Simonsick E M, Guralnik J M, Fried L P
Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, Maryland 20892-9205, USA.
J Am Geriatr Soc. 1999 Jun;47(6):672-80. doi: 10.1111/j.1532-5415.1999.tb01588.x.
To determine how severity of walking difficulty and sociodemographic, psychosocial, and health-related factors influence walking behavior in disabled older women.
Cross-sectional analyses of baseline data from the Women's Health and Aging Study (WHAS).
An urban community encompassing 12 contiguous zip code areas in the eastern portion of Baltimore City and part of Baltimore County, Maryland.
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.
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).
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.
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.
确定步行困难的严重程度以及社会人口学、心理社会和健康相关因素如何影响残疾老年女性的步行行为。
对妇女健康与衰老研究（WHAS）的基线数据进行横断面分析。
一个城市社区，涵盖马里兰州巴尔的摩市东部12个相邻的邮政编码区域以及巴尔的摩县的一部分。
从医疗保险受益人的年龄分层随机样本中确定的920名中度至重度残疾的社区居住女性，年龄在65岁及以上。
步行行为定义为每周用于锻炼的步行分钟数和步行的总街区数。自变量包括自我报告的步行困难、社会人口学因素、心理状态（抑郁、掌控感、焦虑和认知）以及健康相关因素（跌倒和害怕跌倒、疲劳、视力和平衡问题、体重、吸烟和使用拐杖）。
每周至少步行8个街区与步行困难的严重程度呈强烈负相关。与困难程度无关，高龄、黑人种族、疲劳、肥胖和使用拐杖也与步行呈负相关；独居和高掌控感与步行呈正相关。
即使在功能受限的女性中，社会文化、心理和健康相关因素也与步行行为独立相关。因此，旨在提高步行能力的项目除了解决步行困难外，还需要解决这些因素，以最大限度地提高参与度和依从性。
