Mobility Difficulties Are Not Only a Problem of Old Age

Authors

  • Lisa I. Iezzoni MD, MSc,

    Corresponding author
    1. Received from the Division of General Medicine and Primary Care, Departments of Medicine (LII, EPM, RBD), and
    2. Harvard Medical School, Beth Israel Deaconess Medical Center, Charles A. Dana Research Institute, and
    3. Harvard-Thorndike Laboratory (LII, EPM, RBD), Boston, Mass.
      Address correspondence to Dr. Iezzoni: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center East Campus LY-326, 330 Brookline Ave., Boston, MA 02215 (e-mail: liezzoni@caregroup.harvard.edu).
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  • Ellen P. McCarthy PhD,

    1. Received from the Division of General Medicine and Primary Care, Departments of Medicine (LII, EPM, RBD), and
    2. Harvard Medical School, Beth Israel Deaconess Medical Center, Charles A. Dana Research Institute, and
    3. Harvard-Thorndike Laboratory (LII, EPM, RBD), Boston, Mass.
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  • Roger B. Davis ScD,

    1. Received from the Division of General Medicine and Primary Care, Departments of Medicine (LII, EPM, RBD), and
    2. Harvard Medical School, Beth Israel Deaconess Medical Center, Charles A. Dana Research Institute, and
    3. Harvard-Thorndike Laboratory (LII, EPM, RBD), Boston, Mass.
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  • Hilary Siebens MD

    1. Physical Medicine and Rehabilitation (HS),
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Address correspondence to Dr. Iezzoni: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center East Campus LY-326, 330 Brookline Ave., Boston, MA 02215 (e-mail: liezzoni@caregroup.harvard.edu).

Abstract

BACKGROUND: Lower extremity mobility difficulties often result from common medical conditions and can disrupt both physical and emotional well-being.

OBJECTIVES: To assess the national prevalence of mobility difficulties among noninstitutionalized adults and to examine associations with demographic characteristics and other physical and mental health problems.

DESIGN: Cross-sectional survey using the 1994–1995 National Health Interview Survey-Disability Supplement (NHIS-D). We constructed measures of minor, moderate, and major lower extremity mobility difficulties using questions about ability to walk, climb stairs, and stand, and use of mobility aids (e.g., canes, wheelchairs). Age and gender adjustment used direct standardization methods in Software for the Statistical Analysis of Correlated Data (SUDAAN).

PARTICIPANTS: Noninstitutionalized, civilian U.S. residents aged 18 years and older. National Health Interview Survey sampling weights with SUDAAN provided nationally representative population estimates.

RESULTS: An estimated 19 million people (10.1%) reported some mobility difficulty. The mean age of those with minor, moderate, or major difficulty ranged from 59 to 67 years. Of those reporting major difficulties, 32% said their problems began at aged 50 years or younger. Adjusted problem rates were higher among women (11.8%) than men (8.8%), and higher among African American (15.0%) than whites (10.0%). Persons with mobility difficulties were more likely to be poorly educated, living alone, impoverished, obese, and having problems conducting daily activities. Among persons with major mobility difficulties, 30.6% reported being frequently depressed or anxious, compared to 3.8% for persons without mobility difficulties.

CONCLUSIONS: Reports of mobility difficulties are common, including among middle-aged adults. Associations with poor performance of daily activities, depression, anxiety, and poverty highlight the need for comprehensive care for persons with mobility problems.

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