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Taina Rantanen - One of the best experts on this subject based on the ideXlab platform.
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physical activity scaled to preferred Walking speed as a predictor of Walking Difficulty in older adults a 2 year follow up
Journals of Gerontology Series A-biological Sciences and Medical Sciences, 2021Co-Authors: Laura Karavirta, Erja Portegijs, Johanna Eronen, Heidi Leppa, Timo Rantalainen, Taina RantanenAbstract:BACKGROUND The usual accelerometry-based measures of physical activity (PA) are dependent on physical performance. We investigated the associations between PA relative to Walking performance and the prevalence and incidence of early and advanced Walking difficulties compared to generally used measures of PA. METHODS Perceived Walking Difficulty was evaluated in 994 community-dwelling participants at baseline (age 75, 80 or 85 years) and two years later over two kilometers (early Difficulty) and 500 meters (advanced Difficulty). We used a thigh-mounted accelerometer to assess moderate-to-vigorous PA, daily mean acceleration and relative PA as movement beyond the intensity of preferred Walking speed in a 6-minute Walking test (PArel). Self-reported PA was assessed using questionnaires. RESULTS The prevalence and incidence were 36.2 % and 18.9 % for early, and 22.4 % and 14.9 % for advanced Walking Difficulty, respectively. PArel was lower in participants with prevalent (mean 42 (SD 45) vs. 69 (91) mins/week, p<0.001) but not incident early Walking Difficulty (53 (75) vs. 72 (96) mins/week, p=0.15) compared to those without Difficulty. The associations between absolute measures of PA and incident Walking Difficulty were attenuated when adjusted for preferred Walking speed. CONCLUSIONS The variation in habitual PA may not explain the differences in the development of new Walking Difficulty. Differences in physical performance explain a meaningful part of the association of PA with incident Walking Difficulty. Scaling of accelerometry to preferred Walking speed demonstrated independence on physical performance and warrants future study as a promising indicator of PA in observational studies among older adults.
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use of Walking modifications perceived Walking Difficulty and changes in outdoor mobility among community dwelling older people during covid 19 restrictions
Aging Clinical and Experimental Research, 2021Co-Authors: Heidi Leppa, Erja Portegijs, Merja Rantakokko, Laura Karavirta, Timo Rantalainen, Sini Siltanen, Taina RantanenAbstract:Outdoor mobility enables participation in essential out-of-home activities in old age. To compare changes in different aspects of outdoor mobility during COVID-19 restrictions versus two years before according to self-reported Walking. Community-dwelling participants of AGNES study (2017–2018, initial age 75–85) responded to AGNES-COVID-19 postal survey in spring 2020 (N = 809). Life-space mobility, autonomy in participation outdoors, and self-reported physical activity were assessed at both time points and differences according to self-reported Walking modifications and Difficulty vs. intact Walking at baseline were analyzed. Life-space mobility and autonomy in participation outdoors had declined (mean changes -11.4, SD 21.3; and 6.7, SD 5.3, respectively), whereas physical activity had increased (5.5 min/day, SD 25.1) at follow-up. Participants perceiving Walking Difficulty reported the poorest baseline outdoor mobility, a steeper decline in life-space mobility (p = 0.001), a smaller increase in physical activity (p < 0.001), and a smaller decline in autonomy in participation outdoors (p = 0.017) than those with intact Walking. Those with Walking modifications also reported lower baseline life-space mobility and physical activity, a steeper decline in life-space mobility and a smaller increase in physical activity those with intact Walking (p < 0.001 for both). Participants reporting Walking modifications remained the intermediate group in outdoor mobility over time, whereas those with Walking Difficulty showed the steepest decline in outdoor mobility and hence potential risk for accelerated further functional decline. Interventions should target older people perceiving Walking Difficulty, as they may be at the risk for becoming homebound when environmental facilitators for outdoor mobility are removed.
