The Use of Mobility Devices and Personal Assistance: A Joint Modeling Approach

Abstract

Objective: To examine whether mobility device use substitutes for personal assistance among U.S. older adults. Method: Using the National Health and Aging Trends Study, we identified 3,211 community-living older adults (aged 65 and older) who reported mobility difficulties at baseline. We used recursive bivariate probit models to simultaneously estimate the effect of covariates on the likelihood of using (a) mobility devices and (b) personal assistance to accommodate mobility difficulty. Independent variables included age, gender, race, physical/mental health status, cognition, and comorbidities. Results: Predictors of the use of personal assistance and mobility devices exhibit important similarities and differences. Device use reduced the odds of receiving personal assistance by 50% (odds ratio [OR] = 0.50, 95% confidence interval [CI] = [0.29, 0.86]). Discussion: Findings suggest device use substitutes for personal assistance. Practitioners and policymakers should promote the appropriate use of mobility devices while recognizing the importance of assistance with some groups and the potential of increasing mobility device use.

Who uses technical aids in old age? Exploring the implementation of technology-based home modifications in Europe

“…Based on the results, it could only be partially confirmed that mental health issues increase the likelihood of using technical aids in the home. In contrast to some previous studies ( 27 , 28 ), persons who reported depressive symptoms were more likely to use assistive technology. A possible explanation is that this association is mediated by functional limitations since depression is associated with poorer health, which in turn is associated with a higher likelihood of using assistive devices.…”

“…While some studies found no significant relation between mental health problems (e.g., depression, guilt, and sleep problems) and the use of assistive devices ( 12 , 27 ), the results of other studies show that, for example, feelings of loneliness and use of mobility aids (walking sticks) were positively correlated ( 21 ). On the other hand, according to a US study, depressive symptoms of people aged 65 years and older decreased the likelihood of mobility aids (i.e., walkers) by about 25% while at the same time, the likelihood of personal assistance was increased ( 28 ). Moreover, a cross-sectional Swedish study found that the number of physical environmental barriers as well as lack of accessibility (e.g., dependence on mobility aids, functional limitations, narrow doors, and lack of grab bars) were negatively related to life satisfaction ( 29 ).…”