Self-reported functional and mobility limitations in mid-life: a systematic review of prevalence and association with chronic health conditions.

Authors

Roee Hayek, Shmuel Springer, Rebecca T Brown

Published in

BMC public health. Jun 19, 2026. Epub Jun 19, 2026.

Abstract

Middle age is increasingly recognized as a critical period for the emergence of functional and mobility limitations. However, no prior systematic review has synthesized prevalence or incidence data specifically for this age group. This review aimed to summarize epidemiological evidence on self-reported functional and mobility limitations among middle-aged adults and to examine their associations with chronic conditions.
This systematic review was registered in PROSPERO (CRD420251038883) and conducted in accordance with PRISMA 2020 guidelines. A search of PubMed, Scopus, Embase, and Web of Science was performed for studies published between 2000 and 2025. Eligible studies included population-based samples of midlife-related adults reporting prevalence or incidence of functional and/or mobility limitations. When data were available, associations between these limitations and chronic conditions were also examined. Methodological quality was assessed using the Joanna Briggs Institute checklist, and risk of bias was evaluated using the tool developed by Hoy et al. Evidence certainty was assessed using GRADE. Due to conceptual and methodological heterogeneity, a meta-analysis was not performed and findings were synthesized narratively.
Twenty-six population-based studies comprising over 500,000 participants from over 30 countries worldwide met the inclusion criteria. Reported prevalence of functional and mobility limitations varied widely by domain, instrument, and task. Across many studies, estimates fell within the range of 15% to 25%, while mobility limitation exceeded 40% in some settings. In studies assessing both domains, mobility limitations were generally reported more frequently than functional limitations. Chronic conditions were associated with functional and mobility limitations, particularly musculoskeletal pain and arthritis (Population-Attributable Risk [PAR]: 15.0%-38.3%), and multimorbidity (PAR: 12.0%-56.5%). In contrast, lower PAR estimates were reported for hypertension (3%). Most evidence was derived from cross-sectional studies, with heterogeneous age ranges and assessment tools, limiting comparability and causal inference.
Functional and mobility limitations emerge during midlife worldwide and are associated with chronic conditions. The findings should be interpreted cautiously, given methodological variation across studies, including differences in measurement instruments, midlife age-group definitions, and outcome assessment, requiring standardization. Nevertheless, these findings may support earlier detection of functional and mobility changes and inform future prevention-oriented research and strategies.
PROSPERO (CRD420251038883).

PMID:
42321735
Bibliographic data and abstract were imported from PubMed on 20 Jun 2026.

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