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Thompson SM, Delaney D, Lam JC, Kamil-Rosenberg SC, Fairchild JK. Cognitive correlates of caregiver fear of falling. Aging Ment Health 2025:1-9. [PMID: 40007161 DOI: 10.1080/13607863.2025.2468894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 02/13/2025] [Indexed: 02/27/2025]
Abstract
OBJECTIVES Fear of falling is prevalent among older adults and is associated with increased morbidity and mortality. Caregivers have a heightened risk of fear of falling due to the strenuous activities inherent in the caregiving relationship and potential exposure to falls by the care recipient. Cognition is associated with fear of falling; however, cognition's relationship with fear of falling is unclear in the caregiver population. The present study investigated the potential influence of cognitive function on fear of falling in a sample of informal caregivers (n = 50) of persons with a diagnosis of traumatic brain injury or dementia. METHOD Cognitive domains of interest included attention, executive function, processing speed, and learning and memory. Worry was assessed with the Penn State Worry Questionnaire and fear of falling was assessed with the Short Falls Efficacy Scale. Hypotheses were tested using hierarchical linear regressions. RESULTS Executive function had a significant negative association with fear of falling, while processing speed and learning and memory did not. Attention trended toward significance. CONCLUSION Findings support fear of falling as a potential situational anxiety construct and executive functioning as a potential cognitive correlate of fear of falling among caregivers.
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Affiliation(s)
| | - Devon Delaney
- Department of Psychiatry, Palo Alto University, Palo Alto, CA, USA
| | - Jovian C Lam
- VISN21 Mental Illness Research, Education, and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Shirit C Kamil-Rosenberg
- VISN21 Mental Illness Research, Education, and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - J Kaci Fairchild
- VISN21 Mental Illness Research, Education, and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Almarwani MM, Alharbi WM, Alkeridy WA. Cultural adaptation and validation of the Arabic short version of the Iconographical Falls Efficacy Scale (Icon-FES): Assessing concern about falling among older adults. Aging Clin Exp Res 2025; 37:37. [PMID: 39945933 PMCID: PMC11825643 DOI: 10.1007/s40520-025-02949-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2025] [Accepted: 02/02/2025] [Indexed: 02/16/2025]
Abstract
BACKGROUND Concern about falling is a significant issue among older adults, affecting their quality of life and functional independence. Culturally adapted and validated assessment tools are essential for accurately evaluating concern about falling. This study aimed to translate, cross-culturally adapt, and validate the Arabic short version of the Iconographical Falls Efficacy Scale (Icon-FES). METHODS The translation and cultural adaptation process followed established guidelines. Structural validity was assessed using exploratory factor analysis (EFA). Internal consistency reliability, test-retest reliability, convergent validity, and known-groups validity of the scale were evaluated. RESULTS A total of 123 community-dwelling older adults (mean age 69.54 ± 3.48 years; 53.7% male) participated. The Arabic short version of Icon-FES demonstrated strong structural validity, with EFA supporting a unidimensional structure accounting for 73.47% of the variance. It exhibited high internal consistency (Cronbach's α = 0.95) and excellent test-retest reliability (ICC = 0.97). Convergent validity was confirmed through significant correlations with the Arabic Falls Efficacy Scale-International (FES-I; rs = 0.73, p < 0.001), Single Leg Stance (SLS; rs = - 0.34, p < 0.001), and Five Times Sit-to-Stand Test (5TSTS; rs = 0.44, p < 0.001). Known-groups validity showed higher scores in females, those with lower education, and a history of falls. CONCLUSIONS The Arabic short version of Icon-FES is a reliable and valid tool for assessing concern about falling among community-dwelling older adults. It offers an innovative approach through culturally adapted visual elements that could enhance applicability, enabling accurate assessment and supporting targeted interventions among Arabic-speaking older adults.