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self reported hearing is associated with time spent out of home and withdrawal from leisure activities in older community dwelling adults
Aging Clinical and Experimental Research, 2016Co-Authors: Tuija M Mikkola, Hannele Polku, Erja Portegijs, Merja Rantakokko, Litang Tsai, Taina Rantanen, Anne ViljanenAbstract:Hearing difficulties are prevalent among older people and can lead to difficulties in social interaction. These difficulties may increase the tendency to remain at home and withdraw from leisure activities. To investigate whether self-reported hearing problems are associated with time spent out-of-home and withdrawal from a leisure activity among older persons. Cross-sectional and longitudinal data on 75- to 90-year-old community-dwelling men and women (n = 767) was used. Self-reports of hearing, diseases, and Difficulty Walking 2 km were obtained via home interviews at baseline, and withdrawal from a leisure activity via 1- and 2-year follow-up telephone interviews. Time spent out-of-home was obtained from a subsample (n = 532) via seven-day diaries at baseline. Hearing problems were associated with time spent out-of-home (p = 0.025) and withdrawal from a leisure activity (p = 0.025) among persons reporting no Walking Difficulty, but not among those reporting Walking Difficulty (p = 0.269 and 0.396, respectively). Among the former, persons with major hearing problems spent significantly less time out-of-home (estimated marginal mean 161 min, 95 % CI 122–212) than those with good hearing (242, 95 % CI 218–270). Persons with major hearing problems also had 3.0 times higher odds (95 % CI 1.3–7.1) for withdrawal from a leisure activity than persons with good hearing during the two-year follow-up. Among older adults without Walking Difficulty, hearing problems may reduce time spent out-of-home and increase the likelihood for withdrawal from a leisure activity. Decreased leisure and out-of-home activity may have negative effects on older persons’ social, mental and physical functioning.
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environmental facilitators for outdoor Walking and development of Walking Difficulty in community dwelling older adults
European Journal of Ageing, 2014Co-Authors: Johanna Eronen, Merja Rantakokko, Mikaela B Von Bonsdorff, Taina RantanenAbstract:Older adults who report environmental barriers in their neighborhood have a higher risk for Walking Difficulty. However, environmental facilitators that protect against Walking Difficulty are not well known. The objective of this study was to identify the effect of environmental facilitators for outdoor Walking on development of Walking Difficulty in community-dwelling older people. This was a prospective study with a 3.5-year follow-up time on 261 community-dwelling people aged 75–81 years, who at baseline were able to walk 0.5 km without Difficulty. Environmental facilitators for outdoor Walking were self-reported with standardized questionnaires, including having features in one’s home which make it easy to access the outdoors, having a park or other green area within a Walking distance from home, having outdoor recreational facilities within a Walking distance from home, having features in the nearby environment, which are attractive for outdoor activities, and perceiving the surrounding environment or facilities nearby as motivating factors for physical activity. Self-reported Difficulty in Walking 0.5 km was assessed every 6 months. Of the participants, 46 % developed Walking Difficulty during the follow-up. Having a park or other green area within a Walking distance from home was the most frequently reported facilitator. Environmental facilitators decreased the risk for development of Walking Difficulty, hazard ratio per item 0.86, (95 % confidence interval 0.73–1.02). The results indicate that the mobility of older community-dwelling people may be promoted with outdoor recreational facilities that are easy to access and located within a Walking distance from home.
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fear of falling and coexisting sensory difficulties as predictors of mobility decline in older women
Journals of Gerontology Series A-biological Sciences and Medical Sciences, 2012Co-Authors: Anne Viljanen, Merja Rantakokko, Jenni Kulmala, Markku Koskenvuo, Jaakko Kaprio, Taina RantanenAbstract:BACKGROUND: Mobility decline, the coexistence of several sensory difficulties and fear of falling (FOF) are all common concerns in older people; however, knowledge about the combined effect of FOF and coexisting sensory difficulties on mobility is lacking. METHODS: Data on self-reported FOF, difficulties in hearing, vision, balance, and Walking 2 km were gathered with a structured questionnaire among 434 women aged 63-76 years at baseline and after a 3-year follow-up. Logistic regression models were used for analyses. RESULTS: Every third participant reported difficulties in Walking 2 km at baseline. In cross-sectional analysis, the odds ratio for difficulties in Walking 2 km was higher among persons who reported FOF compared with persons without FOF and the odds increased with the increasing number of sensory difficulties. Persons who reported FOF and who had three sensory difficulties had almost fivefold odds (odds ratio = 4.7, 95% confidence interval = 1.9-11.7) for Walking difficulties compared with those who reported no FOF and no sensory difficulties. Among the 290 women without Walking difficulties at baseline, 54 participants developed Difficulty in Walking 2 km during the 3-year follow-up. Odds ratio for incident Walking Difficulty was 3.5 (95% confidence interval = 1.6-7.8) in participants with FOF and with 2-3 sensory difficulties compared with persons without FOF and with at most one sensory Difficulty at baseline. CONCLUSIONS: Older women who have several coexisting sensory difficulties combined with FOF are particularly vulnerable to mobility decline. Avoidance of Walking as a result of FOF is likely to be reinforced when multiple sensory difficulties hinder reception of accurate information about the environment, resulting in accelerated decline in Walking ability. Language: en
Linda P Fried - One of the best experts on this subject based on the ideXlab platform.
