Exploring the hierarchy of mobility performance in high-functioning older women

Area of Science:

• Gerontology
• Mobility research
• Disability prevention

Background:

• Preventing mobility disability requires tailored interventions based on individual needs.
• Mobility performance assessment is key to identifying individuals at risk.
• Understanding the relationship between performance and limitation is crucial for effective targeting.

Purpose of the Study:

• To determine if mobility performance is hierarchically associated with and predicts mobility disability.
• To test the hypothesis that poorer performance on more demanding tasks is more strongly linked to mobility limitation than performance on less demanding tasks.
• To improve the targeting of preventive interventions for mobility disability.

Main Methods:

• Utilized data from the Women's Health and Aging Study II (n=436) at baseline and 36-month follow-up.
• Employed logistic and multinomial regression models to analyze associations.
• Adjusted for known risk factors for disability in the analysis.

Main Results:

• 76.6% of prevalent and 88.4% of new-onset self-reported mobility limitation fit a hierarchical pattern.
• The association between lower extremity performance decrement and reported limitation strengthened with increased task demand.
• Odds ratios for walking limitation increased with task difficulty, e.g., climbing (OR=1.22) vs. walking (OR=1.05).

Conclusions:

• Mobility performance shows a hierarchical pattern in relation to mobility disability.
• More demanding tests, like climbing, are more sensitive to mild mobility disability than walking speed.
• Assessing performance on challenging tasks can enhance the targeting of preventive strategies in high-functioning populations.