Seeing, hearing, and moving: Inequalities in assistive device use and health outcomes among older adults in India

Abstract

Functional limitations related to hearing, vision, and mobility are common among older adults and may adversely affect mental health and functional independence. However, nationally representative evidence from India on assistive device use, unmet need, and related health outcomes remains limited. This study used data from Wave 1 (2017-18) of the Longitudinal Ageing Study in India (LASI), including 31,902 adults aged 60 years and above. Weighted descriptive statistics estimated assistive device use and unmet need, while survey-adjusted logistic regression models examined associations between assistive device use, severe activities of daily living (ADL) limitation (≥3 limitations), and depressive symptoms (CES-D ≥ 4). Among older adults with mobility difficulties, only 12.2% reported using mobility aids, while 87.8% reported unmet need for mobility aids. The use of vision devices was high (91.8%), with only 8.2% reporting unmet need. In contrast, hearing aid use remained very low (7.8%), with 92.2% reported unmet need. Mobility aid use was associated with higher odds of severe ADL limitation, likely reflecting reverse causation and confounding by indication. Sensitivity analyses found no significant association between mobility aid use and depressive symptoms across ADL severity groups. In contrast, the use of vision device was associated with lower odds of severe ADL limitation, highlighting the importance of equitable access to affordable assistive technologies for older adults in India.