Who walks? Factors associated with walking behavior in disabled older women with and without self-reported walking difficulty

OBJECTIVES: To determine how severity of walking difficulty and sociodemogr aphic, psychosocial, and health-related factors influence walking behavior in disabled older women. DESIGN: Cross-sectional analyses of baseline data from the Women's Health a nd Aging Study (WHAS). SETTING: hn urban community encompassing 12 contiguous zip code areas in th e eastern portion of Baltimore City and part of Baltimore County, il Maryla nd. PARTICIPANTS: A total of 920 moderately to severely disabled community-resi dent women, aged 65 years and older, identified from an age-stratified rand om sample of Medicare beneficiaries. MEASUREMENTS: Walking behavior was defined as minutes walked for exercise a nd total blocks walked per week. Independent variables included self-report ed walking difficulty, sociodemographic factors, psychological status (depr ession, mastery, anxiety, and cognition), and health-related factors (falls and fear of falling, fatigue, vision and balance problems, weight, smoking , and cane use). RESULTS: Walking at least 8 blocks per week was strongly negatively related to severity of walking difficulty. Independent of difficulty level, older age, black race, fatigue, obesity, and cane use were also negatively associ ated with walking; living alone and high mastery had a positive association with walking. CONCLUSIONS: Even among functionally limited women, sociocultural, psycholo gical, and health-related factors were independently associated with walkin g behavior. Thus, programs aimed at improving walking ability need to addre ss these factors in addition to walking difficulties to maximize participat ion and compliance.