Incidence and dynamics of mobility device use among community-dwelling older adults in the United States

Mobility devices are crucial in enhancing activities and participation for individuals with mobility disability, particularly among the rapidly expanding population of older adults worldwide. This paper explores patterns of mobility device use among a nationally representative cohort of community-dwelling older adults in the United States, using data from the National Health and Aging Trends Study (NHATS) waves 1-9 (2011-2019). Our descriptive analysis focuses on the characteristics of incident mobility device use, its influencing factors, and related user experiences, aligning with the NHATS late-life disability framework. Mobility devices were categorized into walking aids (WAs), wheeled and seated mobility devices (WSMDs), and mixed use of both. We identified 2,943 incidents of mobility device use among 2,591 participants, spanning 47,722 person-years in community settings, yielding an incidence rate of 61.7 per 1,000 person-years. Over half (51.3%) of mobility device use ended in 1 year, with WAs being the predominantly used (63.8%). About one-third (30.5%) of these incidents involved a change in device combinations, with a notable shift towards WSMDs and mixed use over time. We found that older adults using WSMDs or changing their device combinations were in a more vulnerable state, while those using mixed devices or changing their device combinations experienced poorer user experiences. This study advocates for the implementation of rental and recycling programs, the involvement of NGOs and professional associations, and the adoption of flexible policies responding to the dynamic patterns of mobility device use among community-dwelling older adults. It also recommends expanding services to better serve vulnerable subgroups.