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just get out the door importance of Walking outside the home for maintaining mobility findings from the women s health and aging study
Journal of the American Geriatrics Society, 2005Co-Authors: Eleanor M Simonsick, Jack M. Guralnik, Jennifer L Balfour, Stefano Volpato, Linda P FriedAbstract:Objectives: To determine the association between volitional Walking behavior and change in Walking ability and lower extremity function over 1 year in functionally limited older women. Design: Longitudinal cohort study. Setting: Data were collected in participant's homes in Baltimore, Maryland. Participants: One thousand two cognitively intact community-resident female Medicare beneficiaries aged 65 and older enrolled in the Women's Health and Aging Study. Measurements: Reported Walking behavior and change in reported Walking Difficulty, usual and rapid gait speed, and lower extremity physical performance score over 1 year. Results: Of 800 functionally limited women who could walk unassisted at baseline and were alive and contacted 1 year later, 226 (28%) walked regularly, at least eight blocks per week. These women exhibited better health and functioning than nonwalkers (e.g., lower prevalence of depressive and fatigue symptoms and cardiovascular disease and higher mean ankle-arm index, forced expiratory volume in the first second, and gait speed). One year later, independent of initial functional status, social-psychological and behavioral factors, and health conditions, walkers were 1.8 times (95% confidence interval=1.2–2.7; P=.002) more likely to maintain reported Walking ability and showed less decline in customary Walking speed (0.009 m/s vs −0.070 m/s; P=.001) and functional performance score (−0.17 vs −0.73; P=.01) than women who walked less than eight blocks. Conclusion: The strength, consistency, and specificity of the association between Walking behavior and maintenance of mobility provide strong evidence that even a small amount of regular Walking can confer short-term protection from further mobility loss in functionally limited women. The observation that most women capable of Walking at least eight blocks per week were not doing so indicates the need to get more women “out the door” and to encourage those who walk a little to walk a little more.
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Walking Difficulty Walking speed and age as predictors of self rated health the women s health and aging study
Journals of Gerontology Series A-biological Sciences and Medical Sciences, 2001Co-Authors: Marja Jylha, Jack M. Guralnik, Jennifer L Balfour, Linda P FriedAbstract:Background. Older persons reporting disability are more likely to report poor self-rated health, but little work has been done to assess the independent relationships of reported Walking Difficulty and measured Walking performance with self-rated health. This study examines the associations of Walking Difficulty, Walking speed, and age with self-rated health in older women. Methods. The data are from the baseline of the Women’s Health and Aging Study. Difficulty Walking one quarter mile was used as a measure of mobility in the representative population aged 65 and older screened for the study ( n � 3841) and in the one third most disabled study group ( n � 1002). Maximal Walking speed was measured in the study sample. Results. Increasing severity of Walking Difficulty (in the screened population and in the disabled study group), slower Walking speed (in the study group), and younger age were all associated with fair or poor self-rated health, after simultaneous adjustment for these and other objective measures of physical performance and health. The associations of both measures of Walking with self-rated health weakened with age.
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who walks factors associated with Walking behavior in disabled older women with and without self reported Walking Difficulty
Journal of the American Geriatrics Society, 1999Co-Authors: Eleanor Marie Simonsick, Jack M. Guralnik, Linda P FriedAbstract:OBJECTIVES: To determine how severity of Walking Difficulty and sociodemographic, psychosocial, and health-related factors influence Walking behavior in disabled older women. DESIGN: Cross-sectional analyses of baseline data from the Women's Health and Aging Study (WHAS). SETTING: An urban community encompassing 12 contiguous zip code areas in the eastern portion of Baltimore City and part of Baltimore County, Maryland. PARTICIPANTS: A total of 920 moderately to severely disabled community-resident women, aged 65 years and older, identified from an age-stratified random sample of Medicare beneficiaries. MEASUREMENTS: Walking behavior was defined as minutes walked for exercise and total blocks walked per week. Independent variables included self-reported Walking Difficulty, sociodemographic factors, psychological status (depression, mastery, anxiety, and cognition), and health-related factors (falls and fear of falling, fatigue, vision and balance problems, weight, smoking, and cane use). RESULTS: Walking at least 8 blocks per week was strongly negatively related to severity of Walking Difficulty. Independent of Difficulty level, older age, black race, fatigue, obesity, and cane use were also negatively associated with Walking; living alone and high mastery had a positive association with Walking. CONCLUSIONS: Even among functionally limited women, sociocultural, psychological, and health-related factors were independently associated with Walking behavior. Thus, programs aimed at improving Walking ability need to address these factors in addition to Walking difficulties to maximize participation and compliance. J Am Geriatr Soc 47:672–680, 1999.
