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==History==
==History==


According to [[National Research Council]], the population of older adults is expected to increase in the United States due to [[aging]] with ''[[Baby boomers]]'' by 2030; this will increase the population of [[mobility]] [[disabled]] individuals in the community.<ref> Feasley, Jill C., ed. Health outcomes for older people: Questions for the coming decade. National Academies, 1996.</ref> Due to which, it seems important to predict [[disability]] due to inability to walk at an early stage, the outcome will eventually decrease health care costs. Aging cause a decrease in [[strength]] and [[power]] in lower extremities which ultimately leads to decrease in [[mobility]] <ref> Guralnik, Jack M., et al. "Lower extremity function and subsequent disability consistency across studies, predictive models, and value of gait speed alone compared with the Short Physical Performance Battery." The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 55.4 (2000): M221-M231.</ref>, in turn leading to [[disability]] which is shown to be common in women due to differences in distribution of resources and opportunities.<ref> Zunzunegui, M. V., et al. "The mobility gap between older men and women: the embodiment of gender." Archives of gerontology and geriatrics 61.2 (2015): 140-148.</ref> The early detection of [[mobility disability]] will help clinicians and patients in determining the early management of the conditions which could be associated with the future [[disability]]. It is important to note that [[disability]] due to inability to move is not restricted to older and [[hospitalized]] individuals, it has been reported in young and non-hospitalized individuals as well due to decreased [[mobility]].<ref> Iezzoni, Lisa I et al. “Mobility Difficulties Are Not Only a Problem of Old Age.” Journal of General Internal Medicine 16.4 (2001): 235–243. PMC. Web. 26 Apr. 2017.</ref> The increase in the rate of [[disability]] causes loss of functional independence <ref> Fried, Linda P., and Jack M. Guralnik. "Disability in older adults: evidence regarding significance, etiology, and risk." Journal of the American Geriatrics Society 45.1 (1997): 92-100., Hirvensalo, Mirja, Taina Rantanen, and Eino Heikkinen. "Mobility difficulties and physical activity as predictors of mortality and loss of independence in the community‐living older population." Journal of the American Geriatrics Society 48.5 (2000): 493-498.</ref> and increases the risk of future [[chronic diseases]].<ref>[http://www.ncbi.nlm.nih.gov/pubmed/1466363],[http://www.ncbi.nlm.nih.gov/pubmed/2971088],[http://www.ncbi.nlm.nih.gov/pubmed/11890596].</ref> As we have come across the importance of early detection of [[disability]] due to inability to walk, the question arises, in which conditions person has decreased [[mobility]] or is [[disabled]].
According to [[National Research Council]], the population of older adults is expected to increase in the United States due to [[aging]] with ''[[Baby boomers]]'' by 2030; this will increase the population of [[mobility]] [[disabled]] individuals in the community.<ref> Feasley, Jill C., ed. Health outcomes for older people: Questions for the coming decade. National Academies, 1996.</ref> Due to which, it seems important to predict [[disability]] due to inability to walk at an early stage, the outcome will eventually decrease health care costs. Aging cause a decrease in [[strength]] and [[power]] in lower extremities which ultimately leads to decrease in [[mobility]] <ref> Guralnik, Jack M., et al. "Lower extremity function and subsequent disability consistency across studies, predictive models, and value of gait speed alone compared with the Short Physical Performance Battery." The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 55.4 (2000): M221-M231.</ref>, in turn leading to [[disability]] which is shown to be common in women due to differences in distribution of resources and opportunities.<ref> Zunzunegui, M. V., et al. "The mobility gap between older men and women: the embodiment of gender." Archives of gerontology and geriatrics 61.2 (2015): 140-148.</ref> The early detection of [[mobility disability]] will help clinicians and patients in determining the early management of the conditions which could be associated with the future [[disability]]. It is important to note that [[disability]] due to inability to move is not restricted to older and [[hospitalized]] individuals, it has been reported in young and non-hospitalized individuals as well due to decreased [[mobility]].<ref> Iezzoni, Lisa I et al. “Mobility Difficulties Are Not Only a Problem of Old Age.” Journal of General Internal Medicine 16.4 (2001): 235–243. PMC. Web. 26 Apr. 2017.</ref> The increase in the rate of [[disability]] causes loss of functional independence <ref> Fried, Linda P., and Jack M. Guralnik. "Disability in older adults: evidence regarding significance, etiology, and risk." Journal of the American Geriatrics Society 45.1 (1997): 92-100., Hirvensalo, Mirja, Taina Rantanen, and Eino Heikkinen. "Mobility difficulties and physical activity as predictors of mortality and loss of independence in the community‐living older population." Journal of the American Geriatrics Society 48.5 (2000): 493-498.</ref> and increases the risk of future [[chronic diseases]].<ref> Reuben, David B., et al. "Value of functional status as a predictor of mortality: results of a prospective study." The American journal of medicine 93.6 (1992): 663-669.,Manton, Kenneth G. "A longitudinal study of functional change and mortality in the United States." Journal of Gerontology 43.5 (1988): S153-S161.,Khokhar, Shafiq R., et al. "Persistent mobility deficit in the absence of deficits in activities of daily living: a risk factor for mortality." Journal of the American Geriatrics Society 49.11 (2001): 1539-1543.</ref> As we have come across the importance of early detection of [[disability]] due to inability to walk, the question arises, in which conditions a person has decreased [[mobility]] or is [[disabled]].


