Who walks? Factors associated with walking behavior in disabled older women with and without self-reported walking difficulty

OBJECTIVES: To determine how severity of walking difficulty and sociodemographic, psychosocial, and health-related factors influence walking behavior in disabled older women. DESIGN: Cross-sectional analyses of baseline data from the Women's Health and Aging Study (WHAS). SETTING: hn urban community encompassing 12 contiguous zip code areas in the eastern portion of Baltimore City and part of Baltimore County, il Maryland. PARTICIPANTS: A total of 920 moderately to severely disabled community-resident women, aged 65 years and older, identified from an age-stratified random sample of Medicare beneficiaries. MEASUREMENTS: Walking behavior was defined as minutes walked for exercise and total blocks walked per week. Independent variables included self-reported walking difficulty, sociodemographic factors, psychological status (depression, mastery, anxiety, and cognition), and health-related factors (falls and fear of falling, fatigue, vision and balance problems, weight, smoking, and cane use). RESULTS: Walking at least 8 blocks per week was strongly negatively related to severity of walking difficulty. Independent of difficulty level, older age, black race, fatigue, obesity, and cane use were also negatively associated with walking; living alone and high mastery had a positive association with walking. CONCLUSIONS: Even among functionally limited women, sociocultural, psychological, and health-related factors were independently associated with walking behavior. Thus, programs aimed at improving walking ability need to address these factors in addition to walking difficulties to maximize participation and compliance.