Gregory PC, Fried LP: Why Do Older Adults Decide They Are Having Difficulty with a Task? Am J Phys Med Rehabil 2003;82:9–16.
Previous studies have identified risk factors for decline in physical function, but they have not examined specific reasons older adults report difficulty with mobility tasks.
Community-dwelling people (n = 160) aged 59 yr and older in an observational cohort study were questioned to determine the most common cited reasons for self-reported difficulty in task performance.
Mobility tasks were most often reported to be difficult (66%). The reasons cited for difficulty in low exercise tolerance tasks were task modification by method (33%) and rate (33%). For high exercise tolerance tasks, reasons cited included having to modify the rate of performing the task (20%) or the method (13%). Among those who reported difficulty with low exercise tolerance mobility tasks, >80% reported modification (odds ratio, 46.4 [95% confidence limits: 9.75, 220.51]) and 32% also report frequency change (odds ratio, 5.9 [95% confidence limits: 2.72, 12.85]) as the reason for perceiving difficulty. For those who reported difficulty performing high exercise tolerance–demanding tasks, >90% reported modification (odds ratio, 5.5 [95% confidence limits: 2.05, 14.88]) and 61% also report frequency changes (odds ratio, 3.9 [95% confidence limits: 1.93, 8.04]).
The findings suggest that people are able to cite specific reasons for difficulty with mobility task performance, most commonly related to task modification.
From the Departments of Physical Medicine and Rehabilitation (PCG) and Medicine (LPF), The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Presented as a poster presentation at the Gerontological Society of America Annual Assembly, San Francisco, California, November 1999, and as a poster presentation at the Association of Academic Physiatrists Annual Meeting, Las Vegas, Nevada, February 28, 2002.
Supported by National Institute on Aging grant R01AG11703 (P. C. Gregory) and OPD GCRC Pilot Study RR007122.
Address all correspondence and requests for reprints to Patricia C. Gregory, MD, Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Good Samaritan Professional Office Building, Suite 406, 5601 Loch Raven Boulevard, Baltimore, MD 21239.