Study: Weight issues move up need for walkers, canes, other devices

July 28, 2010

WEST LAFAYETTE, Ind. - Obese older adults are more likely to use walkers, canes and other mobility devices at a younger age, and may run the risk of using them incorrectly, according to new research from Purdue University.

"Baby Boomers are coming of age and obesity is an epidemic for this population as well," said Karis Pressler, a doctoral student in sociology and gerontology and the project's lead author. "This research shows that if obesity continues at this rate, we are going to see an increase in the use of assistive devices, which can be costly to individuals and the health-care system. Reliance on assistive devices can affect everyday life in multiple ways, from how you bathe, to how you dress, to how you move.

"If people don't want to be reliant on these devices in the future, they need to realize how obesity heightens one's risk of becoming disabled and affects how a person will compensate for that disability."

Other studies have evaluated the use of assistive devices, but this study is different because it follows more than 1,000 individuals, ages 65 and older, and tracks both their body weight and use of assistive devices for 10 years. The data is from a national survey about Medicare patients. The findings are published in the summer issue of The Gerontologist.

A third of adults older than 65 use at least one device, and lower body disability is what drives and predicts their use, Pressler said. The most popular devices are shower seats and tub stools, grab or handle bars for bathing, walkers, canes or a raised toilet seat.

"Obesity and disability create issues for society, such as in the number of handicap parking spots or availability of larger beds in hospitals and nursing homes. These challenges will escalate as our largest adult population ages," said co-author Kenneth F. Ferraro, a distinguished professor of sociology and director of Purdue's Center on Aging and the Life Course. "Being obese and disabled also fuels a vicious cycle. When you are functionally limited, physical activity is restricted, thereby burning fewer calories, which may lead to additional weight gain. This is another reminder that body weight matters throughout the life course."

Obesity is defined as more than 30 on the body mass index scale, which is a formula that takes height and weight into account. Study participants considered overweight, with a body mass index between 25 and 29.9, did not have the same need for assistive devices. However, the researchers caution that being overweight is a risk factor for obesity, and weight management for a healthy body mass is important.

Researchers also note that when used improperly, the intended assistive solution could make the problem worse. That is why it is important to consult with a health-care professional, such as a physical therapist, about how and when a device should be used, Ferraro said.

"You can buy these devices almost anywhere - home improvement stores, discount stores or the pharmacy. It's big business," he said. "These older adults, or even their adult children or other caregivers, are just trying to cope by helping adapt to physical changes, but there is no substitute for proper use of the devices. When deciding between a stationary walker and one with wheels, it's best to consult with a specialist to receive the proper fitting and training. It could be dangerous to use or install something improperly, which could even lead to a fall."

Pressler also said there is sometimes a concern about using a device too soon because a mobility tool, such as a walker, could lead to loss of lower body function if used before it is needed.

The idea for this study was sparked by Pressler's observations when she lived in a retirement center for two years as part of Purdue's gerontology program. She will be launching another study to evaluate the social aspect of assistive devices such as how social networks, friendships and relationships may affect how or when people use them.

The current study was supported by Purdue's Center on Aging and the Life Course.

Writer:  Amy Patterson Neubert, 765-494-9723,

Sources:   Kenneth Ferraro, 765-494-4707,

                    Karis Pressler, 765-494-1638,

Note to Journalists: Journalists interested in a copy of the article can contact Judith Austin, Purdue News Service, 765-494-2432,                        


Assistive Device Use as a Dynamic Acquisition Process in Later Life

Karis A. Pressler and Kenneth F. Ferraro

Purpose: This study identifies risk factors, including incident disability, for the use of assistive devices (ADs) among older people.

Design and Methods: Three waves of data from the National Long-Term Care Survey (NLTCS) are used to examine whether upper and lower body disability lead to use of ADs (both number of devices used and number of activities of daily living domains from which ADs are used). Predictors of AD use include demographic variables, body mass index, and disability (both initial and incident). Relationships are estimated with negative binomial regressions models.

Results: Lower body disability, advanced age, and obesity are consistent predictors of the number of ADs used. An interaction between age and incident disability revealed the highest rate of adoption among the younger respondents who experienced increases in disability.

Implications: Many older adults use ADs in response to the disablement process. In addition to need driven by rising disability, obese older adults use more ADs. Results from this study clarify who and why ADs are adopted by older persons and should facilitate effective intervention by health care personnel and caregivers.