==Definition==
==Definition==


There are many definitions that contribute in providing the meaning of [[mobility disability]], it is stated as the “self-reports of a lot of difficulties or inability to walk a [[quarter]] of a mile” <ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270855/].</ref> without sitting and within time limit of fifteen minutes <ref>[https://www.ncbi.nlm.nih.gov/pubmed/8994496],[https://www.ncbi.nlm.nih.gov/pubmed/16460375],[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2640434/],[https://www.ncbi.nlm.nih.gov/pubmed/21975090].</ref> Failure to walk within this time frame results in the use of [[mobility aid]] devices such as [[mobility scooter]], [[wheelchair]], [[crutches]] or a [[walker]] which will eventually help in community [[ambulation]]. Another term that is coined to define [[mobility disability]] based on performance is “performance based mobility disability”.<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392849/].</ref> It is the inability to increase your [[walking speed]] more than 0.4m/s.<ref>[http://www.ncbi.nlm.nih.gov/pubmed/7715059],[http://www.ncbi.nlm.nih.gov/pubmed/10219007],[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1892815/].</ref> If an individual is unable to walk at >0.4 m/s, he or she is considered severely [[disabled]] and would require a [[mobility device]] to walk in community.
There are many definitions that contribute in providing the meaning of [[mobility disability]], it is stated as the “self-reports of a lot of difficulties or inability to walk a [[quarter]] of a mile” <ref> Ward, Rachel E. et al. “Sensory and Motor Peripheral Nerve Function and Incident Mobility Disability.” Journal of the American Geriatrics Society 62.12 (2014): 2273–2279. PMC. Web. 26 Apr. 2017.</ref> without sitting and within time limit of fifteen minutes <ref> Fried, Linda P., and Jack M. Guralnik. "Disability in older adults: evidence regarding significance, etiology, and risk." Journal of the American Geriatrics Society 45.1 (1997): 92-100.,Gill, Thomas M., et al. "The dynamic nature of mobility disability in older persons." Journal of the American Geriatrics Society 54.2 (2006): 248-254., Vestergaard, Sonja et al. “Stopping to Rest during a 400-Meter Walk and Incident Mobility Disability in Older Persons with Functional Limitations.” Journal of the American Geriatrics Society 57.2 (2009): 260–265. PMC. Web. 26 Apr. 2017.,Marsh, Anthony P. et al. “Muscle Strength and BMI as Predictors of Major Mobility Disability in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P).” The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 66A.12 (2011): 1376–1383. PMC. Web. 26 Apr. 2017.</ref> Failure to walk within this time frame results in the use of [[mobility aid]] devices such as [[mobility scooter]], [[wheelchair]], [[crutches]] or a [[walker]] which will eventually help in the community [[ambulation]]. Another term that is coined to define [[mobility disability]] based on performance is “performance based mobility disability”.<ref> Goldman, Noreen et al. “Performance-Based Measures of Physical Function as Mortality Predictors: Incremental Value beyond Self-Reports.” Demographic research 30.7 (2014): 227–252. PMC. Web. 26 Apr. 2017.</ref> It is the inability to increase your [[walking speed]] more than 0.4m/s.<ref> Tinetti, Mary E., et al. "Shared risk factors for falls, incontinence, and functional dependence: unifying the approach to geriatric syndromes." Jama 273.17 (1995): 1348-1353.,Rantanen, Taina, et al. "Coimpairments: strength and balance as predictors of severe walking disability." The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 54.4 (1999): M172-M176., Melzer, David et al. “The Apolipoprotein E e4 Polymorphism Is Strongly Associated With Poor Mobility Performance Test Results But Not Self-Reported Limitation in Older People.” The journals of gerontology. Series A, Biological sciences and medical sciences 60.10 (2005): 1319–1323. Print.</ref> If an individual is unable to walk at >0.4 m/s, he or she is considered severely [[disabled]] and would require a [[mobility device]] to walk in community.


