Mobility Modification Alleviates Environmental Influence on Incident Mobility Difficulty among Community-Dwelling Older People: A Two-Year Follow-Up Study.
Environmental barriers increase risk for mobility difficulties in old age. Mobility difficulty is preceded by a phase where people try to postpone a difficulty through mobility modification. We studied whether perceived environmental mobility barriers outdoors correlate with mobility modification and mobility difficulty, predict development of mobility difficulty over a two-year follow-up, and whether mobility modification alleviates the risk for difficulty.



At baseline, 848 people aged 75-90 were interviewed face-to-face. Telephone follow-up interviews were conducted one (n = 816) and two years (n = 761) later. Environmental barriers to mobility were self-reported using a15-item structured questionnaire at baseline, summed and divided into tertiles (0, 1 and 2 or more barriers). Mobility difficulty was assessed as self-reported ability to walk 2 km at all assessment points and categorized into 'no difficulty', 'no difficulty but mobility modifications' (reducing frequency, stopping walking, using an aid, slowing down or resting during the performance) and 'difficulty'.



At baseline, 212 participants reported mobility modifications and 356 mobility difficulties. Those reporting one or multiple environmental barriers had twice the odds for mobility modifications and up to five times the odds for mobility difficulty compared to those reporting no environmental barriers. After multiple adjustments for health and functioning, reporting multiple environmental barriers outdoors continued to predict the development of incident mobility difficulty over the two-year follow-up. Mobility modifications attenuated the association.



For older people who successfully modify their performance, environmental influence on incident mobility difficulty can be diminished. Older people use mobility modification to alleviate environmental press on mobility.
Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland.
Merja
0000-0003-3546-1600
M
Rantakokko
Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland.
Erja
E
Portegijs
Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland.
Anne
A
Viljanen
Department of Health Sciences, Lund University, Lund, Sweden.
Susanne
S
Iwarsson
Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland.
Taina
T
Rantanen
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057187:Independent Living; D008297:Male; D051346:Mobility Limitation; D057566:Self Report; D011795:Surveys and Questionnaires; D016138:Walking / Q000502:physiology*