Mobility Assessment

Epidemiology

A large proportion of older adults remain independently mobile into late life, and many might not have major problems with mobility unless they experience an accumulation of physiological deficits with age or, less commonly, if they experience an overwhelming injury or an acute medical event. For example, according to the most recent data from the Medicare Expenditure Panel Survey, approximately 53% of adults age 65 years and older do not have, or do not report, limitations with mobility. Fewer than 1% are unable to walk as a primary mode of moving through the environment. Nevertheless, the number who are ambulatory but report mobility limitations is quite substantial, with 31%,11%, and 4% of the Medicare population reporting mild limitations (difficulty not requiring assistive equipment or personal help), moderate limitations (difficulty requiring assistive devices such as canes and crutches), and severe limitations (difficulty requiring the assistance of at least one other person), respectively. So, at a minimum, approximately 14.1 million persons age 65 years and older have at least some mobility difficulty. Overall, approximately 19 million people—roughly 10.1% of all noninstitutionalized residents—have some motor difficulty.

From one third to one half of all older adults reporting mobility problems say that their limitations began before 50 years of age, suggesting a time when mobility limitations are developing but barely noticeable as a problem. This suggests a need for simple tests that can be administered to large numbers of people beginning at or before midlife, before mobility problems become severe and disabling, and perhaps even before they interfere with daily life. Early identification of mobility problems might help delay [Page 385]or prevent mobility problems, disability, dependency, and adverse health events.

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