What do older people understand by mobility-related difficulties?

Area of Science:

• Gerontology and Rehabilitation Sciences
• Disability Studies and Human Functioning

Background:

• The concept of difficulty is central to disability research, yet rarely explored from the perspective of individuals with functional limitations.
• Understanding subjective experiences of difficulty is crucial for accurate assessment of functional limitations in older adults.

Purpose of the Study:

• To describe older adults' understanding of difficulty in mobility activities.
• To examine differences in perceived difficulty across various mobility activities, categorized by the International Classification of Functioning (ICF) mobility domains.

Main Methods:

• Qualitative study involving 17 community-dwelling older adults (70+ years).
• Interviews using a 55-item questionnaire based on ICF mobility domains, with participants thinking aloud.
• Inductive content analysis to identify themes, subthemes, and categories of perceived difficulty.

Main Results:

• Two primary themes emerged: causes of difficulty (pathologies, impairments, symptoms) and accommodations (task modifications, use of aids).
• The significance of these themes varied across different types of mobility activities.
• All participants reported no difficulty in at least one task, often due to employing modifications or aids.

Conclusions:

• Older adults' perspectives align with theoretical disability models and current functional limitation assessment practices.
• Existing measures of functional limitations need refinement to capture 'no difficulty' perceptions when task modifications are utilized.
• Improved measurement tools are essential for a comprehensive understanding of disability and functional status in aging populations.