Perspectives on mobility among older adults living with different frailty and cognitive statuses

Abstract

IntroductionMobility is an important aspect of healthy aging, but little is known about older adults’ perspectives and needs in relation to their mobility. This qualitative study aims to explore the perspectives and needs for mobility among older adults living with different frailty and cognitive statuses in urban and rural areas. MethodsCommunity-dwelling older adults aged 60 years and above were recruited from an ongoing longitudinal aging cohort study and through a recruitment advertisement. Frailty and cognitive statuses were assessed using the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) scale and the Montreal Cognitive Assessment (MoCA-Blind) tool, respectively. Semi-structured telephone interviews were conducted, which were audio-recorded and transcribed verbatim. Transcripts were thematically analyzed, and findings were compared within and between participant groups based on frailty, cognitive, and urban/rural statuses. ResultsForty-seven participants were included. Four themes were identified: mobility matters, unmet health care needs, limited transport options, and technology to support mobility. Unmet health care needs for mobility issues were more prominently discussed among participants with frailty or frailty with mild cognitive impairment. Rural-dwelling participants emphasized on the need to continue driving due to limited transport options. Participants also described how using private ride-hailing services could address their transport needs, though this is limited to participants living in urban areas as these services were not available in rural areas. ConclusionOlder adults continue to live independently regardless of frailty or cognitive status in urban and rural areas, while some continue to cope with mobility limitations. Findings suggest the need to support mobility transitions to help older adults remain independent, improve older adults’ access to health care, and make public and private transport available and accessible for older adults living in rural areas.