{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T16:03:24Z","timestamp":1784736204511,"version":"3.55.0"},"reference-count":61,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine postoperative recovery using LSM among older adults living with frailty and to identify factors associated with restricted mobility and readmission.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Elective noncardiac surgery among older adults.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n 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\u2009&amp;lt;\u200960), and hospital readmission.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 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).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.24553","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T15:30:32Z","timestamp":1784734232000},"page":"e2624553","source":"Crossref","is-referenced-by-count":0,"title":["Life-Space Mobility Trajectories After Elective Surgery in Older Adults"],"prefix":"10.1001","volume":"9","author":[{"given":"Nai-Wen","family":"Ku","sequence":"first","affiliation":[{"name":"Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelly","family":"Toledano","sequence":"additional","affiliation":[{"name":"Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, 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University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianni R.","family":"Lorello","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"The Wilson Centre, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Anesthesia and Pain Management, University Health Network\u2014Toronto Western Hospital, Toronto, Ontario, Canada"},{"name":"Women\u2019s College Research Institute, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Kuluski","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, 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