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AJPH First Look, published online ahead of print Dec 23, 2008
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March 2009, Vol 99, No. 3 | American Journal of Public Health 533-539
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2008.142927

RESEARCH AND PRACTICE

Correlates of Improvement in Walking Ability in Older Persons in the United States

Joe Feinglass, PhD, Jing Song, MS, Larry M. Manheim, PhD, Pamela Semanik, PhD, Rowland W. Chang, MD, MPH and Dorothy D. Dunlop, PhD

Joe Feinglass is with the Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL. Jing Song, Larry M. Manheim, Pamela Semanik, Rowland W. Chang, and Dorothy D. Dunlop are with the Multidisciplinary Clinical Research Center in Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago.

Correspondence: Requests for reprints should be sent to Joe Feinglass, PhD, General Internal Medicine, 750 N Lakeshore Dr, 10th Floor, Chicago, IL 60611 (e-mail: j-feinglass{at}northwestern.edu).

Objectives. We analyzed factors associated with improvement in walking ability among respondents to the nationally representative Health and Retirement Study.

Methods. We analyzed data from 6574 respondents aged 53 years or older who reported difficulty walking several blocks, 1 block, or across the room in 2000 or 2002. We examined associations between improvement (versus no change, deterioration, or death) and baseline health status, chronic conditions, baseline walking difficulty, demographic characteristics, socioeconomic status, and behavioral risk factors.

Results. Among the 25% of the study population with baseline walking limitations, 29% experienced improved walking ability, 40% experienced no change in walking ability, and 31% experienced deteriorated walking ability or died. In a multivariate analysis, we found positive associations between walking improvement and more recent onset and more severe walking difficulty, being overweight, and engaging in vigorous physical activity. A history of diabetes, having any difficulty with activities of daily living, and being a current smoker were all negatively associated with improvement in walking ability. After we controlled for baseline health, improvement in walking ability was equally likely among racial and ethnic minorities and those with lower socioeconomic status.

Conclusions. Interventions to reduce smoking and to increase physical activity may help improve walking ability in older Americans.






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