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Community Environmental Factors Are Associated With Disability in Older Adults With Functional Limitations: The MOST Study
Open accessAbstract
BACKGROUND: There is limited evidence supporting the hypothesized environment-disability link. The objectives of this study were to (a) identify the prevalence of community mobility barriers and transportation facilitators and (b) examine whether barriers and facilitators were associated with disability among older adults with functional limitations. METHODS: Four hundred and thirty-five participants aged 65+ years old with functional limitations were recruited from the Multicenter Osteoarthritis Study, a prospective study of community-dwelling adults with or at risk of developing symptomatic knee osteoarthritis. Presence of community barriers and facilitators was ascertained by the Home and Community Environment survey. Two domains of disability, (a) daily activity limitation (DAL) and (b) daily activity frequency (DAF), were assessed with the Late-Life Disability Instrument. Covariates included age, gender, education, race, comorbidity, body mass index, knee pain, and functional limitation. Multivariable logistic regression was used to examine adjusted associations of community factors with presence of DAL and DAF. RESULTS: Approximately one third of the participants lived in a community with high mobility barriers and low transportation facilitators. High mobility barriers was associated with greater odds of DAL (odds ratio [OR] = 2.0, 95% confidence interval [CI] 1.2-3.1) after adjusting for covariates, and high transportation facilitators was associated with lower odds of DAL (OR = 0.5, 95% CI 0.3-0.8) but not with DAF in adjusted models. CONCLUSION: People with functional limitations who live in communities that were more restrictive felt more limited in doing daily activities but did not perform these daily activities any less frequently.
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“Approximately one third of individuals in this cohort were more likely to have high mobility barriers and low transportation facilitators.”
From Successful aging: Advancing the science of physical independence in older adults (2015) · cites this paper as Keysor et al. 2010
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“(Gray, Hollingsworth, Stark, and Morgan 2008;White, Jette, Felson, LaValley, Lewis, Torner, Nevitt, and Keysor 2010) Thus, social engineering of communities and neighborhoods that provide walking areas adequate handicap parking and public transportation may prevent and/or provide access to older…”
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Metadata
- Authors
- Keysor, J. J., Jette, A. M., LaValley, M. P., Lewis, C. E., Torner, J. C., Nevitt, M. C., Felson, D. T., & the Multicenter Osteoarthritis (MOST) group
- Affiliations
- Boston University (US)
- University of Alabama (US)
- University of Iowa (US)
- University of California, San Francisco (US)
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-12-08
- Volume
- 65A
- Issue
- 4
- Pages
- 393-399
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- PMC
- PMC2905834
- OpenAlex
- W2118103907
- Cited by
- 104
- References
- 35
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 5 · 2021: 10 · 2020: 8 · 2019: 5 · 2018: 3 · 2017: 4 · 2016: 5 · 2015: 11 · 2014: 10 · 2013: 10 · 2012: 9
- FWCI
- 6.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- University of Alabama
- National Institutes of Health (5k12hd043444-10)
- National Institute on Aging (U01-AG-1-8832, U01-AG-18820, U01AG018832, U01‐AG‐18947, U01AG19069, U01AG018947, U01AG019069, U01AG018820)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (P60AR047785)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12 HD043444-02)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Transportation › Urban Transport and Accessibility
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- disability, older adults, functional limitations, mobility barriers, daily activity limitations, knee osteoarthritis, community-dwelling older adults
- MeSH terms
- Activities of Daily Living, Aged, Architectural Accessibility, Female, Humans, Male, Prospective Studies, Residential Facilities, Transportation, Osteoarthritis, Knee
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