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Affiliation(s)
- Maha M Almarwani
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, 11433, Riyadh, Saudi Arabia.
| | - Worood M Alharbi
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, 11433, Riyadh, Saudi Arabia
| | - Walid A Alkeridy
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- General Administration of Home Health Care, Therapeutic Affairs Deputyship, Riyadh, Saudi Arabia
- Department of Medicine, Geriatric Division, University of British Columbia, Vancouver, BC, Canada
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Alcolea-Ruiz N, López-López C, Pérez-Pérez T, Alcolea S, Pérez-Rivas FJ. Effect of a Health Education Intervention to Reduce Fear of Falling and Falls in Older People: A Cluster Randomized Clinical Trial Protocol. Healthcare (Basel) 2024; 12:2510. [PMID: 39765937 PMCID: PMC11728216 DOI: 10.3390/healthcare12242510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Revised: 11/29/2024] [Accepted: 12/09/2024] [Indexed: 01/15/2025] Open
Abstract
Background/Objectives: Fear of falling (FOF) and falls are prevalent issues among older adults, leading to activity restriction, decreased quality of life, and increased dependency. This study aims to assess the effectiveness of a nurse-led health education intervention to reduce FOF and fall incidence in older adults within primary care settings. Methods: This two-arm, multicenter, parallel, cluster-randomized clinical trial includes ten primary care centers in Spain and will enroll 150 adults over 65 years with FOF, mild or no functional dependence, and independent ambulation. Participants will be randomized to either the intervention group, which will receive five initial group education sessions led by community nurses and a booster session at six months, or the control group, which will receive usual care. Primary outcomes include FOF, assessed using the Short Falls Efficacy Scale-International (FES-I), and fall incidence. Data collection will occur at baseline, one month, six months, and twelve months post intervention. This study has been approved by the Ethics Committee for Research with Medicinal Products at Gregorio Marañón University Hospital in accordance with the Declaration of Helsinki. Expected Outcomes: The health education intervention is expected to significantly reduce both FOF and fall incidence, supporting the integration of FOF management in routine primary care for older adults, with potential benefits for safety and quality of life. Trial Registration: ClinicalTrials.gov: NCT05889910. The study protocol follows CONSORT and SPIRIT guidelines.
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Affiliation(s)
- Nuria Alcolea-Ruiz
- Sector III Healthcare Centre, South Assistance Directorate, Primary Care Assistance Management, Madrid Health Service, 28905 Madrid, Spain
- Faculty of Nursing, Physiotherapy, and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Candelas López-López
- Faculty of Nursing, Physiotherapy, and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
- Emergency and Trauma Intensive Care Unit, 12 de Octubre University Hospital, 28041 Madrid, Spain
- Invecuid Care Research Group, Hospital 12 de Octubre Health Research Institute (imas12), 28041 Madrid, Spain
- “Salud Pública-Estilos de Vida, Metodología Enfermera y Cuidados en el Entorno Comunitario” Research Group, Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Teresa Pérez-Pérez
- Department of Statistics and Data Science, Faculty of Statistical Studies, Complutense University of Madrid, 28040 Madrid, Spain
| | - Sonia Alcolea
- La Paz Children’s Hospital, La Paz Biomedical Research Foundation (IdiPAZ), CYBER INFECT, Madrid Health Service, 28046 Madrid, Spain
| | | | - Francisco Javier Pérez-Rivas
- Faculty of Nursing, Physiotherapy, and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
- “Salud Pública-Estilos de Vida, Metodología Enfermera y Cuidados en el Entorno Comunitario” Research Group, Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
- RICAPPS Research Networking Centre in Chronicity, Primary Care, and Health Promotion (RICORS), Carlos III Institute of Health, 28220 Madrid, Spain
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Xie X, Fu J, Chen L, Gao Z, Zhang R, Li G. Assessment tools of the fear of falling: A scoping review. Geriatr Nurs 2024; 60:643-653. [PMID: 39510012 DOI: 10.1016/j.gerinurse.2024.10.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 09/29/2024] [Accepted: 10/28/2024] [Indexed: 11/15/2024]
Abstract
AIM To comprehensively evaluate and synthesize fear of falling assessment tools and their psychometric properties. METHODS The literature in PubMed, Web of Science Core Collection, Cochrane Library, Embase, Google Scholar, CNKI, Wanfang, VIP, and CBM was systematically searched, and the search period was from the establishment of the database to September 1, 2023, and updated on September 1, 2024. RESULTS A total of 104 documents covering 19 assessment tools were included. Of the 19 instruments, the Falls Efficacy Scale-International was the most widely used and had been tested for reliability and validity in different countries and populations. A total of 18 studies focused on tool development and validation, and the remaining 86 were related to tool validation. CONCLUSION Scientific and reliable assessment instruments for FOF are an important part of future targeted intervention research. The future research direction of tools should be based on local demographic characteristics and qualitative interview results, combined with objective quantitative indicators measured by professional instruments.
