American Journal of Epidemiology Vol. 137, No. 8: 845-857
Copyright © 1993 by The Johns Hopkins University School of Hygiene and Public Health
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Maintaining Mobility in Late Life. I. Demographic Characteristics and Chronic Conditions
1Epidemiology, Demography, and Biometry Program, National Institute on Aging Bethesda, MD
2Center for Health Studies, Group Health Cooperative of Puget Sound, and Department of Epidemiology, University of Washington Seattle WA
3Division of Biostatistics, Department of Medicine, University of Virginia School of Medicine Charlottesville, VA
4Department of Epidemiology, Yale University School of Medicine New Haven, CT
5Channing Laboratory, Department of Medicine, Harvard Medical School, and the East Boston Neighborhood Health Center Boston, MA
6Center for Research on Health and Aging, Rush-Presbyterian-St. Luke's Medical Center Chicago, IL
7Department of Preventive Medicine and Environmental Health, University of Iowa Iowa City, IA
Reprint requests to Dr. Jack M. Guralnik, National Institute on Aging, 7201 Wisconsin Ave., Room 3C-309, Bethesda, MD 20892.
To assess the role of demographic factors and chronic conditions in maintaining mobility in older persons, this study utilized longitudinal data collected as part of the Established Populations for Epidemiologic Studies of the Elderly between 1981 and 1987 on 6,981 men and women aged 65 years and older in East Boston, Massachusetts; Iowa and Washington counties, Iowa; and New Haven, Connecticut. Results are presented for those who at baseline reported intact mobility, defined as the ability to climb stairs and walk a half mile without help, and who were followed annually for up to 4 years for changes in mobility status. Age, income, education, and chronic conditions present at baseline and occurring during follow-up were evaluated for their association with loss of mobility. Over the follow-up period, 55.1% of subjects maintained mobility, 36.2% lost mobility, and 8.7% died without evidence of mobility loss prior to death. In both men and women, increasing age and lower income levels were associated with increased risk of losing mobility, even after controlling for the presence of chronic conditions at baseline. After adjustment for age, income, and chronic conditions, lower education levels were a significant risk factor for mobility loss in men, but not in women. Baseline reports of previous heart attack, stroke, high blood pressure, diabetes, dyspnea, and exertional leg pain were associated with small but significant risks for mobility loss. There was a stepwise increase in the risk of mobility loss according to the number of chronic conditions present at baseline that was very consistent between men and women. The occurrence during the study of a new heart attack, stroke, cancer, or hip fracture was associated with a substantially greater risk of mobility loss than was associated with the presence of these conditions at baseline.
activities of daily living; aged; chronic disease; demography; education; income; prospective studies
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