Older adults often use canes, walkers, wheelchairs, and motorized scooters to improve their mobility. At the same time, an estimated 35 percent to 40 percent of adults aged 65 and older fall each year, calling into question the efficacy of these devices in preventing falls.

To learn more, a team of researchers that included Robert Wallace, UI College of Public Health professor of epidemiology, recently examined the prevalence of mobility device use among community-dwelling older adults in the United States. The investigators, led by Nancy Gell of the University of Vermont in Burlington, also looked at the incidence of falls and participants’ worry about falling according to the type and number of mobility devices used.

Based on data from the National Health and Aging Trends Study, the researchers found that 24 percent of the U.S. population aged 65 and older reported using a mobility device in the last month, with one-third of this group using multiple devices. Consistent with previous studies, mobility device use increased with age. Women, ethnic and racial minorities, and those with lower education, obesity, greater disease burden, and impaired balance or coordination more commonly reported using a mobility device.

The incidence of falls and recurrent falls was not associated with the use of multiple devices or any particular type of mobility device. The researchers also found that older adults who used only a cane had a higher incidence of worry severe enough to limit their activity than those who used other devices. The results were published in the May 2015 issue of the Journal of the American Geriatrics Society.

The study is believed to be the first to describe the prevalence of using more than one mobility device. The authors suggest that the use of multiple devices may be related to a number of factors, such as environmental and terrain differences (e.g., cane for inside the home and walker for outside the home) or a change in physical capacity requiring more or less external support (e.g., hip fracture recovery with transition from walker to cane).

The researchers also note there has been an apparent 50 percent increase (from 16 percent) in the use of mobility devices since 2004. This increase may be attributable to greater disability, greater longevity, correction for unmet needs in previous decades, or greater acceptance and use of mobility devices among older adults.

Understanding the determinants and outcomes of multiple device use, circumstances that lead to multiple device use, and determinants of non-device use in those with a previous history of multiple falls may assist with fall prevention efforts, the investigators write.

The research was supported by a grant from the National Institute on Aging.