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Affiliation(s)
- Xing Xie
- School of Medicine, Hunan Normal University, Changsha, Hunan 410013, China
| | - Jingjing Fu
- School of Medicine, Hunan Normal University, Changsha, Hunan 410013, China
| | - Le Chen
- School of Medicine, Hunan Normal University, Changsha, Hunan 410013, China
| | - Zhe Gao
- School of Medicine, Hunan Normal University, Changsha, Hunan 410013, China
| | - Ruiying Zhang
- School of Medicine, Hunan Normal University, Changsha, Hunan 410013, China
| | - Guifei Li
- School of Medicine, Hunan Normal University, Changsha, Hunan 410013, China.
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Ma W, Liang X, Wang H, Wen Z, Liu L, Fan L, Zhang X. Association between fear of falling and mortality in middle-aged and older adults: A systematic review and meta-analysis. Geriatr Nurs 2024; 59:113-120. [PMID: 38996768 DOI: 10.1016/j.gerinurse.2024.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/17/2024] [Accepted: 06/27/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Fear of falling (FOF) has emerged as a significant public health issue, contributing to excess disability among middle-aged and older adults. The association between FOF and mortality remains unclear. METHODS Prominent electronic databases (PubMed, Web of Science, the Cochrane Library, Embase, CINHAL, PsycINFO, Scopus, China National Knowledge Infrastructure, China Biology Medicine disc, and Wanfang Database) were searched from inception until October 21, 2023 (data updated on June 9, 2024), for cohort or longitudinal studies investigating the association between FOF and mortality. The heterogeneity between studies was quantitatively assessed using I2. A fixed-effect model calculated the pooled effect size. RESULTS A total of seven cohort studies, including 27,714 participants, were analyzed in this systematic review and meta-analysis. The meta-analysis results demonstrated a positive association between FOF and mortality, with a significant increase in the risk of mortality for those with FOF (hazard ratio [HR]:1.29, 95 % confidence interval [CI]: 1.19-1.41, p < 0.05). Subgroup analysis indicated that age, male sex, clinical diagnosis of depression, number of chronic diseases, activity restriction due to FOF, and FOF levels were associated with mortality. CONCLUSIONS FOF and mortality have a positive association, which needs to be confirmed by further prospective studies with large samples and long-term follow-up to provide evidence for clinicians to intervene in FOF to reduce mortality in middle-aged and older adults.
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Affiliation(s)
- Wenlian Ma
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoli Liang
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China
| | - Hongyan Wang
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China
| | - Zhifei Wen
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Linfeng Liu
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China
| | - Liangliang Fan
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiangeng Zhang
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China.
