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Assessing Mobility Difficulties for Cross‐National Comparisons: Results from the World Health Organization Study on Global Ageing and Adult Health
Author(s) -
Capistrant Beatrix D.,
Glymour M. Maria,
Berkman Lisa F.
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12633
Subject(s) - medicine , gerontology , ageing , environmental health
Objectives To assess the correspondence between self‐reported and measured indicators of mobility disability in older adults in six low‐ and middle‐income countries ( LMIC s). Design Cross‐sectional analysis of Study on Global AGEing and Adult Health ( SAGE ). Setting Household surveys in China, India, Russia, South Africa, Ghana, and Mexico. Participants Community‐dwelling SAGE respondents aged 65 and older (N = 12,215). Measurements Objective mobility was assessed according to a 4‐m timed walk at normal pace conducted in the respondent's home; slow walking speed was defined according to the Fried frailty criteria (lowest quintile of walking speed, adjusted for age and height). Self‐reported mobility difficulty was assessed according to a question about ability to walk 1 km; this response was dichotomized into any versus no self‐reported difficulty walking 1 km (reference no difficulty). The age‐ (5‐year groups) and sex‐specific probability of self‐reporting difficulty walking 1 km was estimated in those with a measured slow walk using logistic regression. Results Between 42% and 76% of people aged 65 and older reported any difficulty walking 1 km. Average walking speed was slowest in Russia (0.61 m/s) and fastest in China (0.88 m/s). The probabilities of reporting any difficulty walking 1 km in women aged 65 to 69, for example, with a slow walk varied (China = 0.35, India = 0.90, Russia = 0.68, South Africa = 0.81, Ghana = 0.91, Mexico = 0.73; test of country differences P < .001). There was significant variation at older ages, albeit smaller in magnitude. Patterns were similar for men. Conclusion Although correspondence between an objective and self‐reported measure of mobility was generally high, correspondence differed significantly between LMIC s. International comparisons of self‐reported disability measures for clinical, prevention, and policy guidelines in LMIC s should consider that self‐reported data may not correspond to objective measures uniformly between countries.