Eleanor M Simonsick - One of the best experts on this subject based on the ideXlab platform.
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derivation of a measure of physiological multisystem dysregulation results from whas and health abc
Mechanisms of Ageing and Development, 2020Co-Authors: Alden L Gross, Michelle C Carlson, Nadia M Chu, Mara A Mcadamsdemarco, Dan M Mungas, Eleanor M Simonsick, Ravi Varadhan, Qian Li Xue, Jeremy D Walston, Karen BandeenrocheAbstract:Abstract Introduction Multifactorial biological processes underpin dysregulation over several individual physiological systems. However, it is challenging to characterize and model this multisystemic dysregulation and its relationship with individual physiologic systems. We operationalized a theory-driven measure of multisystem dysregulation and empirically tested for measurement differences by key characteristics. Methods We used the Women's Health and Aging Studies (WHAS) I and II (N = 649), and the Health ABC study (N = 1515). Twelve biomarkers representing multiple systems including stress response (e.g., inflammation), endocrine system, and energy regulation were identified. A series of confirmatory factor analyses (CFA) were conducted to evaluate the interplay between physiological systems and underlying multisystem dysregulation. We evaluated convergent criterion validity of a score for multisystem dysregulation against the physical frailty phenotype, and predictive criterion validity with incidence of Walking Difficulty and mortality. Results A bifactor CFA, a model in which dysregulation of individual systems proceeds independently of generalized dysregulation, fit data well in WHAS (RMSEA: 0.019; CFI: 0.977; TLI: 0.961) and Health ABC (RMSEA: 0.047; CFI: 0.874; TLI: 0.787). The general dysregulation factor was associated with frailty (OR: 2.2, 95 % CI: 1.4, 3.5), and elevated risk of incident Walking Difficulty and mortality. Findings were replicated in Health ABC. Discussion Biomarker data from two epidemiologic studies support the construct of multisystem physiological dysregulation. Results further suggest system-specific and system-wide processes have unique and non-overlapping contributions to dysregulation in biological markers.
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mobility limitation in self described well functioning older adults importance of endurance walk testing
Journals of Gerontology Series A-biological Sciences and Medical Sciences, 2008Co-Authors: Eleanor M Simonsick, Anne B Newman, Marjolein Visser, Bret H Goodpaster, Stephen B Kritchevsky, Susan M Rubin, Michael C Nevitt, Tamara B HarrisAbstract:BACKGROUND: Mobility limitations are prevalent, potentially reversible precursors to mobility loss that may go undetected in older adults. This study evaluates standardized administration of an endurance walk test for identifying unrecognized and impending mobility limitation in community elders. METHODS: Men and women (1480 and 1576, respectively) aged 70-79 years with no reported mobility limitation participating in the Health, Aging and Body Composition study were administered the Long Distance Corridor Walk. Walk performance was examined to determine unrecognized mobility deficits at baseline and predict new self-recognition of mobility limitation within 2 years. RESULTS: On testing, 23% and 36% of men and women evidenced mobility deficits defined as a contraindication to exertion, meeting stopping criteria or exceeding 7 minutes to walk 400 m. Unrecognized deficits increased with age and were more prevalent in blacks, smokers, obese individuals, and infrequent walkers. Within 2 years, 21% and 34% of men and women developed newly recognized mobility limitation; those with baseline unrecognized deficits had higher rates, 40% and 54% (p <.001), respectively. For each additional 30 seconds over 5 minutes needed to walk 400 m, likelihood of newly recognized mobility limitation increased by 65% and 37% in men and women independent of age, race, obesity, smoking status, habitual Walking, reported Walking ease, and usual gait speed. CONCLUSIONS: A sizable proportion of elders who report no Walking Difficulty have observable deficits in Walking performance that precede and predict their recognition of mobility limitation. Endurance walk testing can help identify these deficits and provide the basis for treatment to delay progression of mobility loss.
