The aim of this study was to analyze whether the associations between perceived environmental and individual characteristics and perceived walking limitations in older people differ between those with intact and those with poorer lower extremity performance.
Persons aged 75 to 90 ( N = 834) participated in interviews and performance tests in their homes. Standard questionnaires were used to obtain walking difficulties; environmental barriers to and, facilitators of, mobility; and perceived individual hindrances to outdoor mobility. Lower extremity performance was tested using Short Physical Performance Battery (SPPB).
Among those with poorer lower extremity performance, the likelihood for advanced walking limitations was, in particular, related to perceived poor safety in the environment, and among those with intact performance to perceived social issues, such as lack of company, as well as to long distances.
The environmental correlates of walking limitations seem to depend on the level of lower extremity performance.
OBJECTIVES: This study examines whether aspects of social relations at baseline are related to functional decline at 5-year follow-up among nondisabled old men and women. METHODS: The investigation is based on baseline and follow-up data on 651 nondisabled 75-year-old persons in Jyväskylä (Finland) and Glostrup (Denmark). The analyses are performed separately for men and women. Possible selection problems were considered by using three outcome measures: first, functional decline among the survivors (n = 425); second, functional decline, including death, assuming that death is part of a general decline pattern (n = 565); and third, mortality (n = 651). Social relations were measured at baseline by several items focusing on the structure and function of the social network. RESULTS: In men, no weekly telephone contact was related to functional decline and mortality. Among women, less than weekly telephone contact, no membership in a retirement club, and not sewing for others were significantly related to functional decline and mortality. The associations were stronger when the dead were included in the outcome measure. DISCUSSION: The results point to the importance of social relations in the prevention of functional decline in older adults.
The aim of this study was to investigate the incidence of limitations in self-reported mobility as well as the decline in measured walking speed and stair-mounting ability over five years among men and women aged 75 at baseline in two Nordic localities. Another purpose was to analyze the relationship and its consistency over time between self-reports and performance-based measures in the decline of mobility. Identical Interviews and performance tests were carried out in Jyäskylä, Finland (N=244) and Glostrup, Denmark (N=275) at baseline and five years later. The subjects were asked about their ability to manage with transferring from chair or bed, walking indoors and outdoors and climbing stairs. The occurrence of new limitations in these tasks was analyzed among those who did not report limitations in the same task at baseline. Maximal walking speed and step-mounting height were measured in the laboratory. The decline in walking speed below 1.2 m/s and stair-mounting height below 30 cm was analyzed among those whose results were, initially, above these limits. Most frequently, new limitations occurred in walking outdoors and in climbing stairs (44-60%). Walking speed and stair-mounting ability deteriorated below the thresholds mentioned in 4-36% of the participants, depending on gender and locality. There were only minor differences between the two Nordic localities in the decline in mobility functions. A substantial proportion of those whose performance had declined had developed limitations in self-reported mobility as well. However, the relationship between different methods of measurement was not straightforward. This indicates that multiple approaches are needed to obtain thorough knowledge about mobility and its decline among elderly people.
Depressed mood may either precede mobility limitation or follow from mobility limitation.
To compare mood status among people with manifest mobility limitation, those with preclinical mobility limitation and those without mobility limitation and investigate factors explaining the association between depressed mood and mobility limitation.
645 community-living 75- to 81-year-old people.
Depressed mood was assessed using the Centre for Epidemiologic Studies Depression Scale (CES-D, cut-off score 16); difficulty walking 500 m was assessed by self-report. Those reporting difficulty were categorised as having manifest mobility limitation. Those with no difficulty but reporting task modifications, such as reduced frequency of walking, were categorised as having preclinical mobility limitation. The association between depressed mood and mobility limitation was analysed using logistic regression analysis with gender, age, economic situation, the availability of a confidant, chronic conditions, and widespread pain as covariates.
Depressed mood was found in 34% of subjects with manifest mobility limitation, in 26% of those with preclinical mobility limitation, and in 13% of those without mobility limitation. The unadjusted odds ratio for depressed mood was 3.43 (95% CI 2.04-5.76) among subjects with manifest mobility limitation and 2.38 (95% CI 1.52-3.73) among those with preclinical mobility limitation, compared to those without mobility limitation. Adjustment for covariates reduced the risks to 2.10 (95% CI 1.15-3.82) and 1.99 (95% CI 1.24-3.20), respectively. Widespread pain explained 28% of the increased risk of depressed mood among those with manifest mobility limitation.
The dose-response relationship between depressed mood and mobility limitation suggests that both conditions may progress simultaneously and may share aetiology, at least in part. Pain may be an underlying factor in both depressed mood and mobility limitation.