Neighbourhood deprivation and incident mobility disability in older adults

Iain A Lang, David J Llewellyn, Kenneth M Langa, Robert B Wallace, David Melzer
Age and Ageing 2008, 37 (4): 403-10

OBJECTIVE: to assess whether incident mobility disability and neighbourhood deprivation in older people are associated independent of the effects of individual socio-economic status, health behaviours and health status.

METHODS: prospective cohort study with a 2-year follow-up.

SETTING: the English Longitudinal Study of Ageing (ELSA), a national probability sample of non-institutionalised older people.

PARTICIPANTS: 4,148 participants aged 60 years and over.

MEASUREMENTS: exposure was a census-based index of neighbourhood deprivation [the Index of Multiple Deprivation (IMD)]; outcomes were measured and self-reported incident mobility difficulties.

RESULTS: neighbourhood deprivation had a statistically significant effect on physical function following adjustment for individual socio-economic factors, health behaviours and health status. Compared to those living in the least deprived 20% of neighbourhoods, those in the most deprived neighbourhoods had a risk ratio (RR) of incident self-reported mobility difficulties of 1.75 (95% CI 1.14-2.70) and RR of incident-impaired gait speed of 1.63 (95% CI 1.01-2.62). In adjusted models, 4.0 per 100 (95% CI 3.0-5.4) older adults in neighbourhoods in the least deprived 20% had incident mobility difficulties over a 2-year period, whereas 13.6 per 100 (95% CI 10.5-17.4) older adults had incident mobility difficulties in neighbourhoods in the most deprived 20%.

CONCLUSIONS: older people living in deprived neighbourhoods are significantly more likely to experience incident mobility difficulties than those in less-deprived neighbourhoods. The mechanisms underlying this relationship are unclear and research to identify mechanisms and appropriate interventions is needed.

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