Sociodemographic determinants of mobility decline among community-dwelling older adults: findings from the Canadian longitudinal study on ageing.

Abstract

Background: Mobility is fundamental to healthy ageing and quality of life. Mobility decline has been associated with functional impairment, falls, disability, dependency, and death among older adults. We explored the sociodemographic determinants of mobility decline among community-dwelling older Canadians.

Methods: This study was a secondary analysis of a six-year follow-up of the Canadian Longitudinal Study on Ageing (CLSA). Our analysis was based on 3882 community-dwelling older adults 65 years or older whose mobility was measured using timed-up and go (TUG) and 4-meter walk (4MWT) tests at baseline and follow-ups 1 and 2 after three- and six-year intervals, respectively. We analysed the cross-sectional and longitudinal association, main and interaction effects of the participants' sociodemographic characteristics on mobility decline using chi-square, Pearson's correlation, mixed-design repeated measures ANOVA, and bivariate and multivariate linear regression tests.

Results: At baseline, 52% of the participants were female, 70.4% were married, and the average age was 68.82 ± 2.78 years. Mean TUG and 4MWT scores were 9.59 ± 1.98 s and 4.29 ± 0.95 s, respectively. There was a strong positive longitudinal correlation between TUG and 4MWT (r = 0.65 to 0.75, p < 0.001), indicating concurrent validity of 4MWT. The multivariate linear regression (for TUG) showed that older age (β = 0.088, p < 0.001), being a female (β=-0.035, p < 0.001), retired (β=-0.058, p < 0.001), Canadian born (β=-0.046, p < 0.001), non-Caucasian (β=-0.063, p < 0.001), tenant (β = 0.050, p < 0.001), having no spouse/partner (β=-0.057, p < 0.001), household income of $50,000-$99,999 (β = 0.039, p < 0.001), wealth/investment lower than $50,000 (β=-0.089, p < 0.001), lower social status (β=-0.018,p = 0.025), secondary education and below (β = 0.043, p < 0.001), and living in certain provinces compared to others, were significant predictors of a six-year mobility decline.

Conclusion: Our study underscored the impact of modifiable and non-modifiable sociodemographic determinants of mobility trajectory. There is a need for nuanced ageing policies that support mobility in older adults, considering sociodemographic inequalities through equitable resource distribution, including people of lower socioeconomic backgrounds.