Lower educational level increases the likelihood of preclinical changes in mobility in older women
Research Activities, January 2012, No. 377
If you have less than 9 years of schooling, you are more likely than someone with 12 or more years of education to report changing the way or how often you do at least one of four mobility tasks: walking 0.5 miles, climbing up steps, doing heavy housework, and getting in/out of a bed or chair, even though you don't report difficulty with the task, according to a new study. Such a change, made before difficulty with the task arises, is termed preclinical mobility disability (PCD), and has previously been identified as an independent predictor of functional decline in the elderly.
The study authors suggest that PCD is a marker for early attempts to preserve function by compensating for impairments at an early stage, when intervention may be beneficial. Using a longitudinal study of initially high-functioning older women, the researchers found that 66 of 174 women who had high mobility function at their baseline examination developed PCD during the study. Those women with less than 9 years of education were 3.1 times more likely to develop PCD during followup than did those with over 12 years of education—even after adjusting for age, race, income, number of diseases, and other factors. The number of chronic diseases a woman reported was the single other factor significantly associated with increased risk of PCD, which boosted PCD risk by 30 percent.
The researchers recruited 436 women, ages 70-79 years, from neighboring ZIP codes in Baltimore City and Baltimore County, MD. They interviewed the women at baseline and during six followup exams (all spaced 18 months apart, except for an average of 3 years between the third and fourth followup). The researchers suggest that future studies should evaluate the ability of interventions to aid women with lower education in accessing resources to prevent functional loss. The study was funded in part by the Agency for Healthcare Research and Quality (HS17956).
More details are in "Education predicts incidence of preclinical mobility disability in initially high-functioning older women: The Women's Health and Aging Study II," by Patricia C. Gregory, M.D., Sarah L. Szanton, Ph.D., M.S.N., Qian-Li Xue, and others in the May 2011 Journal of Gerontology: Medical Sciences 66A(5); pp. 577-581.