Community ambulation in older adults: which internal characteristics are important?

Abstract

To examine the internal characteristics of older adults independent in community ambulation to gain further understanding of the skills required for its successful execution. Exploratory factor analysis. General community. Healthy, community dwelling older adults (N=113) who were cognitively intact and walked outdoors independently. Not applicable. Spatiotemporal gait parameters derived from accelerometry over 6 minutes walking outdoors and a battery of measures for motor, cognitive, executive, and behavioral characteristics. Mean participant age +/- SD was 75.8+/-7.3 years, with almost a third of the sample over 80 years. Four factors emerged from the Factor Analysis of 23 variables: motor control, self-efficacy, executive function, and cognitive-motor interference, which together explained 61.4% of common variance. Eight variables loaded onto motor control, accounting for 34.5% of common variance; 7 items loaded onto self-efficacy, which explained 12.4% of common variance; 5 variables loaded onto executive function, accounting for 8.4% of common variance; and 3 variables loaded onto cognitive-motor interference, explaining 6% of the variance. Results of this study indicate that factors beyond motor control contribute to independent community ambulation in older adults, reflecting the multidimensional, complex nature of the task. Self-efficacy was shown to be more relevant than executive function to gait performance, suggesting the need for a broader approach to assessment and intervention strategies.