Education predicts incidence of preclinical mobility disability in initially high-functioning older women. The women's health and aging study II

Background. To examine the impact of educational attainment on the incidence of preclinical mobility disability (PCD). Methods. The Women's Health and Aging II Study is a prospective observational cohort study of 436 initially high-functioning community-dwelling women aged 70-79 years at baseline in Baltimore, Maryland. We measured the association of highest attained education level with preclinical mobility disability (PCD) over an 11-year period. PCD is defined as self-reported modification in any of four tasks without reporting difficulty in those tasks. The tasks were walking 1/2 mile, climbing up steps, doing heavy housework, and getting in/out of bed or chair. Results. Participants with less than 9 years of education were more likely to acquire incident PCD (hazard ratio: 3.1, 95% confidence interval = 1.2-7.7) than their counterparts with more education after adjusting for income, marital status, number of diseases, and high self-efficacy. Conclusions. Lower education level is an independent predictor of incident preclinical mobility disability. This association has important implications for primary and secondary prevention and can be easily assessed in clinical encounters.