Mobility assistance preferences and device adoption among community-dwelling older adults in Taiwan

Abstract

Background and Objectives: Mobility decline is a significant concern among older adults; however, many delay or resist adopting assistive walking devices. Guided by the person–environment–occupation model, this study examined attitudes toward mobility decline and assistive devices. It explored how sociodemographic, personal, and environmental factors influenced preferences and predicted device use over time. Research Design and Methods: A longitudinal observational study was conducted with 203 community-dwelling adults aged 65 years and older in Taiwan who walked independently at baseline. Participants, recruited from 18 community centers, completed questionnaires on mobility-related attitudes, and underwent gait assessments at baseline and one-year follow-up. Logistic regression models were applied to examine preferences for mobility assistance and the likelihood of device adoption. Results: Participants with fewer socio-financial concerns (Est = −0.57, p = 0.01) and those less skeptical toward walking aids (Est = −0.59, p = 0.02) were more likely to prefer device use. Women showed a lower, though non-significant, likelihood of preferring walking devices (Est = −0.65). Higher IADL scores (Est = −0.79, p = 0.01) and increased use of antihypertensive medication (Est = −2.28, p = 0.04) were significantly associated with a reduced probability of walking device adoption. Attitudinal factors and repeated falls were not significant predictors in the follow-up model. Discussion and Implications: The findings suggest that while attitudes shape preferences, the actual adoption of walking devices is more closely tied to functional decline. Declining IADL and antihypertensive use were linked to higher rates of device adoption, possibly reflecting greater health monitoring needs. Clinicians should regard the use of antihypertensive medications as a potential prompt for mobility screening and counseling, notably where device uptake lags behind physical need.