title: Fear of moving outdoors and development of outdoor walking difficulty in older people.
abstract: OBJECTIVE
  To study which individual characteristics and environmental factors correlate with fear of moving outdoors and whether fear of moving outdoors predicts development of mobility limitation.
  
  
  METHODS
  Observational prospective cohort study and cross-sectional analyses.
  
  
  METHODS
  Community and research center.
  
  
  METHODS
  Seven hundred twenty-seven community-living people aged 75 to 81 were interviewed at baseline, of whom 314 took part in a 3.5-year follow-up.
  
  
  METHODS
  Fear of moving outdoors and its potential individual and environmental correlates were assessed at baseline. Perceived difficulties in walking 0.5 km and 2 km were assessed twice a year over a 3.5-year period.
  
  
  RESULTS
  At baseline, 65% of the women and 29% of the men reported fear of moving outdoors. Poor socioeconomic status; musculoskeletal diseases; slow walking speed; and the presence of poor street conditions, hills in the nearby environment, and noisy traffic correlated with fear of moving outdoors. At the first 6-month follow-up, participants with fear of moving outdoors had more than four times the adjusted risk (odds ratio (OR)=4.6, 95% confidence interval (CI)=1.92-11.00) of developing difficulties in walking 0.5 km and a three times greater adjusted risk (OR=3.10, 95% CI=1.49-6.46) for developing difficulty in walking 2 km compared with those without fear. The difference in the prevalence of walking difficulties remained statistically significant over the 3.5-year follow-up (P=.02 and P=.009, respectively).
  
  
  CONCLUSIONS
  Fear of moving outdoors is common in older adults and increases the risk of developing self-reported difficulties in walking 0.5 km and 2 km. Knowledge about individual and environmental factors underlying fear of moving outdoors and finding ways to alleviate fear of moving outdoors are important for community planning and prevention of disability.
authors.affiliation: Department of Health Sciences, Finnish Centre for Interdisciplinary Gerontology, University of Jyväskylä, Jyväskylä, Finland. merja.rantakokko@sport.jyu.fi
authors.forename: Merja
authors.initials: M
authors.lastname: Rantakokko
authors.forename: Minna
authors.initials: M
authors.lastname: Mänty
authors.forename: Susanne
authors.initials: S
authors.lastname: Iwarsson
authors.forename: Timo
authors.initials: T
authors.lastname: Törmäkangas
authors.forename: Raija
authors.initials: R
authors.lastname: Leinonen
authors.forename: Eino
authors.initials: E
authors.lastname: Heikkinen
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004777:Environment; D005239:Fear; D005260:Female; D005387:Finland; D015577:Geriatric Assessment; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D051346:Mobility Limitation; D009140:Musculoskeletal Diseases / Q000150:complications; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors