Environmental Components of Mobility Disability in Community-Living Older Persons


Address correspondence to Anne Shumway-Cook, PhD, Rehabilitation Medicine, University of Washington, Box 356490, Seattle, WA 98195. E-mail: ashumway@u.washington.edu


OBJECTIVES:  To examine the relationship between characteristics of the physical environment and mobility disability in community-living older persons.

DESIGN:   Cross-sectional study conducted on three groups of community-dwelling older adults.

SETTING:   Community-dwelling older people in Seattle, Washington, and Waterloo, Ontario, Canada.

PARTICIPANTS:   Fifty-four older adults (≥70) were recruited from two geographic sites and grouped according to level of physical function (elite, physically able, physically disabled).

MEASUREMENT:   Subjects reported on frequency of encounter versus avoidance of 24 features of the physical environment, grouped into eight dimensions, using a five-point ordinal scale (never, rarely, sometimes, often, always). Never and rarely responses were combined and coded as not encountered or not avoided, whereas the sometimes, often or always responses were combined and coded as encountered or avoided.

RESULTS:   Disabled older adults reported fewer encounters with and concomitantly greater avoidance of physical challenges to mobility than nondisabled older adults. However, both encounter and avoidance varied by environmental dimension.

CONCLUSION:   Results support the hypothesis that mobility disability results from an interaction of individual and environmental factors. Mobility disability is associated with avoidance of some, but not all, physically challenging features within the environment, suggesting that some environmental features may disable community mobility more than others.