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Thompson HM, Thanik E, Sabra A, Ko F, Hung WW, Colicino E, Lucchini RG, Bello G, Crane M, Teitelbaum SL, Ornstein KA. A pilot study to identify factors associated with frailty within the World Trade Center general responder cohort. Am J Ind Med 2024; 67:582-591. [PMID: 38735862 DOI: 10.1002/ajim.23590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Given the significant exposures experienced by the World Trade Center (WTC) general responders, there is increasing interest in understanding the effect of these exposures on aging in this population. We aim to identify factors that may be associated with frailty, a clinical syndrome characterized by a decrease in one's reserve that has been linked to poor health outcomes. METHODS WTC general responders enrolled in the WTC Health Program aged 50 and older provided informed consent. Validated frailty assessments, the Frailty Phenotype (with the Johns Hopkins Frailty Assessment Calculator) along with the FRAIL scale, categorized nonfrail from prefrail/frail. Fall risk, functional status, and cognition were also assessed. WTC variables, including an identified WTC-certified condition, were utilized. The risk of frailty was estimated using log binomial regression analysis. A 95% confidence interval (CI) was used to estimate the prevalence ratio (PR). RESULTS One hundred and six participants were included; 38 (35.8%) were classified as pre-frail or frail. More of the pre-frail/frail group were obese (57.9% vs. 25%; p = 0.004) and had a WTC-certified condition (78.9% vs. 58.8%; p = 0.036). Obesity (PR = 2.43, 95% CI = 1.31, 4.53), a WTC-certified condition (PR = 1.77, 95% CI = 1.09, 2.89), and risk of falling (PR = 1.97, 95% CI = 1.01, 3.84) were independently associated with frailty. CONCLUSIONS Obesity and having a WTC-certified condition were found to be risk factors for frailty in our pilot study. Future work may focus on further identifying risk factors for frailty in the larger WTC general responder population.
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Affiliation(s)
- Hannah M Thompson
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Erin Thanik
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ahmad Sabra
- General Responder Data Center, Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Fred Ko
- Brookdale Department of Geriatrics and Palliative Medicine, Geriatric, Research, Education and Clinical Center, Icahn School of Medicine at Mount Sinai, James J Peters VA Medical Center, New York, New York, USA
| | - William W Hung
- Brookdale Department of Geriatrics and Palliative Medicine, Geriatric, Research, Education and Clinical Center, Icahn School of Medicine at Mount Sinai, James J Peters VA Medical Center, New York, New York, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Roberto G Lucchini
- Department of Environmental Health Sciences, School of Public Health, Florida International University, Miami, Florida, USA
| | - Ghalib Bello
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael Crane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Susan L Teitelbaum
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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7
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Li C, Wang S, Liu K, Zheng Y, Li Q, Zhang Y, Jiang L, Sun H, Liu M. The association of cardiometabolic multimorbidity and fear of falling among older adults: Data from the national health and aging trends study. Geriatr Nurs 2024; 58:361-367. [PMID: 38875762 DOI: 10.1016/j.gerinurse.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/05/2024] [Accepted: 05/13/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES Cardiometabolic diseases (CMDs) have been individually associated with fall-related outcomes, but their combined effect on fear of falling (FOF) has not been investigated. This study aims to examine the association between cardiometabolic multimorbidity and FOF in older adults. METHODS Data from the National Health and Aging Trends Study, 4,295 community-dwelling older adults ≥ 65 years were analyzed in this longitudinal study. CMDs were assessed at baseline, including heart disease, diabetes, stroke, and hypertension. FOF was evaluated by asking participants if they worried about falling in the past month. Data were analyzed using multi-adjusted logistic regression. RESULTS Cardiometabolic multimorbidity was associated with a higher risk of FOF. The combination of heart disease and diabetes showed the highest risk of FOF (OR = 3.47, 95 % CI: 1.63-7.40). CONCLUSIONS These findings underscore the need for targeted interventions to mitigate the combined impact of cardiometabolic multimorbidity on FOF in older adults.
