Abstract
BackgroundOutdoor mobility enables participation in essential out-of-home activities in old age.AimTo compare changes in different aspects of outdoor mobility during COVID-19 restrictions versus two years before according to self-reported walking.MethodsCommunity-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.ResultsLife-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).DiscussionParticipants 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.ConclusionInterventions 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.
Highlights
Outdoor mobility indicates an individual’s actual mobility behavior and perceived possibilities for participation in essential out-of-home activities [1, 2]
Age-related diseases and functional decline may increase the risk for walking difficulty [3], in turn hindering possibilities to participate in out-of-home activities and leading to further decline in outdoor mobility [4]
Life-space mobility scores decreased on average − 11.4 points (SD 21.3) in all participants during the COVID19 restrictions when compared to their scores two years before (72.6, SD 18.6 vs. 61.2, SD 24.7)
Summary
Outdoor mobility indicates an individual’s actual mobility behavior and perceived possibilities for participation in essential out-of-home activities [1, 2]. Age-related diseases and functional decline may increase the risk for walking difficulty [3], in turn hindering possibilities to participate in out-of-home activities and leading to further decline in outdoor mobility [4]. 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. 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. Discussion 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 potential risk for accelerated further functional decline. Conclusion 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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