"Head and Neck Injury and Walking Difficulty in Adults: Health Retirement Study"

Research Objectives To determine if the associations between self-reported head or neck injury and walking difficulty differs by gender. Design Cross-Sectional analysis of the 2014 interview wave of the U.S. Health and Retirement Study. Setting Community-dwelling middle-aged and older adults in the United States. Participants We identified 1,478 participants who responded to a questionnaire about whether they have experienced a head or neck injury from a vehicle accident, fall, sports, or violent act (i.e. fight, shot, explosion) Half (n=742) of the participants responded "yes" to a questionnaire about whether they have experienced a head or neck injury. Main Outcome Measures Walking Difficulty was the main outcome measure. All participants were asked, “Because of a health problem, do you have difficulty walking several blocks”? Participants could respond with “yes”, “no”, “can’t do”, or “doesn’t do”. We categorized participants who responded yes, can’t do, or don’t do as having difficulty walking. All other participants were categorized as not having difficulty walking several blocks. Results Nearly 60% of participants (59.8%) were female, and the, mean age was of 67.0. Those who reported having experienced a head or neck injury, compared to participants who did not report having experienced a head or neck injury, were approximately three years younger on average (65.8 years vs. 68.4 years, p< 0.01) and were more likely to be male (47.0% vs. 33.4%, p< 0.01). Among the 465 (31.5%) reporting walking difficulty, ages ranged from 32 to 99 years of age. Thirty-two percent of all participants reported they had difficulty walking. In a logistic regression model adjusting for age, sex, and education, having head or neck injury was associated with 1.73 (95% CI=1.36 – 2.20) higher odds of having difficulty walking. This association was similar for men (OR=1.79, 95% CI=1.20-2.69) and women (OR=1.69, 95% CI=1.26-2.28. Conclusions These findings are evidence that having experienced a head or neck injury is associated with difficulty walking several blocks among middle-aged and older adults, but that this association is similar for men and women.