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Purpose: To analyze the associations between pain and physical performance in different aging contexts., Methods: Data from 1725 older adults from Canada, Brazil, Colombia, and Albania from the 2014 wave of the IMIAS were used to assess the associations between Back Pain (BP) or Lower Limb Pain (LLP) and physical performance by the Short Physical Performance Battery (SPPB). Three binary logistic regression models adjusted for sex, age, study site, education, income sufficiency, BMI, depressive symptoms, and chronic conditions were used to estimate the associations between LLP or BP and SPPB. The SPPB was classified into good performance (8 points or more) and poor physical performance (< 8 points)., Results: The mean age of the older men was 71.2 (± 3.0) and the mean age of the women was 71.2 (± 2.8) years. Older men (72.8%, p < 0.05) and women (86.1%, p-value < 0.05) from Albania had the highest frequencies of self-reported general pain. Older women in Colombia had the highest frequencies of LLP or BP (33.5%, p-value < 0.05). In the fully adjusted logistic regression model, LLP or BP was significantly associated with poor SPPB (OR = 0.48, 0.35 to 0.66 95% CI, p < 0.01)., Conclusions: Pain symptoms are associated with reduced physical performance in older people, even when adjusted for other clinical and sociodemographic factors. Protocols for aiming to increase the level of physical activity to manage pain should be incorporated into health care strategies., (© 2023. The Author(s), under exclusive licence to European Geriatric Medicine Society.)

Objectives: To investigate a 4-year longitudinal relationship between falls, recurrent falls, and injurious falls, according to different levels of life-space mobility (LSM)., Methods: Longitudinal analysis of an international cohort study. The participants were older adults from the International Mobility in Aging Study (IMIAS) aged between 65 and 74 years at baseline. Three waves of data (2012, 2014, 2016) were used. Fall history during the past year was recorded. Recurrent fallers were identified as those who fell at least twice and injurious fallers as participants who required medical attention. LSM measurements included Total Life-Space (LS-C), Maximal Life-Space (LS-M), Assisted Life-Space (LS-A), Independent Life-Space (LS-I) and Restricted Life-space (LS-ID) scores. Generalized estimation equation (GEE) models were used to determine whether life-space mobility measures and their change over time differed between recurrence of falls and injurious falls., Results: At baseline, the prevalence of falls in the last year was 28%. 11.8% reported recurrent falls and 2.6% had serious injurious falls in the last year preceding the assessments. Recurrent fallers were more likely to be female, with insufficient income and, with comorbidities. GEE models showed that life-space mobility was lower among those with recurrent falls or serious injurious falls compared to those who never fell, but the rate of change did not differ over the 4-year follow-up except for the LS-A and LS-I scores, where some improvements were observed over time., Conclusions and Implications: Falls were independently associated with a decrease in LSM over 4 years. Targeting older adults with recurrent and injurious falls with appropriate interventions may improve community mobility and social participation.

Background: fear of falling (FOF) is a major health concern among community-dwelling older adults that could restrict mobility., Objective: to examine the association of FOF with life-space mobility (i.e. the spatial area a person moves through in daily life) of community-dwelling older adults from five diverse sites., Methods: in total, 1,841 older adults (65-74 years) were recruited from Kingston, Canada; Saint-Hyacinthe, Canada; Tirana, Albania; Manizales, Colombia and Natal, Brazil. FOF was assessed using the Fall Efficacy Scale-International (FES-I total score), and the life space was quantified using the Life-Space Assessment (LSA), a scale that runs from 0 (minimum life space) to 120 (maximum life space)., Results: the overall average LSA total score was 68.7 (SD: 21.2). Multiple-linear regression analysis demonstrated a significant relationship of FOF with life-space mobility, even after adjusting for functional, clinical and sociodemographic confounders (B = -0.15, 95% confidence interval (CI) -0.26 to -0.04). The FOF × site interaction term was significant with a stronger linear relationship found in the Canadian sites and Tirana compared with the South American sites. After adjusting for all confounders, the association between FOF with LSA remained significant at Kingston (B = -0.32, 95% CI -0.62 to -0.01), Saint-Hyacinthe (B = -0.81, 95% CI -1.31 to -0.32) and Tirana (B = -0.57, 95% CI -0.89 to -0.24)., Conclusion: FOF is an important psychological factor that is associated with reduction in life space of older adults in different social and cultural contexts, and the strength of this association is site specific. Addressing FOF among older adults would help improve their mobility in local communities, which in turn would improve social participation and health-related quality of life., (© The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com)

