title: Neighbourhood deprivation and incident mobility disability in older adults.
abstract: OBJECTIVE
  to assess whether incident mobility disability and neighbourhood deprivation in older people are associated independent of the effects of individual socio-economic status, health behaviours and health status.
  
  
  METHODS
  prospective cohort study with a 2-year follow-up.
  
  
  METHODS
  the English Longitudinal Study of Ageing (ELSA), a national probability sample of non-institutionalised older people.
  
  
  METHODS
  4,148 participants aged 60 years and over.
  
  
  METHODS
  exposure was a census-based index of neighbourhood deprivation [the Index of Multiple Deprivation (IMD)]; outcomes were measured and self-reported incident mobility difficulties.
  
  
  RESULTS
  neighbourhood deprivation had a statistically significant effect on physical function following adjustment for individual socio-economic factors, health behaviours and health status. Compared to those living in the least deprived 20% of neighbourhoods, those in the most deprived neighbourhoods had a risk ratio (RR) of incident self-reported mobility difficulties of 1.75 (95% CI 1.14-2.70) and RR of incident-impaired gait speed of 1.63 (95% CI 1.01-2.62). In adjusted models, 4.0 per 100 (95% CI 3.0-5.4) older adults in neighbourhoods in the least deprived 20% had incident mobility difficulties over a 2-year period, whereas 13.6 per 100 (95% CI 10.5-17.4) older adults had incident mobility difficulties in neighbourhoods in the most deprived 20%.
  
  
  CONCLUSIONS
  older people living in deprived neighbourhoods are significantly more likely to experience incident mobility difficulties than those in less-deprived neighbourhoods. The mechanisms underlying this relationship are unclear and research to identify mechanisms and appropriate interventions is needed.
authors.affiliation: Epidemiology and Public Health Group, Peninsula Medical School, Exeter EX2 5DW, UK. iain.lang@pms.ac.uk
authors.forename: Iain A
authors.initials: IA
authors.lastname: Lang
authors.forename: David J
authors.initials: DJ
authors.lastname: Llewellyn
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Langa
authors.forename: Robert B
authors.initials: RB
authors.lastname: Wallace
authors.forename: David
authors.initials: D
authors.lastname: Melzer
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D004185:Disability Evaluation; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D011446:Prospective Studies; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data; D016138:Walking