Exploring age-related physical and cognitive decline in a nationally representative sample of US women.

Background: Functional limitations play a critical role in shaping overall health and quality of life. Among women, functional difficulties are influenced by a variety of factors, which may vary across difference life stages.

Objectives: This study examined the association between self-reported walking/communication difficulty and individual-level characteristics among women at three different life stages.

Design: Cross-sectional data from the National Health and Nutrition Examination Survey 2021-2023 wave included women aged 18 and above (N = 3475 unweighted).

Methods: Binary dependent variable analysis evaluated the association between demographic characteristics, income, and health status and walking/communication difficulties. A sensitivity analysis estimated these relationships within three different age groups: 18-45, 46-64, and 65 years and older.

Results: High income (communication β = -0.40, p = 0.03; walking β = -0.60, p = 0.00) and having at least a college education (communication β = -0.30, p = 0.01; walking β = -0.32, p = 0.00) were associated with lower marginal likelihood of communication and walking difficulty. However, being out of the labor force had higher likelihood of communication (β = 0.36, p = 0.00) and walking difficulty (β = 0.30, p = 0.00). Among young adults, Hispanics demonstrated lower marginal likelihood of walking difficulty relative to their non-Hispanic White counterparts (β = -0.31, p = 0.05). Among middle-aged adults, Blacks had higher marginal likelihood of walking difficulty (β = 0.23, p = 0.02) relative to Whites while Hispanics has lower marginal likelihoods of communication difficulty (β = -0.36, p = 0.04).

Conclusion: Individual characteristics were significantly associated with both types of functional difficulties in women, but these relationships differed between age groups. Understanding differences in functional difficulty will require understanding of how risk and protective factors vary throughout the lifespan.