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Research Reports |
A Shumway-Cook, PT, PhD, is Associate Professor, Department of Rehabilitation Medicine, University of Washington, Box 356490, Seattle, WA 98195 (USA) (ashumway{at}u.washington.edu).
AE Patla, PhD, is Professor, Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
A Stewart, PhD, is Professor, Institute for Health and Aging, University of California-San Francisco, San Francisco, Calif
L Ferrucci, MD, PhD, is Director, Clinical Epidemiology, INRCA, Florence, Italy
MA Ciol, PhD, is Biostatistician, Department of Rehabilitation Medicine, University of Washington
JM Guralnik, MD, PhD, is Director, Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, Md
Address all correspondence to Dr Shumway-Cook
Background and Purpose. In this study, the influence of 8 dimensions of the physical environment on mobility in older adults with and without mobility disability was measured. This was done in order to identify environmental factors that contribute to mobility disability. Subjects. Subjects were 36 older adults (
70 years of age) who were recruited from 2 geographic sites (Seattle, Wash, and Waterloo, Ontario, Canada) and were grouped according to level of mobility function (physically able [ability to walk 
mile (0.8 km) or climb stairs without assistance], physically disabled). Methods. Subjects were observed and videotaped during 3 trips into the community (trip to grocery store, physician visit, recreational trip). Frequency of encounters with environmental features within each of the 8 dimensions was recorded. Differences in baseline characteristics and environmental encounters were analyzed using an analysis of variance or the Fisher exact test, as appropriate. Results. Mobility disability among older adults was not associated with a uniform decrease in encounters with environmental challenges across all dimensions. Environmental dimensions that differed between subjects who were physically able and those with physical disability included temporal factors, physical load, terrain, and postural transition. Dimensions that were not different included distance, density, ambient conditions (eg, light levels and weather conditions), and attentional demands. Discussion and Conclusion. Understanding the relationship of the environment to mobility is crucial to both prevention and rehabilitation of mobility disability in older adults. Among older adults, certain dimensions of the environment may disable community mobility more than others.
Key Words: Aging • Disability • Environment • Mobility
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