their Trails B score (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) and declined by 1.2 (95% CI, 1.0-1.3) points in their 3MS score (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) over 7 years.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi231234-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this study of 1684 men followed up over 7 years, change in life space was associated with faster cognitive decline and increased likelihood of neurodegenerative illness. Future studies should examine the role of clinician assessments or wearable electronics in tracking life space in older adults at risk of cognitive decline and neurodegenerative illness.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.42670","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T16:02:24Z","timestamp":1699545744000},"page":"e2342670","source":"Crossref","is-referenced-by-count":11,"title":["Constricting Life Space and Likelihood of Neurodegenerative Disease in Community-Dwelling Older Men"],"prefix":"10.1001","volume":"6","author":[{"given":"Meredith A.","family":"Bock","sequence":"first","affiliation":[{"name":"Department of Neurology, University of California, San Francisco"},{"name":"San Francisco Veterans Affairs Medical Center, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Hoang","sequence":"additional","affiliation":[{"name":"San Francisco Veterans Affairs Medical Center, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy","family":"Cawthon","sequence":"additional","affiliation":[{"name":"California Pacific Medical Center Research Institute, San Francisco"},{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn C.","family":"Mackey","sequence":"additional","affiliation":[{"name":"Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada"},{"name":"Centre for Aging SMART, Vancouver Coastal Health Research Institute and the University of British Columbia, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheena","family":"Patel","sequence":"additional","affiliation":[{"name":"California Pacific Medical Center Research Institute, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa A.","family":"Hillier","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Center for Health Research, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Yaffe","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of California, San Francisco"},{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco"},{"name":"San Francisco Veterans Affairs Medical Center, San Francisco, California"},{"name":"Department of Psychiatry, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"issue":"1","key":"zoi231234r1","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1080\/03610730601006420","article-title":"Correlates of life space in a volunteer cohort of older adults.","volume":"33","author":"Barnes","year":"2007","journal-title":"Exp Aging 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