The purpose of this study was to stratify an older adult population for subsequent interventions based on functional ability, and to estimate prevalence, characteristics and impact of mobility limitations on health outcomes. In 2016, surveys were sent to a stratified random sample of AARP Medicare Supplement insureds; mobility limitations were defined using two screening questions. Responses were stratified to three mobility limitation levels. Multivariate regression models determined characteristics and impact on health outcomes. Among weighted survey respondents (N = 15,989), severe, moderate and no limitation levels were 21.4%, 18.4% and 60.3%, respectively. The strongest predictors of increased limitations included pain and poor health. Individuals with more severe limitations had increased falls, decreased preventive services compliance and increased healthcare utilization and expenditures. Utilizing two screening questions stratified this population to three meaningful mobility limitation levels. Higher levels of mobility limitations were strongly associated with negative health outcomes. Mobility-enhancing interventions could promote successful aging.
Social Determinants of Health (SDOH) are defined as the broad community-scale conditions and factors shaping daily life. Meanwhile, less is known about the personal, individual-level characteristics impacting health outcomes. These have not been defined as a construct, leaving a gap in overall understanding of the resources that shape healthy and successful aging. Our primary purpose is to propose and define a new construct encompassing critical personal resources to be known as the Personal Determinants of Health (PDOH), built on resilience as a key strength later in life and supported by factors that buffer challenges and declining health. A literature search was conducted to streamline the scope of this review, with key terms determined to identify relevant publications; common databases and resources were utilized. Search strategies failed to identify a standard definition for Personal Determinants of Health as a construct, nor does this term exist regarding applied initiatives with older adults. Thus, a clear opportunity exists to establish PDOH as a unique construct. Despite evidence that individual characteristics impact late-life health outcomes, these key personal resources have not been established as a separate construct. Thus, we propose to define PDOH with a foundation of resilience supported by selected personal resources. Establishing this new construct will be critical in designing initiatives to support older adults and improve their health outcomes.
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