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Affiliation(s)
- Chunxiao Li
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Shuomin Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Kehan Liu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yu Zheng
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Qianyuan Li
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yunpeng Zhang
- Suzhou Institute of Biomedical Engineering and Technology, Suzhou, China
| | - Li Jiang
- Guangxi Medical University Nursing College, Nanning, China
| | - Hongyu Sun
- Peking University School of Nursing, Beijing, China.
| | - Minhui Liu
- Ningxia Medical University School of Nursing, Ningxia, China. https://twitter.com/MinhuiLiu2
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Manz W, Novack J, Fink J, Jacobson J, Bariteau J. Elective Foot and Ankle Procedures in the Patients Greater than 65 Years of Age: Worth the Mobility Gains. Geriatr Orthop Surg Rehabil 2023; 14:21514593231184316. [PMID: 37492762 PMCID: PMC10363904 DOI: 10.1177/21514593231184316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 06/02/2023] [Accepted: 06/08/2023] [Indexed: 07/27/2023] Open
Abstract
Chronic, non-traumatic pathologies of the foot and ankle can be mobility-limiting for patients of all ages. The objective of this study was to compare postoperative changes in LifeSpace Mobility Assessment (LSA) scores of adult and elderly patients following elective foot and ankle surgery. A prospective study of 184 patients undergoing elective ankle, hindfoot, and midfoot procedures conducted by one surgeon between 2015 and 2019 was undertaken. Patient-reported LSA scores were collected at preoperative, 6-month, and 12-month follow-up. Patient data was compared using an independent sample t-test for continuous, normally distributed data and a chi-squared or Fischer's exact test for categorical data. Alpha and beta were .05 and .8. Patients were divided based on age. 140 patients were observed in the younger (<65) group, 44 patients were observed in the elderly (≥65) group. The average LSA score of elderly patients at the preoperative visit was 58.3 (SD 38.0) vs 79.3 (SD 38.8) in the younger cohort (P = .041). Both patient cohorts saw decreased mobility at 3-month postoperative visits but surpassed preoperative mobility scores by 6 months and 1 year postop. No difference in average mobility score was observed between young (85.6, SD 36.1) and elderly (90.1, SD 34.3) cohorts at 1-year follow up. Given the increased rates of perioperative comorbidities and the heightened risks of intraoperative complications, physicians may be more inclined to manage elderly patients with longer periods of conservative treatment for similar pathologies. However, these results imply that elderly patients experience similar improvements after surgery to younger cohorts and should not be excluded from surgical consideration. Our results, in tandem with literature showing the deleterious effects of decreased mobility in the elderly, suggest that the discussion to pursue or hold surgical correction of chronic foot and ankle disease in patients over age 65 must consider the mobility benefits of surgery.
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Affiliation(s)
- Wesley Manz
- Department of Orthopaedic Surgery, Emory University, Atlanta, GA, USA
| | - Joseph Novack
- School of Medicine, Emory University, Atlanta, GA, USA
| | - Juliet Fink
- School of Medicine, Emory University, Atlanta, GA, USA
| | - Joseph Jacobson
- Department of Orthopaedic Surgery, Emory University, Atlanta, GA, USA
| | - Jason Bariteau
- Department of Orthopaedic Surgery, Emory University, Atlanta, GA, USA
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Korenhof SSA, van Grieken AA, Franse CCB, Tan SSSS, Verma AA, Alhambra TT, Raat HH. The association of fear of falling and physical and mental Health-Related Quality of Life (HRQoL) among community-dwelling older persons; a cross-sectional study of Urban Health Centres Europe (UHCE). BMC Geriatr 2023; 23:291. [PMID: 37179319 PMCID: PMC10182691 DOI: 10.1186/s12877-023-04004-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The share of people over 80 years in the European Union is estimated to increase two-and-a-half-fold from 2000 to 2100. A substantial share of older persons experiences fear of falling. This fear is partly associated with a fall in the recent past. Because of the associations between fear of falling, avoiding physical activity, and the potential impact of those on health, an association between fear of falling and low health-related quality of life, is suggested. This study examined the association of fear of falling with physical and mental Health-Related Quality of Life (HRQoL) among community-dwelling older persons in five European countries. METHODS A cross-sectional study was conducted using baseline data of community-dwelling persons of 70 years and older participating in the Urban Health Centers Europe project in five European countries: United Kingdom, Greece, Croatia, the Netherlands and Spain. This study assessed fear of falling with the Short Falls Efficacy Scale-International and HRQoL with the 12-Item Short-Form Health Survey. The association between low, moderate or high fear of falling and HRQoL was examined using adjusted multivariable linear regression models. RESULTS Data of 2189 persons were analyzed (mean age 79.6 years; 60.6% females). Among the participants, 1096 (50.1%) experienced low fear of falling; 648 (29.6%) moderate fear of falling and 445 (20.3%) high fear of falling. Compared to those who reported low fear of falling in multivariate analysis, participants who reported moderate or high fear of falling experienced lower physical HRQoL (β = -6.10, P < 0.001 and β = -13.15, P < 0.001, respectively). In addition, participants who reported moderate or high fear of falling also experienced lower mental HRQoL than those who reported low fear of falling (β = -2.31, P < 0.001 and β = -8.80, P < 0.001, respectively). CONCLUSIONS This study observed a negative association between fear of falling and physical and mental HRQoL in a population of older European persons. These findings emphasize the relevance for health professionals to assess and address fear of falling. In addition, attention should be given to programs that promote physical activity, reduce fear of falling, and maintain or increase physical strength among older adults; this may contribute to physical and mental HRQoL.
