Construct and Predictive Validity of a Self-Reported Measure of Preclinical Mobility Limitation

Mänty M, Heinonen A, Leinonen R, Törmäkangas T, Sakari-Rantala R, Hirvensalo M, von Bonsdorff MB, Rantanen T. Construct and predictive validity of a self-reported measure of preclinical mobility limitation.

Objectives

To validate self-reported preclinical mobility limitation concept and self-report assessment method against muscle power and walking speed, and to study the predictive validity of preclinical mobility limitation with respect to future risk of manifest mobility limitation.

Design

Observational prospective cohort study and cross-sectional analysis.

Setting

Research laboratory and community.

Participants

A total of 632 community-living (age range, 75−81y) women and men took part in the baseline assessments and 302 persons in the semi-annual interviews on mobility limitation over 2 years.

Interventions

Not applicable.

Main Outcome Measures

Walking speed, muscle power, and self-reported preclinical and manifest mobility limitation. Preclinical mobility limitation was defined as self-reported tiredness or modification of task performance without task difficulty. At baseline, 4 subgroups were created according to self-reported preclinical mobility limitation in any of 3 mobility tasks (walking 2km, walking 0.5km, climbing up stairs): no limitation, preclinical limitation, and minor and major manifest limitation.

Results

At baseline, participants with preclinical mobility limitation showed intermediate levels of walking speed and muscle power, compared with those with no limitation or manifest mobility limitation. Participants reporting baseline preclinical mobility limitation had 3- to 6-fold higher age- and sex-adjusted risk of progressing to major manifest mobility limitation during the 2-year follow-up compared with participants with no limitation at baseline, whereas the risk among those with minor limitation at baseline was 14- to 18-fold higher compared with those with no limitation.

Conclusions

The self-report assessment tool proved to be a valid measure to capture the early signs of disability and may serve as an inexpensive tool for identifying those nondisabled persons at high risk for future disability.