Objectives: To examine the relationships between physical function and gender-stereotyped traits and whether these relationships are modified by sex or social context., Methods: A total of 1995 community-dwelling older adults from the International Mobility in Aging Study (IMIAS) aged 65 to 74 years were recruited in Natal (Brazil), Manizales (Colombia), Tirana (Albania), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). We performed a cross-sectional analysis. Study outcomes were mobility disability, defined as having difficulty in walking 400 meters without assistance or climbing a flight of stairs without resting, and low physical performance, defined as a score < 8 on the Short Physical Performance Battery. The 12-item Bem Sex Role Inventory (BSRI) was used to classify participants into four gender roles (Masculine, Feminine, Androgynous, and Undifferentiated) using site-specific medians of femininity and masculinity as cut-off points. Poisson regression models were used to estimate prevalence rate ratios (PRR) of mobility disability and poor physical performance according to gender roles., Results: In models adjusted for sex, marital status, education, income, and research site, when comparing to the androgynous role, we found higher prevalence of mobility disability and poor physical performance among participants endorsing the feminine role (PRR = 1.20, 95% confidence interval (CI) 1.03-1.39 and PRR = 1.37, CI 1.01-1.88, respectively) or the undifferentiated role (PRR = 1.23, 95% CI 1.07-1.42 and PRR = 1.58, CI 1.18-2.12, respectively). Participants classified as masculine did not differ from androgynous participants in prevalence rates of mobility disability or low physical performance. None of the multiplicative interactions by sex and research site were significant., Conclusion: Feminine and undifferentiated gender roles are independent risk factors for mobility disability and low physical performance in older adults. Longitudinal research is needed to assess the mediation pathways through which gender-stereotyped traits influence functional limitations and to investigate the longitudinal nature of these relationships.

With an aging population, hip fractures and recovery from hip fractures are becoming a growing public health concern. Recovery after hip fractures is particularly challenging in those who are frail. Typically, frail patients with hip fractures are seen in acute care settings and followed as they transition to inpatient and/or outpatient rehabilitation. This article first summarizes existing literature describing the relationship between frailty and hip fracture and then provides a review of evidence about caring for this population in various care settings with special consideration for frail patients. To conclude, it outlines recommendations for future clinical rehabilitation research for frail patients with hip fractures. [ABSTRACT FROM AUTHOR]

Highlights • Women had a higher adjusted incidence of ADL and mobility disability over time. • Women have higher incidences of disability in self-reported outcomes measures, but not not necessarly in performance-based measures. • Future research should focus on exploring sources of discrepant self-reporting of incident disability between men and women. Abstract Objectives To examine differences in incidence of functional disability between older women and men. Methods 2002 participants (65–74 years) were recruited in 2012 from Canada, Brazil, Colombia, and Albania, and re-assessed in 2016. Three measures of functional disability were used (1) Difficulty in any of five mobility-related Activities of Daily Living (ADL disability); (2) Self-reported difficulty climbing a flight of stairs or walking 400 m (mobility disability); and (3) Poor physical performance. We estimated the adjusted gender-specific incidence risk ratios (IRR) for each outcome in 2016. Results In 2016, 1506 participants (52% women) were re-examined, 80% of the surviving cohort. Among those not disabled in 2012, seventy-four (12.9%) men developed ADL disability, while 105 (19.2%) developed mobility disability, and 97 (16.1%) developed poor physical performance. For women, numbers were higher 120 (21.4%) developed ADL disability, 117 (26.5%) developed mobility disability, and 140 (23.0%) developed poor physical performance. Compared to men, women had a higher adjusted incidence of self-reported ADL disability (IRR 1.4; 95% CI 1.04–1.88) and mobility disability (IRR 1.4; 95% CI 1.06–1.77), but not of poor physical performance (IRR 1.03; 95% CI 0.88–1.32). Conclusions Although women have a higher self-reported incidence of ADL and mobility disability than men, there was no significant difference in poor physical performance. Reasons for this discrepancy between self-reported and performance-based measures require further investigation. Understanding gender differences in functional disabilities can provide the basis for interventions to prevent mobility loss and minimize any gender gap. [ABSTRACT FROM AUTHOR]

Objective: We estimated the 2-year incidence of poor physical performance according to gender roles and examined mediating pathways related to health behaviors and chronic conditions. Method: Data are from the International Mobility in Aging Study (n = 1,676). The Bem Sex Role Inventory was used to classify participants into four gender roles as “masculine,” “feminine,” “androgynous,” and “undifferentiated.” Results: We found a higher incidence of poor physical performance among participants endorsing the feminine (adjusted incidence rate ratio [IRR] = 2.36, 95% confidence interval (CI) = [1.55, 3.60]) or the undifferentiated role (adjusted IRR = 2.19, 95% CI = [1.45, 3.30]) compared with the androgynous role. Smoking, physical activity, the number of chronic conditions, high body mass index, and depression were mediators of this association but not alcohol consumption. Discussion: This study provides evidence that gender roles are independently associated with physical performance. Health behaviors and chronic conditions are mediators of the relationship between gender roles and lower extremity physical function. [ABSTRACT FROM AUTHOR]