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just get out the door importance of Walking outside the home for maintaining mobility findings from the women s health and aging study
Journal of the American Geriatrics Society, 2005Co-Authors: Eleanor M Simonsick, Jack M. Guralnik, Jennifer L Balfour, Stefano Volpato, Linda P FriedAbstract:Objectives: To determine the association between volitional Walking behavior and change in Walking ability and lower extremity function over 1 year in functionally limited older women. Design: Longitudinal cohort study. Setting: Data were collected in participant's homes in Baltimore, Maryland. Participants: One thousand two cognitively intact community-resident female Medicare beneficiaries aged 65 and older enrolled in the Women's Health and Aging Study. Measurements: Reported Walking behavior and change in reported Walking Difficulty, usual and rapid gait speed, and lower extremity physical performance score over 1 year. Results: Of 800 functionally limited women who could walk unassisted at baseline and were alive and contacted 1 year later, 226 (28%) walked regularly, at least eight blocks per week. These women exhibited better health and functioning than nonwalkers (e.g., lower prevalence of depressive and fatigue symptoms and cardiovascular disease and higher mean ankle-arm index, forced expiratory volume in the first second, and gait speed). One year later, independent of initial functional status, social-psychological and behavioral factors, and health conditions, walkers were 1.8 times (95% confidence interval=1.2–2.7; P=.002) more likely to maintain reported Walking ability and showed less decline in customary Walking speed (0.009 m/s vs −0.070 m/s; P=.001) and functional performance score (−0.17 vs −0.73; P=.01) than women who walked less than eight blocks. Conclusion: The strength, consistency, and specificity of the association between Walking behavior and maintenance of mobility provide strong evidence that even a small amount of regular Walking can confer short-term protection from further mobility loss in functionally limited women. The observation that most women capable of Walking at least eight blocks per week were not doing so indicates the need to get more women “out the door” and to encourage those who walk a little to walk a little more.
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assessment of physical function and exercise tolerance in older adults reproducibility and comparability of five measures
Aging Clinical and Experimental Research, 2000Co-Authors: Eleanor M Simonsick, A W Gardner, Eric T PoehlmanAbstract:This study examined the reproducibility and comparability of five measures of function and exercise tolerance. The test battery and questionnaire on function and physical activity were administered twice, 7-10 days apart to 38 men and 12 women aged 54-80 years at the Baltimore Veterans Affairs Medical Center. Tests included fast pace 4 and 20-meter walks, 6-minute and graded treadmill walks, and a seated step test. All tests demonstrated good reproducibility with Pearson and intraclass correlation coefficients ranging from 0.84 to 0.98, and percent differences on retest ranging from 4 to 11%. Although correlations between different tests were all significant (range 0.34-0.89), comparison of performance ranks and linear regression analyses indicated that the short fast walks and seated step test may not be suitable substitutes for treadmill or long self-paced corridor walks. Only 28% had the same quintile performance ranking on the step test as on the treadmill walk, and 36% had rankings 2 or more points apart. The fast 20m walk shows the most promise as a low-level alternative to the 6-minute walk; performances had a correlation of 0.73, 82% of ranks were within one point, and 20m speed explained 42% of the variance in distance covered. More development is needed for comprehensive assessment of exercise tolerance in older adults; the 6-minute walk did not adequately discriminate fitness level in persons who walk regularly, and the treadmill posed problems for those with Walking Difficulty.
Jack M. Guralnik - One of the best experts on this subject based on the ideXlab platform.
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just get out the door importance of Walking outside the home for maintaining mobility findings from the women s health and aging study
Journal of the American Geriatrics Society, 2005Co-Authors: Eleanor M Simonsick, Jack M. Guralnik, Jennifer L Balfour, Stefano Volpato, Linda P FriedAbstract:Objectives: To determine the association between volitional Walking behavior and change in Walking ability and lower extremity function over 1 year in functionally limited older women. Design: Longitudinal cohort study. Setting: Data were collected in participant's homes in Baltimore, Maryland. Participants: One thousand two cognitively intact community-resident female Medicare beneficiaries aged 65 and older enrolled in the Women's Health and Aging Study. Measurements: Reported Walking behavior and change in reported Walking Difficulty, usual and rapid gait speed, and lower extremity physical performance score over 1 year. Results: Of 800 functionally limited women who could walk unassisted at baseline and were alive and contacted 1 year later, 226 (28%) walked regularly, at least eight blocks per week. These women exhibited better health and functioning than nonwalkers (e.g., lower prevalence of depressive and fatigue symptoms and cardiovascular disease and higher mean ankle-arm index, forced expiratory volume in the first second, and gait speed). One year later, independent of initial functional status, social-psychological and behavioral factors, and health conditions, walkers were 1.8 times (95% confidence interval=1.2–2.7; P=.002) more likely to maintain reported Walking ability and showed less decline in customary Walking speed (0.009 m/s vs −0.070 m/s; P=.001) and functional performance score (−0.17 vs −0.73; P=.01) than women who walked less than eight blocks. Conclusion: The strength, consistency, and specificity of the association between Walking behavior and maintenance of mobility provide strong evidence that even a small amount of regular Walking can confer short-term protection from further mobility loss in functionally limited women. The observation that most women capable of Walking at least eight blocks per week were not doing so indicates the need to get more women “out the door” and to encourage those who walk a little to walk a little more.
