Predicting catastrophic decline in mobility among older people

Objective: to investigate the associations between chronic health conditions, psychosocial and environmental factors and catastrophic decline in mobility among older people. Design: longitudinal cohort. Setting: national sample living in private households. Participants: nine hundred and ninety-nine adults aged ≥65 years at initial interview, of which 786 agreed to take part in a follow-up survey 12 months later, and 531 responded to the questionnaire. Measurements: catastrophic decline in mobility: inability to do any of the three activities of daily living items—walking 400 yards, climbing up and down stairs or steps and getting on a bus—having been capable of independently doing all three one year earlier. Results: similar annual rates of catastrophic decline were reported for men and women: 4.8 [95 % confidence interval (CI) 2.7–8.3] and 4.6 % (2.4–8.6), respectively. Strong associations were found between catastrophic decline and age>70 years, hearing problems and health deterioration, odds ratio (OR) 3.7 (95 % CI 1.1–11.8), 2.8 (1.1–7.3) and 4.3 (1.2–14.7), respec-tively. Poor perceptions of health, loss of control and feeling fearful also appeared to be important: below average summary psychological status, OR 6.5 (1.9–22.3). Inability to do heavy housework, carry heavy shopping or bend to cut own toenails