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Projecting long-term trends in mobility limitations: impact of excess weight, smoking and physical inactivity
  1. Tommi Härkänen1,
  2. Päivi Sainio1,
  3. Sari Stenholm2,
  4. Annamari Lundqvist1,
  5. Heli Valkeinen1,
  6. Arpo Aromaa1,
  7. Seppo Koskinen1
  1. 1 National Institute for Health and Welfare, Helsinki, Finland
  2. 2 Department of Public Health, University of Turku, Turku, Finland
  1. Correspondence to Dr Tommi Härkänen, National Institute for Health and Welfare, PO Box 30, Helsinki FI-00271, Finland; tommi.harkanen{at}


Background Policy makers need disability projections for planning adequate services and measures for health promotion. The aim of this study is to provide projections on severe mobility limitations up to year 2044 and illustrate how the projected prevalence and the number of persons with severe mobility limitations are affected by potential changes in the modifiable risk factors, namely excess weight, physical inactivity and smoking.

Methods We analysed the nationally representative, repeated measures Health 2000 and 2011 Surveys (BRIF8901) with 8615 and 6740 participants, respectively, aged 18 years and older. Severe mobility limitations were defined as major difficulties or unable to walk about half a kilometre. We applied a multistate model on repeated measures to account for both individual risk factors and their changes over time.

Results The number of people with severe mobility limitations was projected to double by the year 2044 in Finland, due to the rapid ageing of the population. Eliminating half of the excess weight would reduce their number by one-fifth, while reductions in the prevalence of smoking and physical inactivity would have a minor impact. Even if excess weight, smoking and physical inactivity were completely eliminated, the number of persons with severe mobility limitations is projected to increase.

Conclusions Designing and implementing strategies to promote healthy weight are important to slow down the rapid increase in mobility limitations due to population ageing. Providing adequate health and social services for the increasing population with disabilities will nevertheless be an increasing national challenge.

  • ageing
  • longitudinal studies
  • obesity
  • public health
  • physical function

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  • TH and PS contributed equally.

  • Contributors TH and PS contributed equally in the manuscript preparation. TH, PS and SK participated in concept and design, and all authors participated in interpretation, writing and approved the final version.

  • Funding This work was supported by the Academy of Finland (grant numbers 266251, 286294, 294154 and 307907).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Both surveys were approved by the Ethics Committee of the Hospital District of Helsinki and Uusimaa.

  • Provenance and peer review Not commissioned; externally peer reviewed.