Lower extremity physical performance, self-reported mobility difficulty, and use of compensatory strategies for mobility by elderly women

Ganesh SP, Fried LP, Taylor DH Jr, Pieper CF, Hoenig HM. Lower extremity physical performance, self-reported mobility difficulty, and use of compensatory strategies for mobility by elderly women.

Objective

To describe the relationship between lower extremity physical performance, self-reported mobility difficulty, and self-reported use of compensatory strategies (CSs) for mobility inside the home.

Design

Cross-sectional exploratory study.

Setting

Community-dwelling elders.

Participants

Disabled, cognitively intact women 65 years or older (N=1002), from the Women's Health and Aging Study I.

Interventions

Not applicable.

Main Outcome Measures

CS scale: no CS, behavioral modifications (BMs) only, durable medical equipment (DME) with or without use of BMs, and any use of human help (HH); and 3 dichotomous CS measures: any CS (vs none); DME+HH (vs BMs only, among users of any CS); any HH (vs DME only, among users of any DME/HH).

Results

Self-reported mobility difficulty and physical performance were significantly correlated with one another (r=−.57, P<.0001) and with the CS scale ([r=.51, P<.001] and [r=−.54, P<.0001], respectively). Sequential logistic regressions showed self-reported difficulty and physical performance were significant independent predictors of each category of CS. For the any CS and DME+HH models, the odds ratio for self-reported difficulty decreased by approximately 50% when physical performance was included in the model, compared with difficulty alone ([18.0 to 8.6] and [7.3 to 3.8], respectively), but both physical performance and difficulty remained significant predictors (P<.0001). The effects of covariates differed for the various CS categories, with some covariates having independent relationships to CS, and others appearing to have moderating or mediating effects on the relationship of self-reported difficulty or physical performance to CS.

Conclusions

Physical performance, self-reported difficulty, health conditions, and contextual factors have complex effects on the way elders carry out mobility inside the home.