Functional limitations in women at midlife: the role of health conditions, behavioral and environmental factors


      This study examined risk factors for functional limitations in a community-based sample of 16,065 women from 5 ethnic groups, aged 40–55 years, enrolled in the Study of Women’s Health Across the Nation. Almost 20% of this sample reported physical-functioning limitations. Functional limitations were associated with numerous disease conditions, including high blood pressure, diabetes, heart attack or angina, arthritis, osteoporosis, and cancer, and with several behavioral and environmental risk factors, including body mass index, difficulty paying for basics, and high levels of perceived stress. Consistent with findings in older women, this study shows that in addition to health conditions, potentially modifiable risk factors including high body mass index, difficulty paying for basics, and high levels of stress are associated with physical-functioning limitations of women at midlife.
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        • National Center for Health Statistics
        Healthy People 2000 - Review 1993. US Department of Human Health Services, Hyattsville, MD 19941994
        • Schneider E.L
        • Guralnik J.M
        The aging of America.
        J Am Med Assoc. 1990; 236: 2335-2340
        • LaCroix A.Z
        • Guralnik J.M
        • Berkman L.F
        • Wallace R.B
        • Satterfield S
        Maintaining mobility in late life.
        Am J Epidemiol. 1993; 137: 858-869
        • Guralnik J.M
        • LaCroix A.Z
        Assessing physical function in older populations.
        in: Wallace R.B Woolson R.F The Epidemiologic Study of the Elderly. Oxford University Press, New York1992
        • Schultz-Larsen K
        • Avlund K
        • Kreiner S
        Functional ability of community dwelling elderly.
        J Clin Epidemiol. 1992; 45: 1315-1326
        • Guralnik J.M
        • Kaplan G.A
        Predictors of healthy aging.
        Am J Public Health. 1989; 79: 703-708
        • Kaplan G.A
        Maintenance of functioning in the elderly.
        Ann Epidemiol. 1992; 2: 823-834
        • Strawbridge W.J
        • Comacho T
        • Cohen R.D
        • Kaplan G.A
        Gender differences in factors associated with change in physical functioning in old age.
        Gerontologist. 1993; 33: 603-609
        • Verbrugge L.M
        • Patrick D.L
        Seven chronic conditions.
        Am J Public Health. 1995; 85: 173-182
      1. National Center for Health Statistics. Health, United States, 1996–1997 and Injury Chartbook. DHHS Publ. No. (PHS) 97–1232. Hyattsville, MD, U.S. Department of Health and Human Services; 1997.

      2. Centers for Disease Control. Current trends prevalence of disabilities and associated health conditions-United States, 1991–1992. MMWR, 1994;43:730–1, 737–9.

        • Sowers M.F.R
        in: Lobo R.A Kelsey J Marcus R Menopause Biology and Pathobiology. Academic Press, San Diego, CA2000
        • Nelson H.D
        • Nevitt M.C
        • Scott J.C
        • Stone K.L
        • Cummings S.R
        Smoking, alcohol, and neuromuscular and physical function of older women.
        JAMA. 1994; 272: 1825-1831
        • Becket L.A
        • Brock D.B
        • Lemke J.H
        • et al.
        Analysis of change in self-reported physical function among older persons in four population studies.
        Am J Epidemiol. 1996; 143: 766-778
        • Cohen S
        • Kamarck T
        • Mermelstein R
        A global measure of perceived stress.
        J Health Soc Behav. 1983; 24: 386-396
        • Hosmer D.W
        • Lemeshow S
        Assessing the fit of the model.
        in: Hosmer D.W Lemeshow S Applied Logistic Regression. John Wiley & Sons, Inc, New York1989: 135-175
        • Clark D.O
        • Stump T.E
        • Wolinsky F.D
        Predictors of onset of and recovery from mobility difficulty among adults aged 51–61 years.
        Am J Epidemiol. 1998; 148: 63-71
        • Ensrud K.E
        • Nevitt M.C
        • Yunis C
        • et al.
        Correlates of impaired function in older women.
        J Am Geriatr Soc. 1994; 42: 481-489
        • Harris T.B
        • Visser M
        • Everhart J
        • et al.
        Waist circumference and sagittal diameter reflect total body fat better than visceral fat in older men and women.
        Ann NY Acad Sci. 2000; 904: 462-473
        • Mor V
        • Murphy J
        • Masterson-Allen S
        • et al.
        Risk of functional decline among well elders.
        J Clin Epidemiol. 1989; 42: 895-904
        • Brill P.A
        • Giles W.H
        • Keenan N.L
        • et al.
        Effect of body mass index on activity limitation and mortality among older women.
        J Women’s Health. 1997; 6: 435-440
        • Huang Y
        • Macera C.A
        • Blair S.N
        • et al.
        Physical fitness, physical activity, and functional limitation in adults aged 40 and older.
        Med Sci Sports Exerc. 1998; 30: 1430-1435
        • Boult C
        • Kane R.L
        • Louis T.A
        • Boult L
        • McCaffrey D
        Chronic conditions that lead to functional limitation in the elderly.
        J Gerontol. 1994; 49: M28-M36
        • Thurston-Hicks A
        • Paine S
        • Hollifield M
        Functional impairment associated with psychological distress and medical severity in rural primary care patients.
        Psychiatr Serv. 1998; 49: 951-955
        • Armenian H.K
        • Pratt L.A
        • Gallo J
        • Eaton W.W
        Psychopathology as a predictor of disability.
        Am J Epidemiol. 1998; 148: 269-275