Objective Primary care practitioners need simple algorithms to identify older adults at higher risks of falling. Classification and regression tree (CaRT) analyses are useful tools for identification of clinical predictors of falls. Design Prospective cohort. Setting Community-dwelling older adults at 5 diverse sites: Tirana (Albania), Natal (Brazil), Manizales (Colombia), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). Participants In 2012, 2002 participants aged 65–74 years from 5 international sites were assessed in the International Mobility in Aging Study. In 2014 follow-up, 86% of the participants (n = 1718) were reassessed. Measurements These risk factors for the occurrence of falls in 2014 were selected based on relevant literature and were entered into the CaRT as measured at baseline in 2012: age, sex, body mass index, multimorbidity, cognitive deficit, depression, number of falls in the past 12 months, fear of falling (FoF) categories, and timed chair-rises, balance, and gait. Results The 1-year prevalence of falls in 2014 was 26.9%. CaRT procedure identified 3 subgroups based on reported number of falls in 2012 (none, 1, ≥2). The 2014 prevalence of falls in these 3 subgroups was 20%, 30%, and 50%, respectively. The “no fall” subgroup was split using FoF: 30% of the high FoF category (score >27) vs 20% of low and moderate FoF categories (scores: 16–27) experienced a fall in 2014. Those with multiple falls were split by their speed in the chair-rise test: 56% of the slow category (>16.7 seconds) and the fast category (<11.2 seconds) had falls vs 28% in the intermediate group (between 11.2 and 16.7 seconds). No additional variables entered into the decision tree. Conclusions Three simple indicators: FoF, number of previous falls, and time of chair rise could identify those with more than 50% probability of falling. [ABSTRACT FROM AUTHOR]

• Feminine and undifferentiated gender roles were related to poor self-rated health. • Gender roles confer risks and benefits independent of biological sex. • Female sex, insufficient income and study site also associated with self-rated health. To examine the relationship between gender roles and self-rated health in older men and women from different contexts. 2002 community-dwelling older adults from the International Mobility in Aging Study were recruited from 5 research sites. Gender role was measured with the 12-item Bem Sex Role Inventory, which categorized study participants into four gender roles: Masculine, Feminine, Androgynous, and Undifferentiated. Self-rated health was collapsed into a dichotomous variable (Very Good/Good and Fair/Poor/Very Poor). Prevalence risk ratios (PRR) of self-rated health relative to gender roles were estimated with Poisson regression models adjusted for all relevant confounders. After complete adjustment, feminine (PRR 1.22 (95 % CI 1.01–1.49)) and undifferentiated (PRR 1.25 (95 % CI 1.05–1.50)) gender roles were associated with poorer relative self-rated health. Gender roles confer independent risks and benefits for self-rated health in older adults. [ABSTRACT FROM AUTHOR]

We examined the lower extremity function trajectories of older men and women over 4 years and baseline predictors of these trajectories. Longitudinal analysis of an international cohort study. Older adults from the International Mobility in Aging Study (IMIAS) aged between 65 and 74 years at baseline. Physical performance of the lower extremities was measured in 2012, with follow-ups in 2014 and in 2016, using the Short Physical Performance Battery (SPPB). Group-based trajectory analysis of physical performance by gender was performed. Multinomial logistic regression was used to derive relative risk ratios with 95% confidence intervals between the physical performance trajectories and the potential baseline predictors in men and women separately. Three physical performance trajectories were identified in men and women: high-stable (30.0% vs 35.5%), gradual functional decline (63.1% vs 54.3%), and rapid functional decline (6.9% vs 10.2%). Common baseline characteristics associated with memberships in the gradual functional decline and rapid functional decline trajectory groups in men and women were age, single marital status, and multiple chronic conditions (>3). Among men, depression was a strong predictor of the membership in the rapid functional decline trajectory group. Women in the rapid functional decline trajectory group were more likely to be obese, with feminine and undifferentiated gender roles, and have poor self-rated health at baseline. There are gender differences in the physical performance trajectories and related factors among older adults. Programs aiming at preventing or slowing functional decline in old age should be sensitive to gender. [ABSTRACT FROM AUTHOR]