Mobility Decline in Old Age

Merja Rantakokko; Minna Mänty; Taina Rantanen

Disclosures

Exerc Sport Sci Rev. 2013;41(1):19-25. 

In This Article

Abstract and Introduction

Abstract

Mobility is important for community independence. With increasing age, underlying pathologies, genetic vulnerabilities, physiological and sensory impairments, and environmental barriers increase the risk for mobility decline. Understanding how mobility declines is paramount to finding ways to promote mobility in old age.

Introduction

The proportion of people older than 80 yr is growing rapidly. To guarantee the sustainability of health and social care systems while enhancing quality of life, it is important to find ways to promote the functional capacity of older people. Mobility is a key issue in maintaining independence in old age. Mobility refers to a person's ability to move himself or herself independently and safely from one place to another. In the present article, we focus on epidemiological studies that have examined walking as an indicator of mobility. Mobility in older people can be assessed either through self-report or through performance-based measures. Performance-based measures rely on a rater's assessment of a subject's performance of a specific mobility task, measured in a controlled environment, and provide information on the upper limit of mobility. Maximal gait speed is an example of a widely used performance-based indicator of mobility. Self-report measures are subject completed, relying on self-perception of mobility. They typically assess the subject's perceived difficulties, restrictions, or need for assistance associated with the activity. An example of a widely used self-report measure of mobility would be a hierarchical series of questions posed to the participants, "Do you have difficulty walking a distance of 1 mile/a quarter of a mile/across a room," with the response options "no difficulty," "some difficulty," "a great deal of difficulty," or "unable without help from another person."

Mobility limitations — referring to performance deficits assessed using an objective mobility test or perceived difficulties in mobility — increase with advancing age and are often the first signs of further functional decline. Mobility limitations hinder the ability to manage tasks of daily life and may lead to the need for help and an increased risk for disability and institutionalization.[6,18] To prevent disability, it is important to identify people who are not yet disabled but who are at risk for disability progression in the near future.[2] For this purpose, knowledge of the progression of the mobility limitation is important.

In the present article, the purpose is to provide a broad view of the progression of mobility decline in older people. We present recent findings from our study center on the individual and environmental factors on the pathway to mobility limitations among older people.

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