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Frequency of Going Outdoors: A Predictor of Functional and Psychosocial Change Among Ambulatory Frail Elders Living at Home

¹ Sepulveda VA GRECC, and UCLA School of Medicine, Los Angeles, California.
² Department of Social Gerontology, Graduate School of Medicine, The University of Tokyo, Japan.
³ Senior Citizens' Welfare Section, Saku City Government Office, Nagano, Japan.

Correspondence: Address correspondence to Ayumi Kono, RN, PhD, Sepulveda VA Medical Center GRECC, 16111 Plummer Street, Sepulveda, CA 91343. E-mail: [email protected]

Background. This study investigated the relationship between the frequency of going outdoors among ambulatory frail elders living at home and subsequent functional and psychosocial changes.

Methods. In this 9-month prospective cohort study, data were collected via questionnaire from 112 frail elderly persons living at home and their families. Functional and psychosocial status at baseline and follow-up regarding activities of daily living, functional capacity, depression, self-efficacy for daily activities, self-efficacy for health promotion, and social support, were compared among 3 groups defined by the frequency of going outdoors: 1) more than 4 times a week, 2) 1–3 times a week, 3) less than once a week. At baseline, elders going outdoors more often were less functionally impaired, more socially active, and scored less depressed than elders going outdoors less often.

Results. There were significant differences in functional capacity (p =.0201) and intellectual activities (p =.0026) over time according to the frequency of going outdoors, even when controlling for baseline differences, and the scores of those who seldom went outdoors decreased rapidly. There were similar relationships between frequency of going outdoors and changes in self-efficacy for both daily activities (p =.0067) and for health promotion (p =.0245), with participants going outdoors most frequently improving significantly more.

Conclusions. These results suggest that the frequency of going outdoors may be a useful and simple indicator to predict changes in functional capacity, intellectual activity and self-efficacy.