Balance and mobility challenges in older adults: implications for preserving community mobility.

Mobility is a critical component of most activities of daily living. Therefore, maintenance of mobility independence is essential for health and well-being. Balance control is a primary requirement for successful mobility. In this article, we first discuss the challenges to mobility and balance that older adults face within the community. Next, we examine the implications for preserving mobility, in particular the efficacy of different types of exercise-based interventions that have been used. Exercise and training done in relatively sterile environments, such as a laboratory, do not simulate the environmental challenges one faces in the community and are not particularly beneficial. In addition, the outcome measure(s) used to evaluate the success of the intervention programs need to reflect improvement in functional mobility within the community. We propose a mobility envelope measured from excursions into the community over a week as a likely candidate for outcome measure.