Gender differences in lower extremity function in Latin American elders - Seeking explanations from a life-course perspective

Objective: The authors examined the contribution of life-course exposures to gender differences in mobility in later life. Method: Data originate from a survey of persons aged 60 and older living in six Latin American and Caribbean cities (n = 10,661). Lower extremity limitations (LEL) were defined as the presence of three or more reported difficulties with five activities: lifting and carrying 10 lb, walking several blocks, climbing a flight of stairs, kneeling/stooping/crouching, and getting up from a chair. Data were pooled after testing homogeneity of effects across cities. A multivariate model was fitted using logistic regression analysis. Complete data analyses were performed on 8,166 (72%) participants. Results: Prevalence of LEL varies across cities (9.3-23.7% in men, 23.3-42.9% in women). Intervening life-course and health factors explained a small proportion of the gender difference in LEL (odds ratio = 2.39; 95% confidence interval = 2.04-2.79). Childhood hunger was predictive of LEL in women, and a stronger association between depression and LEL was found in men than in women. Little education and insufficient income were associated with LEL for both men and women. Discussion: Life-course exposures predict mobility, but further research is needed to identify intervening factors relating gender to mobility in old age.