Advances in mobility aid use reporting: situational context and objective measurement improve understanding of daily aid use in older adults

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 ( 1 3 ) = .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.