Abstract
Background
Understanding mobility aid use has implications for falls risk reduction and aid prescription. However, aid use in daily life is understudied and more complex than revealed by commonly used yes/no self-reporting.
Aims
To advance approaches for evaluating mobility aid use among older adults using a situational (context-driven) questionnaire and wearable sensors.
Methods
Data from two cross-sectional observational studies of older adults were used: (1) 190 participants (86 ± 5 years) completed tests of standing, sit-to-stand, walking, grip strength, and self-reported fear of falling and (2) 20 participants (90 ± 4 years) wore two body-worn and one aid-mounted sensors continuously for seven days to objectively quantify aid use during walking. Situational and traditional binary reporting stratified participants into aid dependency levels (0–4) and aid-user groups, respectively. Physical performance and fear of falling were compared between aid users, and dependency levels and sensor-derived walking behaviors were compared to reported aid use.
Results
Physical performance and fear of falling differed between aid-user groups (P < 0.05). Sensor-derived outputs revealed differences in walking behaviors and aid use when categorized by dependency level and walking bout length (P < 0.05). Walking bout frequency (rho(18) = − 0.47, P = 0.038) and aid use time (rho(13) = .72, P = 0.002) were associated with dependency level.
Discussion
Comparisons of situational aid dependency revealed heterogeneity between aid users suggesting binary aid use reporting fails to identify individual differences in walking and aid use behaviors.
Conclusions
Enhanced subjective aid use reporting and objective measurements of walking and aid use may improve aid prescription and inform intervention to support safe and effective mobility in older adults.
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Data availability
The datasets generated during and/or analyzed during the current study are not publicly available but may be available from the corresponding author on reasonable request.
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Acknowledgements
The authors would like to thank study participants and acknowledge Schlegel Villages together with the Schlegel-UW Research Institute for Aging for their support of this project as well as access to clinical data.
Funding
This work was supported by a grant to W. McIlroy from the Natural Sciences and Engineering Research Council (NSERC) Canada (# 1145753) and with the support of the Ontario Brain Institute, an independent non-profit corporation, funded partially by the Ontario government. The opinions, results, and conclusions are those of the authors and no endorsement by the Ontario Brain Institute is intended or should be inferred.
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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by ST, BFC, AP. The first draft of the manuscript was written by ST and BFC and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Thomson, S., Cornish, B.F., Pun, A. et al. Advances in mobility aid use reporting: situational context and objective measurement improve understanding of daily aid use in older adults. Aging Clin Exp Res 35, 2543–2553 (2023). https://doi.org/10.1007/s40520-023-02533-5
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DOI: https://doi.org/10.1007/s40520-023-02533-5