Mobility aids increase falls risk with dementia

Use of a cane or walker can increase the risk of falls in seniors—and people with dementia are three times more likely to fall when using an aid than without. Susan Hunter, physical therapy professor at Western University in London, Ontario, Canada, is leading a U.S. Alzheimer’s Association-funded study to understand why.

Mobility aids can be a distraction, much like texting while driving. “How many things can you do at the same time and not cause an accident?” Hunter says in a press release.

The study represents a shift in how physical therapists think about fall prevention, best practices for rehabilitation and use of a mobility aid as a complex cognitive task. In a pilot survey with physiotherapists, none reported including executive function or cognitive load in their assessments with a patient. Hunter and colleagues are optimistic that their results will show the importance of cognitive assessments before prescribing a mobility aid for people with dementia.  

They will conduct a series of walking tests to study how people at different cognitive levels maneuver with and without mobility aids in a straight line, around obstacles and while making figure-eight patterns. Researchers will measure gait velocity, cognition, vision, balance, strength and fear of falling to hopefully develop a clinical assessment for people with dementia that takes into account factors of the disease like cognition and vision changes.

“There’s a knowledge gap where, on the one hand, you’re providing a person with dementia with a complex mobility aid that you can provide physical support,” Hunter says. “But then you’re giving somebody potentially new complex tasks. Do we follow people long enough to say that they’re safe? Can we train people better in using the aids?”

Hunter previously researched how much cognitive work is required when using a mobility aid. She found the increase was slight in healthy older adults but around 35 to 40 percent in people with dementia. One possible explanation is that using a mobility aid while walking is multitasking, which can add cognitive load. 

Topics: Alzheimer's/Dementia , Clinical