Prevalence and Characteristics of Community-Dwelling Older Adults Using Mobility Devices: A Cross-National Comparison between the United States and China.

Abstract

Mobility disability is a significant global issue, particularly affecting older adults in low- and middle-income countries (LMICs), where access to mobility devices and national statistics on their use is limited. Additionally, research on mobility device usage often overlooks cross-national and cultural perspectives. This study aims to address this gap by comparing mobility device usage and associated characteristics among community-dwelling older adults in the United States and China, using harmonized, nationally representative data from the 2015 National Health and Aging Trends Study (NHATS) and the China Health and Retirement Longitudinal Study (CHARLS). U.S. older adults exhibited a higher prevalence of mobility device use than those in China (22.2% vs. 16.3%, P<0.001), particularly in the use of walkers (9.9% vs. 0.5%, P<0.001) and wheelchairs (5.0% vs. 1.9%, P<0.001). In both countries, older mobility devices users were significantly more disadvantaged than non-users (Ps<0.001). The sensitivity analysis further reveals that U.S. users were more likely to be obese with a higher burden of chronic diseases, while Chinese users were more likely engaged in work and caregiving tasks rather than recreational activities (Ps<0.001). These findings underscore the widespread disadvantages faced by older mobility devices users in community settings, highlighting the global needs for targeted supports.