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Walking Difficulty Walking speed and age as predictors of self rated health the women s health and aging study
Journals of Gerontology Series A-biological Sciences and Medical Sciences, 2001Co-Authors: Marja Jylha, Jack M. Guralnik, Jennifer L Balfour, Linda P FriedAbstract:Background. Older persons reporting disability are more likely to report poor self-rated health, but little work has been done to assess the independent relationships of reported Walking Difficulty and measured Walking performance with self-rated health. This study examines the associations of Walking Difficulty, Walking speed, and age with self-rated health in older women. Methods. The data are from the baseline of the Women’s Health and Aging Study. Difficulty Walking one quarter mile was used as a measure of mobility in the representative population aged 65 and older screened for the study ( n � 3841) and in the one third most disabled study group ( n � 1002). Maximal Walking speed was measured in the study sample. Results. Increasing severity of Walking Difficulty (in the screened population and in the disabled study group), slower Walking speed (in the study group), and younger age were all associated with fair or poor self-rated health, after simultaneous adjustment for these and other objective measures of physical performance and health. The associations of both measures of Walking with self-rated health weakened with age.
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who walks factors associated with Walking behavior in disabled older women with and without self reported Walking Difficulty
Journal of the American Geriatrics Society, 1999Co-Authors: Eleanor Marie Simonsick, Jack M. Guralnik, Linda P FriedAbstract:OBJECTIVES: To determine how severity of Walking Difficulty and sociodemographic, psychosocial, and health-related factors influence Walking behavior in disabled older women. DESIGN: Cross-sectional analyses of baseline data from the Women's Health and Aging Study (WHAS). SETTING: An urban community encompassing 12 contiguous zip code areas in the eastern portion of Baltimore City and part of Baltimore County, Maryland. PARTICIPANTS: A total of 920 moderately to severely disabled community-resident women, aged 65 years and older, identified from an age-stratified random sample of Medicare beneficiaries. MEASUREMENTS: Walking behavior was defined as minutes walked for exercise and total blocks walked per week. Independent variables included self-reported Walking Difficulty, sociodemographic factors, psychological status (depression, mastery, anxiety, and cognition), and health-related factors (falls and fear of falling, fatigue, vision and balance problems, weight, smoking, and cane use). RESULTS: Walking at least 8 blocks per week was strongly negatively related to severity of Walking Difficulty. Independent of Difficulty level, older age, black race, fatigue, obesity, and cane use were also negatively associated with Walking; living alone and high mastery had a positive association with Walking. CONCLUSIONS: Even among functionally limited women, sociocultural, psychological, and health-related factors were independently associated with Walking behavior. Thus, programs aimed at improving Walking ability need to address these factors in addition to Walking difficulties to maximize participation and compliance. J Am Geriatr Soc 47:672–680, 1999.
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foot pain and disability in older women
American Journal of Epidemiology, 1998Co-Authors: Suzanne G. Leveille, Jack M. Guralnik, Rosemarie Hirsch, Eleanor Marie Simonsick, Luigi Ferrucci, Marc C. HochbergAbstract:In a study of the relation between foot pain and disability, a cross-sectional analysis was performed using baseline data (1992-1995) from the Women's Health and Aging Study, a population-based study of 1,002 disabled women aged 65 years and older living in Baltimore, Maryland. Chronic and severe foot pain, defined as pain lasting 1 month or longer in the previous year, plus pain in the previous month rated severe (7-10 on a scale of 0 to 10), was reported by 14% of the women. Severe foot pain was more common in women who were younger (aged 65-74 years), obese, or had hand or knee osteoarthritis. Walking speed and five repeated chair stands were slower in women with foot pain. After adjustment for age, body mass index, race, education, self-rated health, smoking status, comorbidities, and number of other pain sites, severe foot pain was independently associated with increased risk for Walking Difficulty (adjusted odds ratio = 1.69, 95% confidence interval 1.10-2.59) and disability in activities of daily living (adjusted odds ratio = 1.91, 95% confidence interval 1.21-3.01). These findings suggest that severe foot pain may play a key role in disability in older women. Further studies are warranted to confirm these results longitudinally and to determine whether interventions to alleviate foot pain could reduce or prevent disability in older women.
Merja Rantakokko - One of the best experts on this subject based on the ideXlab platform.
