Objective: To assess the correspondence between self-reported and measured indicators of mobility disability among older adults across six low and middle income countries [LMICs].

Design: Cross-sectional analysis of Study of Ageing and Adult Health [SAGE]

Setting: Household surveys in China, India, Russia, South Africa, Ghana, and Mexico

Participants: Community-dwelling SAGE respondents aged 65+ (total n= 12,215)

Measurements: Objective mobility was assessed by a 4-meter timed walk at normal pace conducted in the respondent’s home; we defined slow walking speed per the Fried frailty criteria (lowest quintile of walking speed, adjusted for age and height). Self-reported mobility difficulty was assessed with a question about ability to walk 1 kilometer (km); we dichotomized this response into any/no self-reported difficulty walking 1 km (reference: no difficulty). We estimated the age (5-year groups) and gender-specific probability of self-reporting difficulty walking 1 km among those with a measured slow walk with logistic regression.

Results: Across the countries, between 42% and 76% of people aged 65+ reported any difficulty walking 1 km. Average walking speed was slowest in Russia (0.61 m/s) and fastest in China (0.88 m/s). The probabilities of reporting any difficulty walking 1km among women aged 65–69, for example, with a slow walk varied: China=0.35; India=0.90; Russia=0.68; South Africa=0.81; Ghana=0.91; Mexico=0.73; test of country differences p-value<0.001. There was significant variation at older ages, albeit smaller in magnitude. Patterns were similar for men.

Conclusion: Although correspondence between an objective and self-reported measure of mobility was generally high, correspondence differed significantly across LMICs. International comparisons of self-reported disability measures for clinical, prevention and policy guidelines in LMICs should consider that self-reported data may not correspond to objective measures uniformly across countries.