==Risk Factors==
==Risk Factors==

Revision as of 20:34, 26 April 2017

Age-related mobility disability is a self-reported inability to walk due to impairments, limited mobility, dexterity or stamina.[1] It has been found mostly in older adults with decreased strength in lower extremities.[2]

History

According to National Research Council, the population of older adults is expected to increase in the United States due to aging with Baby boomers by 2030; this will increase the population of mobility disabled individuals in the community.[3] Due to which, it seems important to predict disability due to inability to walk at an early stage, the outcome will eventually decrease health care costs. Aging cause a decrease in strength and power in lower extremities which ultimately leads to decrease in mobility [4], in turn leading to disability which is shown to be common in women due to differences in distribution of resources and opportunities.[5] The early detection of mobility disability will help clinicians and patients in determining the early management of the conditions which could be associated with the future disability. It is important to note that disability due to inability to move is not restricted to older and hospitalized individuals, it has been reported in young and non-hospitalized individuals as well due to decreased mobility.[6] The increase in the rate of disability causes loss of functional independence [7] and increases the risk of future chronic diseases.[8] As we have come across the importance of early detection of disability due to inability to walk, the question arises, in which conditions a person has decreased mobility or is disabled.

Definition

There are many definitions that contribute in providing the meaning of mobility disability, it is stated as the “self-reports of a lot of difficulties or inability to walk a quarter of a mile” [9] without sitting and within time limit of fifteen minutes [10] Failure to walk within this time frame results in the use of mobility aid devices such as mobility scooter, wheelchair, crutches or a walker which will eventually help in the community ambulation. Another term that is coined to define mobility disability based on performance is “performance based mobility disability”.[11] It is the inability to increase your walking speed more than 0.4m/s.[12] If an individual is unable to walk at >0.4 m/s, he or she is considered severely disabled and would require a mobility device to walk in community.

Risk Factors

There are number of factors that could be associated with mobility disability, but according to center for disease control and prevention, “stroke is found to be the leading cause of mobility disability, in turn reducing mobility in more than half of the stroke survivors above 65 years of age”.[13]

Measures

It is important to find measurement scales that can detect mobility disability at an early onset. The measures that can detect mobility disability are classified into two categories, self-reported measures and performance measures. There is a need to differentiate between these measures based on their ability to detect mobility disability, such as differences in their reliability and validity. Self-reported measures are commonly used to detect mobility disability [14] but recently developed performance measures shown to be strongly associated with risk of future mobility disability in older adults.[15]

Self- Reported measures

Several qualitative studies use surveys, questionnaires and self-reported scales to detect a decrease in mobility or to predict future mobility disability in older adults.[16] The advantages of these qualitative scales are easier data acquisition and can be performed on the larger population. Although there is difference in perception of condition between subjects (gender difference), type of chronic conditions and age-related changes such as memory and reasoning, all of which can affect the information and scores of the individual, still self-reported measures have been used extensively in behavioral and correlation studies.[17] The commonly used self-reported measures to detect mobility disability are Stroke Impact scale [11], Rosow- Breslau scale [12], Barthel index, Tinetti Falls Efficacy Scale Tinetti Falls Efficacy Scale. Based on reliability and validity of these scales, stroke impact scale [13] has proven to have excellent test-retest reliability and construct validity, however, if it can predict future mobility disability in older adults is yet to be found. In contrast, Rosow- Breslau scale [14], Barthel Index and Tinetti Falls Efficacy Scale [15] proved important to predict future mobility disability based on the activities involved in these questionnaire scales.

Performance-based measures

Mobility disability due to age-related musculoskeletal pain or increase in chronic conditions is easier to detect by performance measures. The commonly used performance measures to detect mobility disability are 400-meter walk test [16], 5-minute walk test [17], walking speed, short physical performance battery test [18]. Among these measures, 400-meter walk test [19] and short physical performance battery test [20] has been proven to be strong predictors of mobility disability in older adults. In addition to prediction, there is moderate to excellent correlation between these two tests.[18] Based on reliability and validity of measurement scales to predict mobility disability, self-reported measures such as Barthel index, and performance measures such as 400 m walk test [21] and short physical performance battery test [22] are strongly associated with prediction of mobility disability in older adults.

