Age and Ageing Advance Access published online on May 16, 2008
Age and Ageing, doi:10.1093/ageing/afn092
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Neighbourhood deprivation and incident mobility disability in older adults
1 Epidemiology and Public Health Group, Peninsula Medical School, Exeter EX2 5DW, UK
2 Institute for Public Health, School of Clinical Medicine, University of Cambridge, Cambridge CB2 2SR, UK
3 Division of General Medicine, University of Michigan, Ann Arbor, MI 48109, USA
4 Department of Epidemiology, College of Public Health, E107 General Hospital, The University of Iowa, Iowa City, IA 52242, USA
Address correspondence to: Dr Iain Lang. Tel: +44 (0)1392 406749. E-mail: iain.lang{at}pms.ac.uk
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.
Keywords: Elderly, walking, local, gait speed, socio-economic status, community
Received 21 May 2007; accepted in revised form 11 December 2007.
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