Environmental demands associated with community mobility in older adults with and without mobility disabilities.
OBJECTIVE
In this study, the influence of 8 dimensions of the physical environment on mobility in older adults with and without mobility disability was measured. This was done in order to identify environmental factors that contribute to mobility disability.


METHODS
Subjects were 36 older adults ((> or = 70 years of age) who were recruited from 2 geographic sites (Seattle, Wash, and Waterloo, Ontario, Canada) and were grouped according to level of mobility function (physically able [ability to walk 1/2 mile (0.8 km) or climb stairs without assistance], physically disabled).


METHODS
Subjects were observed and videotaped during 3 trips into the community (trip to grocery store, physician visit, recreational trip). Frequency of encounters with environmental features within each of the 8 dimensions was recorded. Differences in baseline characteristics and environmental encounters were analyzed using an analysis of variance or the Fisher exact test, as appropriate.


RESULTS
Mobility disability among older adults was not associated with a uniform decrease in encounters with environmental challenges across all dimensions. Environmental dimensions that differed between subjects who were physically able and those with physical disability included temporal factors, physical load, terrain, and postural transition. Dimensions that were not different included distance, density, ambient conditions (eg, light levels and weather conditions), and attentional demands.


CONCLUSIONS
Understanding the relationship of the environment to mobility is crucial to both prevention and rehabilitation of mobility disability in older adults. Among older adults, certain dimensions of the environment may disable community mobility more than others.
Shumway-Cook
Anne
A
Department of Rehabilitation Medicine, University of Washington, Box 356490, Seattle, WA 98195, USA. ashumway@u.washington.edu
Patla
Aftab E
AE
Stewart
Anita
A
Ferrucci
Luigi
L
Ciol
Marcia A
MA
Guralnik
Jack M
JM
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D008019:Life Style; D008297:Male; D009864:Ontario; D012111:Residence Characteristics; D012307:Risk Factors; D012931:Social Environment; D016138:Walking; D014861:Washington