See also

References

  1. ^ Ward, Rachel E. et al. “Sensory and Motor Peripheral Nerve Function and Incident Mobility Disability.” Journal of the American Geriatrics Society 62.12 (2014): 2273–2279. PMC. Web. 26 Apr. 2017.
  2. ^ Guralnik, Jack M., et al. "Lower extremity function and subsequent disability consistency across studies, predictive models, and value of gait speed alone compared with the Short Physical Performance Battery." The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 55.4 (2000): M221-M231.
  3. ^ Feasley, Jill C., ed. Health outcomes for older people: Questions for the coming decade. National Academies, 1996.
  4. ^ Guralnik, Jack M., et al. "Lower extremity function and subsequent disability consistency across studies, predictive models, and value of gait speed alone compared with the Short Physical Performance Battery." The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 55.4 (2000): M221-M231.
  5. ^ Zunzunegui, M. V., et al. "The mobility gap between older men and women: the embodiment of gender." Archives of gerontology and geriatrics 61.2 (2015): 140-148.
  6. ^ Iezzoni, Lisa I et al. “Mobility Difficulties Are Not Only a Problem of Old Age.” Journal of General Internal Medicine 16.4 (2001): 235–243. PMC. Web. 26 Apr. 2017.
  7. ^ Fried, Linda P., and Jack M. Guralnik. "Disability in older adults: evidence regarding significance, etiology, and risk." Journal of the American Geriatrics Society 45.1 (1997): 92-100., Hirvensalo, Mirja, Taina Rantanen, and Eino Heikkinen. "Mobility difficulties and physical activity as predictors of mortality and loss of independence in the community‐living older population." Journal of the American Geriatrics Society 48.5 (2000): 493-498.
  8. ^ Reuben, David B., et al. "Value of functional status as a predictor of mortality: results of a prospective study." The American journal of medicine 93.6 (1992): 663-669.,Manton, Kenneth G. "A longitudinal study of functional change and mortality in the United States." Journal of Gerontology 43.5 (1988): S153-S161.,Khokhar, Shafiq R., et al. "Persistent mobility deficit in the absence of deficits in activities of daily living: a risk factor for mortality." Journal of the American Geriatrics Society 49.11 (2001): 1539-1543.
  9. ^ Ward, Rachel E. et al. “Sensory and Motor Peripheral Nerve Function and Incident Mobility Disability.” Journal of the American Geriatrics Society 62.12 (2014): 2273–2279. PMC. Web. 26 Apr. 2017.
  10. ^ Fried, Linda P., and Jack M. Guralnik. "Disability in older adults: evidence regarding significance, etiology, and risk." Journal of the American Geriatrics Society 45.1 (1997): 92-100.,Gill, Thomas M., et al. "The dynamic nature of mobility disability in older persons." Journal of the American Geriatrics Society 54.2 (2006): 248-254., Vestergaard, Sonja et al. “Stopping to Rest during a 400-Meter Walk and Incident Mobility Disability in Older Persons with Functional Limitations.” Journal of the American Geriatrics Society 57.2 (2009): 260–265. PMC. Web. 26 Apr. 2017.,Marsh, Anthony P. et al. “Muscle Strength and BMI as Predictors of Major Mobility Disability in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P).” The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 66A.12 (2011): 1376–1383. PMC. Web. 26 Apr. 2017.
  11. ^ Goldman, Noreen et al. “Performance-Based Measures of Physical Function as Mortality Predictors: Incremental Value beyond Self-Reports.” Demographic research 30.7 (2014): 227–252. PMC. Web. 26 Apr. 2017.
  12. ^ Tinetti, Mary E., et al. "Shared risk factors for falls, incontinence, and functional dependence: unifying the approach to geriatric syndromes." Jama 273.17 (1995): 1348-1353.,Rantanen, Taina, et al. "Coimpairments: strength and balance as predictors of severe walking disability." The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 54.4 (1999): M172-M176., Melzer, David et al. “The Apolipoprotein E e4 Polymorphism Is Strongly Associated With Poor Mobility Performance Test Results But Not Self-Reported Limitation in Older People.” The journals of gerontology. Series A, Biological sciences and medical sciences 60.10 (2005): 1319–1323. Print.
  13. ^ [1].
  14. ^ [2],[3],[4],[5],[6].
  15. ^ [7].
  16. ^ [8].
  17. ^ [9].
  18. ^ [10].
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