Prevalence and incidence of mobility limitation in Chinese older adults: evidence from the China health and retirement longitudinal study

BACKGROUND: Mobility limitation, a manifestation of impaired intrinsic capacity, is the first obvious sign of functional decline. However, few studies have been conducted on the prevalence and incidence of mobility limitation. This study aimed to estimate the prevalence and incidence of mobility limitation in Chinese older adults (over 60 years old) and evaluate its impact on mortality. METHODS: The study used two waves of data from China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2013. The prevalence and incidence of mobility limitation were assessed using the methods recommended by the World Health Organization in the integrated care for older people guidelines, using the five-time sit-to-stand test as a screening and then the Short Physical Performance Battery assessment for diagnosis. Multivariable logistic regression was used to analyze the association between mobility limitation and death. RESULTS: Of the 5507 participants with complete baseline data, 1486 had limited mobility, and 4021 had intact mobility at baseline; 4093 participants completed follow-up assessment 2 years later, and 189 died between the baseline and follow-up assessments. Of the 2828 participants with intact mobility at baseline who completed the follow-up mobility assessment, 408 developed mobility limitation. The standardized prevalence was 30.4% (95% CI = 28.8-32.1 %). The standardized incidence of mobility limitation in 2 years was 18.1% (95% CI = 15.8-20.4 %). A total of 189 patients died during the follow-up period. After adjusting for sociodemographic factors and chronic diseases, mobility limitation was associated with an increased risk of death (odds ratio = 1.84, 95% CI = 1.33-2.55, P < .001). CONCLUSIONS: The standardized prevalence of mobility limitation in Chinese older adults living in the community was 30.4%, and the standardized incidence was 18.1%. Mobility limitation significantly predicts 2-year death in older adults. This suggests that early screening, assessment of intrinsic capacity (particularly locomotion domain) as well as tailored interventions to tackle mobility limitation in older adults might reduce mortality.