Onset of mobility disability among community-dwelling old men and women. The role of tiredness in daily activities.

BACKGROUND in the primary prevention of disability among older adults it might be useful to identify individuals at high risk for functional decline before it occurs. OBJECTIVE to examine whether tiredness in daily activities is an independent determinant of onset of mobility disability at 1 1/2-year follow-up among non-disabled older men and women. DESIGN a prospective study with 1 1/2-year follow-up. SETTING 34 communities in four counties in Denmark. SUBJECTS 1396 older non-disabled adults (74-75 and 80 years old) living in 17 of the participating communities. METHODS questionnaire surveys at baseline and at 1 1/2-year follow-up. Tiredness in daily activities was measured by questions about tiredness in six mobility activities. Onset of mobility disability was measured as onset of need for help in one to six mobility activities. RESULTS men and women who felt tired in their daily activities at baseline had a higher risk of onset of mobility disability at 1 1/2-year follow-up, when adjusted by the covariates. In addition, low social participation, poor psychological function, and physical inactivity were independent risk factors of onset of mobility disability among men, and home help, low sense of coherence and physical inactivity were independent risk factors of onset of mobility disability among women. CONCLUSION older people who complain about tiredness are at higher risk of becoming disabled than others. This highlights the need for alertness and management of this early sign of functional decline in a preventive perspective.