Projecting long-term trends in mobility limitations: impact of excess weight, smoking and physical inactivity

Abstract

BackgroundPolicy makers need disability projections for planning adequate services and measures for health promotion. The aim of this study is to provide projections on severe mobility limitations up to year 2044 and illustrate how the projected prevalence and the number of persons with severe mobility limitations are affected by potential changes in the modifiable risk factors, namely excess weight, physical inactivity and smoking.MethodsWe analysed the nationally representative, repeated measures Health 2000 and 2011 Surveys (BRIF8901) with 8615 and 6740 participants, respectively, aged 18 years and older. Severe mobility limitations were defined as major difficulties or unable to walk about half a kilometre. We applied a multistate model on repeated measures to account for both individual risk factors and their changes over time.ResultsThe number of people with severe mobility limitations was projected to double by the year 2044 in Finland, due to the rapid ageing of the population. Eliminating half of the excess weight would reduce their number by one-fifth, while reductions in the prevalence of smoking and physical inactivity would have a minor impact. Even if excess weight, smoking and physical inactivity were completely eliminated, the number of persons with severe mobility limitations is projected to increase.ConclusionsDesigning and implementing strategies to promote healthy weight are important to slow down the rapid increase in mobility limitations due to population ageing. Providing adequate health and social services for the increasing population with disabilities will nevertheless be an increasing national challenge.

Using multiple imputation and intervention-based scenarios to project the mobility of older adults

“…Our projections suggest that the prevalence of walking limitations will decrease between 2012 and 2026 while there will be no change in the prevalence of stair climbing limitations. Other studies have reported an increase in mobility limitations in the future [ 23 , 59 ]. Our results may be due to the selection proportion of variable study being lower for walking limitations compared to stair climbing limitations (Table 2 ), which in turn caused the study-specific projections to develop similarly to each other (Fig.…”

“…The intervention effect (scenarios 1 and 2) was incorporated when generating values for 2014. Our method was presented by Härkänen et al [ 23 ].…”

Projections for obesity, smoking and hypertension based on multiple imputation

“…It could be investigated how fixing the values of some variables to the level of interest would change the projection of a health indicator. These kinds of scenario projections have been carried out using longitudinal data, for instance, in Härkänen et al [ 18 ], in which the number of people with mobility limitations was projected. Instead of setting the predictor into a single value, a more realistic scenario could be tested by generating values of the predictor from a distribution possibly depending on some other background variables agreeing to the scenario.…”