Exploring the hierarchy of mobility performance in high-functioning older women.

Full Abstract

BACKGROUND:
Preventing mobility disability depends on matching interventions to individual needs. The purpose of this study is to improve targeting by determining whether mobility performance is associated with, and predicts, mobility disability hierarchically. The hypothesis is that poorer performance tested by more demanding tasks is more strongly associated with current and future mobility "limitation" (self-reported task modification or difficulty) than is that tested by less demanding tasks, in a graded manner.

METHODS:
Data come from the Women's Health and Aging Study II (n = 436) at baseline and at 36-month follow-up. Logistic and multinomial regression models examined associations between performance on mobility tests and reported limitation in walking one-half mile, adjusting for risk factors for disability.

RESULTS:
We found that 76.6% of prevalent and 88.4% of new-onset self-reported limitation fit within the hypothesized hierarchical pattern. The estimated strength of association between a decrement in lower extremity performance and reported limitation increased with task demand for the primary outcome, reported limitation in walking one-half mile. For example, the odds ratios for prevalent report of walking limitation, versus no limitation, for 10% lower performance walking, dressing, repeating chair stands, and climbing, respectively, were 1.05 (95% confidence interval, 0.97-1.17), 1.08 (1.00-1.16), 1.15 (1.06-1.25), and 1.22 (1.12-1.33).

CONCLUSIONS:
This study partially supports the hypothesis that mobility performance tends to follow a hierarchical pattern. For studying mild mobility disability, walking speed may not be as useful as more demanding tests. Identifying declines in performance through more demanding tests such as climbing should improve the ability to target preventive interventions to individuals at risk of mild mobility decline within a high-functioning population.

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Author information

Author/s: Weiss, Carlos O (CO); Fried, Linda P (LP); Bandeen-Roche, Karen (K);

Affiliation: Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA. cweiss9(-atsign-)jhmi.edu

Grants: AG11703-05 (Agency:NIA NIH HHS) ; M01-RR00052 (Agency:NCRR NIH HHS) ; T32AG00247 (Agency:NIA NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural

Journal: The journals of gerontology. Series A, Biological sciences and medical sciences (J Gerontol A Biol Sci Med Sci), published in United States. (Language: eng)

Reference: 2007-Feb; vol 62 (issue 2) : pp 167-73

Dates: Created 2007/03/06; Completed 2007/05/23; Revised 2007/12/03;

PMID: 17339641, status: MEDLINE (last retrieval date: 12/26/2008)

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