Jm. Guralnik et al., MAINTAINING MOBILITY IN LATE-LIFE .1. DEMOGRAPHIC CHARACTERISTICS ANDCHRONIC CONDITIONS, American journal of epidemiology, 137(8), 1993, pp. 845-857
To assess the role of demographic tactors and chronic conditions in ma
intaining mobility in older persons, this study utilized longitudinal
data collected as part of the Established Populations for Epidemiologi
c 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 Washin
gton counties, Iowa; and New Haven, Connecticut. Results are presented
for those who at baseline reported intact mobility, defined as the ab
ility 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. Ag
e, income, education, and chronic conditions present at baseline and o
ccurring during follow-up were evaluated for their association with lo
ss of mobility. Over the follow-up period, 55.1% of subjects maintaine
d mobility, 36.2% lost mobility, and 8.7% died without evidence of mob
ility loss prior to death. In both men and women, increasing age and l
ower income levels were associated with increased risk of losing mobil
ity, even after controlling for the presence of chronic conditions at
baseline. After adjustment for age, income, and chronic conditions, lo
wer education levels were a significant risk factor for mobility loss
in men, but not in women. Baseline reports of previous heart attack, s
troke, high blood pressure, diabetes, dyspnea, and exertional leg pain
were associated with small but significant risks for mobility loss. T
here was a stepwise increase in the risk of mobility loss according to
the number of chronic conditions present at baseline that was very co
nsistent between men and women. The occurrence during the study of a n
ew 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.