Restricted yet expanded: A case study of mobility adaptations among older adults with mild cognitive impairment in Zhengzhou, China

Abstract

Introduction

Cognitive impairment is likely to restrict older adults' mobility. Most existing evidence has examined the declining mobility of older adults with mild cognitive impairment (MCI) and proposed ways to improve neighborhood environments to support this vulnerable group. Yet these older adults’ nuanced experiences and perceptions of adapting to changing mobility remain understudied. Integrating community gerontology and the preventive and corrective proactivity model, this study explores how older adults with MCI adapt to their changing mobility in their neighborhood environment.

Methods

Through snowball sampling, we took a phenomenological approach and conducted in-depth interviews with community-dwelling older adults with MCI in Zhengzhou, China (N = 34). We performed a thematic analysis of participants’ experiences of mobility changes, their adaptions to these mobility changes, and their interactions with neighborhood environments.

Results

Three themes emerged: experiencing mobility changes; ambivalent family responses to mobility changes; and continual interactions with the neighborhood environment. Participants recognized cognitive decline and mobility changes while trying to sustain their existing mobility, which was protected by their neighborhood-based social networks and mutual support. Their restricted mobility in the physical environment was bolstered and even expanded by their neighborhood social environment.

Conclusion

We identified three dynamics of participants' mobility adaptation: within individual participants' own functioning; with family members; and within their neighborhood environment. These interactions enhanced participants' adaptive efforts to maintain their mobility by integrating supports from family members and neighborhood networks, highlighting the importance of developing neighborhood physical and social features to support older adults’ changing cognitive and mobility functioning.