Maintaining Mobility: What Predicts Walker, Wheelchair, and Cane Adoption among a National Sample of Older Adults?

Introduction: The purpose of this study is to predict the adoption of mobility devices, giving special attention to the contributions of disease, impairment, and prior mobility device use. Panel data from the 1994, 1999, and 2004 National Long Term Care Survey (NLTCS) were used (N=1,047). Methods: The NLTCS is a national probability sample of adults ages 65 and older that draws from the Medicare beneficiary population, and has a response rate exceeding 90% between survey waves. Results: A series of logistic regressions controlling for mortality selection show that older adults were more likely to adopt a cane between 1999 and 2004 if they were older, obese, and had a greater number of nursing home stays. Walker adoption was predicted by being older, diabetic, receiving personal care, having a high frequency of nursing home stays, and having used a cane in the past. Finally, wheelchair adoption between 1999 and 2004 was predicted by an increase in lower-body disability between 1994 and 1999, having diabetes, having used a walker in the past, personal care, and age. Mobility devices are a means to preserve independence and maintain function, and these findings suggest that predictors of mobility device adoption vary across mobility device types. Implications: Findings from this research can be used to inform policy makers and health care practitioners of the importance of variables such as obesity and diabetes in raising an older adult's likelihood for adopting a mobility assistive device in the future.