Task Modifications in Walking Postpone Decline in Life-Space Mobility Among Community-Dwelling Older People: A 2-year Follow-up Study.
BACKGROUND
Task modification refers to performing a task differently than before. While task modification in walking may be a sign of looming walking difficulty, it may also be adaptive in and postpone the decline in life-space mobility. However, this has not been studied. This study examined whether changes in life-space mobility over a 2-year period differ between people who at baseline report no walking difficulty and no task modification, those who report no walking difficulty but task modification, and those who report walking difficulty.


METHODS
Community-dwelling people aged 75-90 years were interviewed face-to-face at baseline (N = 848), and over phone one (n = 816) and two (n = 761) years later. Life-space mobility was assessed annually with the Life-Space Assessment (range 0-120, higher scores indicate better life-space mobility). Self-reported ability to walk 2 km was assessed at baseline and categorized into "no difficulty," "no difficulty but task modifications" (reduced frequency, given up walking, walking slower or resting during walking) and "difficulty." The analyses were adjusted for age, gender, number of chronic conditions, cognitive impairment, lower extremity performance and education.


RESULTS
The life-space mobility score was highest and remained stable over 2-years among those with no walking difficulties at baseline and lowest and showing a steady decline among those with walking difficulties. Those with task modifications formed the middle group. They showed no marked changes in life-space mobility during the first year, but significant decline during the second year.


CONCLUSIONS
Task modifications in walking may help community-dwelling older people to postpone life-space mobility decline.
Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Finland.
Merja
M
Rantakokko
Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Finland.
Erja
E
Portegijs
Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Finland.
Anne
A
Viljanen
Department of Health Sciences, Lund University, Sweden.
Susanne
S
Iwarsson
Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Finland.
Taina
T
Rantanen
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005387:Finland; D015577:Geriatric Assessment; D006801:Humans; D057187:Independent Living; D008297:Male; D051346:Mobility Limitation; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D016138:Walking / Q000502:physiology*
Adaptation; Aging; Disability; Mobility; Participation