title: Spinal deformity and mobility self-confidence among women with osteoporosis and vertebral fractures.
abstract: This study evaluated the direct and indirect effects of spinal deformity on confidence in mobility among 185 older women with osteoporosis and vertebral fractures. We administered multidimensional tests of physical and psychosocial impairment and function to female residents of continuing care retirement communities, and used path analytic regression methods to delineate relationships between spinal deformity, pain, function and mobility self-confidence. No direct effect of spinal deformity on confidence in mobility was observed. However, important indirect paths mediated by functional limitations were confirmed. A pattern of indirect effects was observed for a broad array of impairment-level constructs. These results support current models of the disablement process that propose functional limitations as the major pathway to disability. However, they also suggest that the impact of impairment-level constructs might be overlooked unless we evaluate indirect, as well as direct effects, on disability.
authors.affiliation: Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC 27710, USA. jlp@geri.duke.edu
authors.forename: J L
authors.initials: JL
authors.lastname: Purser
authors.forename: C F
authors.initials: CF
authors.lastname: Pieper
authors.forename: L G
authors.initials: LG
authors.lastname: Branch
authors.forename: K M
authors.initials: KM
authors.lastname: Shipp
authors.forename: D T
authors.initials: DT
authors.lastname: Gold
authors.forename: K W
authors.initials: KW
authors.lastname: Lyles
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D010024:Osteoporosis / Q000150:complications*; D012649:Self Concept; D013121:Spinal Curvatures / Q000150:complications / Q000523:psychology*; D016103:Spinal Fractures / Q000150:complications*