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use of Walking modifications perceived Walking Difficulty and changes in outdoor mobility among community dwelling older people during covid 19 restrictions
Aging Clinical and Experimental Research, 2021Co-Authors: Heidi Leppa, Erja Portegijs, Merja Rantakokko, Laura Karavirta, Timo Rantalainen, Sini Siltanen, Taina RantanenAbstract:Outdoor mobility enables participation in essential out-of-home activities in old age. To compare changes in different aspects of outdoor mobility during COVID-19 restrictions versus two years before according to self-reported Walking. Community-dwelling participants of AGNES study (2017–2018, initial age 75–85) responded to AGNES-COVID-19 postal survey in spring 2020 (N = 809). Life-space mobility, autonomy in participation outdoors, and self-reported physical activity were assessed at both time points and differences according to self-reported Walking modifications and Difficulty vs. intact Walking at baseline were analyzed. Life-space mobility and autonomy in participation outdoors had declined (mean changes -11.4, SD 21.3; and 6.7, SD 5.3, respectively), whereas physical activity had increased (5.5 min/day, SD 25.1) at follow-up. Participants perceiving Walking Difficulty reported the poorest baseline outdoor mobility, a steeper decline in life-space mobility (p = 0.001), a smaller increase in physical activity (p < 0.001), and a smaller decline in autonomy in participation outdoors (p = 0.017) than those with intact Walking. Those with Walking modifications also reported lower baseline life-space mobility and physical activity, a steeper decline in life-space mobility and a smaller increase in physical activity those with intact Walking (p < 0.001 for both). Participants reporting Walking modifications remained the intermediate group in outdoor mobility over time, whereas those with Walking Difficulty showed the steepest decline in outdoor mobility and hence potential risk for accelerated further functional decline. Interventions should target older people perceiving Walking Difficulty, as they may be at the risk for becoming homebound when environmental facilitators for outdoor mobility are removed.
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self reported hearing is associated with time spent out of home and withdrawal from leisure activities in older community dwelling adults
Aging Clinical and Experimental Research, 2016Co-Authors: Tuija M Mikkola, Hannele Polku, Erja Portegijs, Merja Rantakokko, Litang Tsai, Taina Rantanen, Anne ViljanenAbstract:Hearing difficulties are prevalent among older people and can lead to difficulties in social interaction. These difficulties may increase the tendency to remain at home and withdraw from leisure activities. To investigate whether self-reported hearing problems are associated with time spent out-of-home and withdrawal from a leisure activity among older persons. Cross-sectional and longitudinal data on 75- to 90-year-old community-dwelling men and women (n = 767) was used. Self-reports of hearing, diseases, and Difficulty Walking 2 km were obtained via home interviews at baseline, and withdrawal from a leisure activity via 1- and 2-year follow-up telephone interviews. Time spent out-of-home was obtained from a subsample (n = 532) via seven-day diaries at baseline. Hearing problems were associated with time spent out-of-home (p = 0.025) and withdrawal from a leisure activity (p = 0.025) among persons reporting no Walking Difficulty, but not among those reporting Walking Difficulty (p = 0.269 and 0.396, respectively). Among the former, persons with major hearing problems spent significantly less time out-of-home (estimated marginal mean 161 min, 95 % CI 122–212) than those with good hearing (242, 95 % CI 218–270). Persons with major hearing problems also had 3.0 times higher odds (95 % CI 1.3–7.1) for withdrawal from a leisure activity than persons with good hearing during the two-year follow-up. Among older adults without Walking Difficulty, hearing problems may reduce time spent out-of-home and increase the likelihood for withdrawal from a leisure activity. Decreased leisure and out-of-home activity may have negative effects on older persons’ social, mental and physical functioning.
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environmental facilitators for outdoor Walking and development of Walking Difficulty in community dwelling older adults
European Journal of Ageing, 2014Co-Authors: Johanna Eronen, Merja Rantakokko, Mikaela B Von Bonsdorff, Taina RantanenAbstract:Older adults who report environmental barriers in their neighborhood have a higher risk for Walking Difficulty. However, environmental facilitators that protect against Walking Difficulty are not well known. The objective of this study was to identify the effect of environmental facilitators for outdoor Walking on development of Walking Difficulty in community-dwelling older people. This was a prospective study with a 3.5-year follow-up time on 261 community-dwelling people aged 75–81 years, who at baseline were able to walk 0.5 km without Difficulty. Environmental facilitators for outdoor Walking were self-reported with standardized questionnaires, including having features in one’s home which make it easy to access the outdoors, having a park or other green area within a Walking distance from home, having outdoor recreational facilities within a Walking distance from home, having features in the nearby environment, which are attractive for outdoor activities, and perceiving the surrounding environment or facilities nearby as motivating factors for physical activity. Self-reported Difficulty in Walking 0.5 km was assessed every 6 months. Of the participants, 46 % developed Walking Difficulty during the follow-up. Having a park or other green area within a Walking distance from home was the most frequently reported facilitator. Environmental facilitators decreased the risk for development of Walking Difficulty, hazard ratio per item 0.86, (95 % confidence interval 0.73–1.02). The results indicate that the mobility of older community-dwelling people may be promoted with outdoor recreational facilities that are easy to access and located within a Walking distance from home.
