Promoting mobility in older people.

Out-of-home mobility is necessary for accessing commodities, making use of neighborhood facilities, and participation in meaningful social, cultural, and physical activities. Mobility also promotes healthy aging as it relates to the basic human need of physical movement. Mobility is typically assessed either with standardized performance-based tests or with self-reports of perceived difficulty in carrying out specific mobility tasks. Mobility declines with increasing age, and the most complex and demanding tasks are affected first. Sometimes people cope with declining functional capacity by making changes in their way or frequency of doing these tasks, thus avoiding facing manifest difficulties. From the physiological point of view, walking is an integrated result of the functioning of the musculoskeletal, cardio-respiratory, sensory and neural systems. Studies have shown that interventions aiming to increase muscle strength will also improve mobility. Physical activity counseling, an educational intervention aiming to increase physical activity, may also prevent mobility decline among older people. Sensory deficits, such as poor vision and hearing may increase the risk of mobility decline. Consequently, rehabilitation of sensory functions may prevent falls and decline in mobility. To promote mobility, it is not enough to target only individuals because environmental barriers to mobility may also accelerate mobility decline among older people. Communities need to promote the accessibility of physical environments while also trying to minimize negative or stereotypic attitudes toward the physical activity of older people.