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Method: Baseline interviews ( n = 848, 75-90 years) on difficulties in walking 500 m, frequency of moving through the neighborhood, and perceived hilliness as a barrier to outdoor mobility were conducted. Two-year follow-up interviews ( n = 551) on difficulties in walking 500 m were conducted among participants without baseline walking difficulties. Hilliness objectively defined as the mean slope in 500-m road network. Results: Logistic regression showed that hilliness was associated with incident walking difficulties at the 2-year follow-up (odds ratio [OR] = 1.66, 95% confidence interval [CI] = [1.09, 2.51]) but not with the prevalence of walking difficulties at baseline. Adding behavioral, health, or socioeconomic factors to the models did not markedly change the results. Discussion: Greater hilliness should be considered a risk factor for developing walking difficulties among older adults.<\/jats:p>","DOI":"10.1177\/0898264318820448","type":"journal-article","created":{"date-parts":[[2018,12,27]],"date-time":"2018-12-27T03:37:02Z","timestamp":1545881822000},"page":"278-284","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Hilliness and the Development of Walking Difficulties Among Community-Dwelling Older People"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9876-5658","authenticated-orcid":false,"given":"Kirsi E.","family":"Keskinen","sequence":"first","affiliation":[{"name":"Faculty of Sport and Health Sciences, University of Jyv\u00e4skyl\u00e4, Finland"},{"name":"Gerontology Research Center, University of Jyv\u00e4skyl\u00e4, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merja","family":"Rantakokko","sequence":"additional","affiliation":[{"name":"Faculty of Sport and Health Sciences, University of Jyv\u00e4skyl\u00e4, Finland"},{"name":"Gerontology Research Center, University of Jyv\u00e4skyl\u00e4, Finland"},{"name":"JAMK University of Applied Sciences, Jyv\u00e4skyl\u00e4, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimmo","family":"Suomi","sequence":"additional","affiliation":[{"name":"Faculty of Sport and Health Sciences, University of Jyv\u00e4skyl\u00e4, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1604-1945","authenticated-orcid":false,"given":"Taina","family":"Rantanen","sequence":"additional","affiliation":[{"name":"Faculty of Sport and Health Sciences, University of Jyv\u00e4skyl\u00e4, Finland"},{"name":"Gerontology Research Center, University of Jyv\u00e4skyl\u00e4, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5205-9616","authenticated-orcid":false,"given":"Erja","family":"Portegijs","sequence":"additional","affiliation":[{"name":"Faculty of Sport and Health Sciences, University of Jyv\u00e4skyl\u00e4, Finland"},{"name":"Gerontology Research Center, University of Jyv\u00e4skyl\u00e4, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,12,26]]},"reference":[{"key":"bibr1-0898264318820448","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2003.51512.x"},{"key":"bibr2-0898264318820448","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.276566"},{"key":"bibr3-0898264318820448","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2015.12.011"},{"key":"bibr4-0898264318820448","volume-title":"Digiroad road and street database, R-format 2013","author":"Finnish Transport Agency","year":"2013"},{"key":"bibr5-0898264318820448","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2012.08.004"},{"key":"bibr6-0898264318820448","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2017.06.019"},{"key":"bibr7-0898264318820448","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2017.04.008"},{"key":"bibr8-0898264318820448","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/49.2.M85"},{"key":"bibr9-0898264318820448","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-010-1543-2"},{"key":"bibr10-0898264318820448","doi-asserted-by":"publisher","DOI":"10.1037\/10044-020"},{"key":"bibr11-0898264318820448","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.06.016"},{"key":"bibr12-0898264318820448","volume-title":"I\u00e4kk\u00e4iden henkil\u00f6iden kaatumistapaturmat. 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