Walk with cane

Use of more than one mobility device could be related to differences in terrain. (Dimitar Dilkoff/AFP/Getty)

Nearly a quarter of people aged 65 and older used mobility devices such as canes and they may cut back on activity over fear of falling, a U.S. study suggests.

Wednesday's study in the Journal of the American Geriatrics Society was based on a nationally representative sample of people who were interviewed in their homes in 2011 and 2012.

A main reason to prescribe mobility devices is to reduce the risk of falling, the researchers said. Falls are the leading cause of death from injury in older adults in Canada and the U.S.  

Between 20 per cent and 30 per cent of seniors fall each year, according to the Public Health Agency of Canada.

In the study, about 8.5 million older adults or 24 per cent said they used a mobility device such as a cane, walker, wheelchair or scooter in the last month. Of these, nine per cent said they'd used more than one device.

"The percentage of older adults using mobility devices has increased over the last three decades, and multiple device use is common in those who use any device," Dr. Nancy Gell, the study's lead author from the department of rehabilitation and movement science at the University of Vermont, Burlington, and her co-authors concluded.

Gell said staying active is key to maintaining mobility and function.

Study participants were asked about medical conditions such as osteoarthritis, hip fracture, stroke and dementia and their physical capacity was assessed for tasks such as walking three or six blocks, placing a heavy object overhead or  opening a sealed jar.

There was no difference in incidence of falls or recurrent falls between older adults who used any number of mobility devices and non-device users after adjusting for demographic characteristics, medical conditions, physical capacity, cognitive function, and fall history.

But "activity-limiting worry" about falls was 30 per cent higher in those who used canes only than those who used no mobility devices, the researchers said.

Use of more than one device could be related to differences in terrain, such as using a cane inside the home and a walker outside, or changes in physical capacity after a hip fracture, or variation in symptoms like chronic pain, they said.

Gell suggested people use the device that best matches their needs to stay as mobile as possible in a safe manner. People may also need more training and safety assessments on using more than one device, with follow-up if needs change.

Previous research pointed to greater risk of falling with use of walkers, based on studies on people already using the devices without a comparison group of non-device users.