Outdoor Mobility and Use of Adaptive or Maladaptive Walking Modifications among Older People

Abstract

Background. In old age, decline in functioning may cause changes in walking ability. Our aim was to study whether older people who report adaptive, maladaptive or no walking modifications differ in outdoor mobility.

Methods. Community-dwelling people aged 75–90 years (N=848) were interviewed at baseline, of whom 761 participated in the 2-year follow-up. Walking modifications were assessed by asking the participants whether they had modified their way of walking 2 kilometers due to their health. Based on the responses, three categories were formed: no walking modifications (reference), adaptive (e.g., walking more slowly, using an aid) and maladaptive walking modifications (reduced frequency of walking, or having given up walking 2 km). Differences between these categories in life-space mobility, autonomy in participation outdoors and unmet physical activity need were analyzed using Generalized Estimation Equations (GEE) models.

Results. Participants with maladaptive walking modifications (n=238) reported the most restricted life-space mobility (β -9.6, SE 2.5, p<0.001) and autonomy in participation outdoors (β 1.7, SE 0.6, p=0.004) and the highest prevalence of unmet physical activity need (OR 4.3, 95% CI 1.1–16.5) at baseline and showed a decline in these variables over time. Those with no walking modifications (n=285) at baseline exhibited the best values in all outdoor mobility variables and no change over time. Although at baseline those with adaptive walking modifications (n=325) resembled those with no modifications, their outdoor mobility declined over time.

Conclusion. Adopting adaptive modifications may postpone decline in outdoor mobility whereas the use of maladaptive modifications has unfavorable consequences for outdoor mobility.