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fear of falling and coexisting sensory difficulties as predictors of mobility decline in older women
Journals of Gerontology Series A-biological Sciences and Medical Sciences, 2012Co-Authors: Anne Viljanen, Merja Rantakokko, Jenni Kulmala, Markku Koskenvuo, Jaakko Kaprio, Taina RantanenAbstract:BACKGROUND: Mobility decline, the coexistence of several sensory difficulties and fear of falling (FOF) are all common concerns in older people; however, knowledge about the combined effect of FOF and coexisting sensory difficulties on mobility is lacking. METHODS: Data on self-reported FOF, difficulties in hearing, vision, balance, and Walking 2 km were gathered with a structured questionnaire among 434 women aged 63-76 years at baseline and after a 3-year follow-up. Logistic regression models were used for analyses. RESULTS: Every third participant reported difficulties in Walking 2 km at baseline. In cross-sectional analysis, the odds ratio for difficulties in Walking 2 km was higher among persons who reported FOF compared with persons without FOF and the odds increased with the increasing number of sensory difficulties. Persons who reported FOF and who had three sensory difficulties had almost fivefold odds (odds ratio = 4.7, 95% confidence interval = 1.9-11.7) for Walking difficulties compared with those who reported no FOF and no sensory difficulties. Among the 290 women without Walking difficulties at baseline, 54 participants developed Difficulty in Walking 2 km during the 3-year follow-up. Odds ratio for incident Walking Difficulty was 3.5 (95% confidence interval = 1.6-7.8) in participants with FOF and with 2-3 sensory difficulties compared with persons without FOF and with at most one sensory Difficulty at baseline. CONCLUSIONS: Older women who have several coexisting sensory difficulties combined with FOF are particularly vulnerable to mobility decline. Avoidance of Walking as a result of FOF is likely to be reinforced when multiple sensory difficulties hinder reception of accurate information about the environment, resulting in accelerated decline in Walking ability. Language: en
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fear of moving outdoors and development of outdoor Walking Difficulty in older people
Journal of the American Geriatrics Society, 2009Co-Authors: Merja Rantakokko, Minna Manty, Susanne Iwarsson, Timo Tormakangas, Raija Leinonen, Eino Heikkinen, Taina RantanenAbstract:OBJECTIVES: To study which individual characteristics and environmental factors correlate with fear of moving outdoors and whether fear of moving outdoors predicts development of mobility limitation. DESIGN: Observational prospective cohort study and cross-sectional analyses. SETTING: Community and research center. PARTICIPANTS: Seven hundred twenty-seven community-living people aged 75 to 81 were interviewed at baseline, of whom 314 took part in a 3.5-year follow-up. MEASUREMENTS: Fear of moving outdoors and its potential individual and environmental correlates were assessed at baseline. Perceived difficulties in Walking 0.5 km and 2 km were assessed twice a year over a 3.5-year period. RESULTS: At baseline, 65% of the women and 29% of the men reported fear of moving outdoors. Poor socioeconomic status; musculoskeletal diseases; slow Walking speed; and the presence of poor street conditions, hills in the nearby environment, and noisy traffic correlated with fear of moving outdoors. At the first 6-month follow-up, participants with fear of moving outdoors had more than four times the adjusted risk (odds ratio (OR)=4.6, 95% confidence interval (CI)=1.92-11.00) of developing difficulties in Walking 0.5 km and a three times greater adjusted risk (OR=3.10, 95% CI=1.49-6.46) for developing Difficulty in Walking 2 km compared with those without fear. The difference in the prevalence of Walking difficulties remained statistically significant over the 3.5-year follow-up (P=.02 and P=.009, respectively). CONCLUSION: Fear of moving outdoors is common in older adults and increases the risk of developing self-reported difficulties in Walking 0.5 km and 2 km. Knowledge about individual and environmental factors underlying fear of moving outdoors and finding ways to alleviate fear of moving outdoors are important for community planning and prevention of disability. Language: en
