M. Hirvensalo et al., Mobility difficulties and physical activity as predictors of mortality andloss of independence in the community-living older population, J AM GER SO, 48(5), 2000, pp. 493-498
Citations number
27
Categorie Soggetti
Public Health & Health Care Science","General & Internal Medicine
OBJECTIVE: In older people, mobility impairments and physical inactivity ar
e risk factors for further disability and death. We studied the interaction
of physical activity and mobility impairment as a predictor of dependence
and mortality.
DESIGN: A population-based, prospective study. The data were collected in s
tructured interviews in the year 1988 and 8 years later in the year 1996 as
part of the Evergreen Project.
PARTICIPANTS: Subjects were 1109 independently living, at baseline 65- to 8
4-year-old people in the city of Jyvaskyla, in central Finland.
METHODS: Participants were ranked into four groups: (1) Intact mobility and
physically active (Mobile-Active), (2) Intact mobility and sedentary (Mobi
le-Sedentary), (3) Impaired mobility and physically active (Impaired-Active
), and (4) Impaired mobility and sedentary (Impaired-Sedentary). The confou
nders adjusted for in the models included age, marital status, education, c
hronic conditions, smoking, and physical exercise earlier in life.
RESULTS: In men and women, the relative risk of death was two times greater
in Impaired-Active and three times greater in Impaired-Sedentary groups th
an the risk of death in Mobile-Active groups. However, the risk of death di
d not differ between Mobile-Active and Mobile-Sedentary groups. The odds ra
tio for dependency (95% confidence interval) in Impaired-Sedentary men was
5.21 (1.44-18.70) and in Impaired-Sedentary women was 2.92 (1.52-5.60) comp
ared to Mobile-Active groups. The risk of dependence did not differ signifi
cantly between Mobile-Active, Mobile-Sedentary, and Impaired-Active groups.
CONCLUSIONS: Mobility impairments predicted mortality and dependence. Howev
er, among people with impaired mobility, physical activity was associated w
ith lower risks, whereas the risk did not differ according to activity leve
l among those with intact mobility. Despite of their overall greater risk,
mobility-impaired people may be able to prevent further disability and mort
ality by physical exercise.