Mobility Device Use in Older Adults and Incidence of Falls and Worry About Falling: Findings from the 2011–2012 National Health and Aging Trends Study
“An age-adjusted comparison of results from the 1980 and 1990 National Health Interview Survey (NHIS) found a
- 26% increase in the use of canes, a
- 57% increase in the use of walkers, and a
- 65% increase in the use of wheelchairs at all ages”
Possible reasons include
- Recognition of need to keep moving
- More socially acceptable to use a mobility device
- More easily used now – change of environment
- Seniors living longer with a disability
- Seniors have become more aware of the risk of falling
- Seniors have become more vitamin D deficient
Note:
- Device use higher among blacks, Hispanics, and Obese
(all of whom have low vitamin D levels) - Seniors who use a mobility device appeared no more likely to fall than seniors who did not.
- Some previous studies have suggested that devices may actually contribute to falls.
- Vitamin D prevents falls – majority of meta-analyses conclude – meta-meta analysis Feb 2015
- Falls are prevented by vitamin D - provided you get enough - Dec 2014
- Fallers often had less than 20 ng of vitamin D – meta-analysis April 2014
- Incidence of 22 health problems related to vitamin D have doubled in a decade huge # of charts
- Save 2 billion dollars annually in fractures if take Vitamin D and Calcium – Frost and Sullivan Sept 2013
- Seniors need at least 4,000 IU vitamin D, no test needed – Consensus Jan 2014
- Seniors with adequate vitamin D could rebalance themselves 80% faster, and thus not fall as often – 2013
- Falls and Fractures category listing has
258 items along with related searches - 13 reasons why many seniors need more vitamin D (both dose and level) - July 2023 has the following
- Senior skin produces 4X less Vitamin D for the same sun intensity
- Seniors have fewer vitamin D receptor genes as they age
Receptors are needed to get Vitamin D in blood actually into the cells - Many other Vitamin D genes decrease with age
- Since many gene activations are not detected by a blood test,
more Vitamin D is often needed, especially by seniors - Seniors are indoors more than when they were younger
not as agile, weaker muscles; frail, no longer enjoy hot temperatures - Seniors wear more clothing outdoors than when younger
Seniors also are told to fear skin cancer & wrinkles - Seniors often take various drugs which end up reducing vitamin D
Some reductions are not detected by a vitamin D test of the blood
statins, chemotherapy, anti-depressants, blood pressure, beta-blockers, etc - Seniors often have one or more diseases that consume vitamin D
osteoporosis, diabetes, Multiple Sclerosis, Cancer, ... - Seniors generally put on weight as they age - and a heavier body requires more vitamin D
- Seniors often (40%) have fatty livers – which do not process vitamin D as well
- Reduced stomach acid means less Magnesium is available to get vitamin D into the cells
- Vitamin D is not as bioavailable in senior intestines
- Seniors with poorly functioning kidneys do not process vitamin D as well
- Glutathione (which increases Vitamin D getting to cells) decreases with age
Seniors category has431 items
Journal of the American Geriatrics Society. DOI: 10.1111/jgs.13393
Nancy M. Gell PhD, MPH1,*, Robert B. Wallace MD, MSc2, Andrea Z. LaCroix PhD3, Tracy M. Mroz PhD4 andKushang V. Patel PhD, MPH5Objectives: To examine the prevalence of mobility device use in community-dwelling older adults in the United States and to investigate the incidence of falls and worry about falling according to type and number of mobility devices used.
Design: Analysis of cross-sectional and longitudinal data from the 2011–12 National Health and Aging Trends Study.
Setting: In-person interviews in the homes of study participants.
Participants: Nationally representative sample of Medicare beneficiaries (n = 7,609).
Measurements: Participants were asked about mobility device use (e.g., canes, walkers, wheelchairs and scooters) in the last month, 1-year fall history and worry about falling.
Results: Twenty-four percent of adults aged 65 and older reported mobility device use in 2011, and 9.3% reported using multiple devices within the last month. Mobility device use increased with advancing age and was associated with nonwhite race and ethnicity, female sex, lower education level, greater multimorbidity, and obesity (all P < .001). Adjusting for demographic and health characteristics and physical function, the incidence of falls and recurrent falls was not associated with the use of multiple devices or any particular type of mobility device. Activity-limiting worry about falling was significantly higher in cane-only users than in nonusers.
Conclusion: The percentage of older adults reporting mobility device use is higher than results from previous national surveys, and multiple device use is common in those who use any device. Mobility device use is not associated with greater incidence of falls. Cane-only users may compensate for worry about falling by limiting activity.
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