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Affiliation(s)
- Sophie S A Korenhof
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Amy A van Grieken
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Carmen C B Franse
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Siok Swan S S Tan
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
- Inholland University of Applied Sciences, Rotterdam, the Netherlands
| | - Arpana A Verma
- Manchester Urban Collaboration On Health, Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Tamara T Alhambra
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - Hein H Raat
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.
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Mo C, Peng W, Luo Y, Tang S, Liu M. Bidirectional relationship between fear of falling and frailty among community-dwelling older adults: A longitudinal study. Geriatr Nurs 2023; 51:286-292. [PMID: 37031580 DOI: 10.1016/j.gerinurse.2023.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 04/11/2023]
Abstract
This study aims to examine the bidirectional association between fear of falling (FOF) and frailty among community-dwelling older adults. Longitudinal analyses were conducted over a representative sample of 5,829 community-dwelling individuals ≥65 years from the National Health and Aging Trends Study. FOF was ascertained by asking participants whether they worried about falling and if this worry ever limited their activities. Frailty status was assessed based on frailty phenotype. At baseline, 71.4% of participants reported no FOF, 16.7% reported FOF without fear-related activity restriction (FAR), and 11.9% reported FOF with FAR. The proportion of robust, pre-frail and frail respondents at baseline was 36.1%, 48.7% and 15.2%, respectively. Multinomial logistic regression models indicated FOF with and without FAR predicted pre-frailty and frailty. Pre-frailty predicted FOF with and without FAR, while frailty only predicted FOF with FAR. Tailored intervention strategies are needed for preventing adverse outcomes of FOF and frailty among the older population.
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Affiliation(s)
- Cen Mo
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha 410013, China
| | - Wenting Peng
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha 410013, China
| | - Yuqian Luo
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha 410013, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha 410013, China
| | - Minhui Liu
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha 410013, China.
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dos Santos EPR, Ohara DG, Patrizzi LJ, de Walsh IAP, Silva CDFR, da Silva Neto JR, Oliveira NGN, Matos AP, Iosimuta NCR, Pinto ACPN, Pegorari MS. Investigating Factors Associated with Fear of Falling in Community-Dwelling Older Adults through Structural Equation Modeling Analysis: A Cross-Sectional Study. J Clin Med 2023; 12:545. [PMID: 36675475 PMCID: PMC9867366 DOI: 10.3390/jcm12020545] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
The scientific literature mentions the existence of factors associated with fear of falling in older adults. However, the direct and indirect paths of its predictors have not yet been fully explored. This study aimed to analyze the socioeconomic, clinical, and health factors directly and indirectly associated with fear of falling in community-dwelling older adults. This is a cross-sectional study conducted in older adults (n = 410 - 70.11 ± 7.22 years). Clinical and health-condition data were collected, as were data on fear of falling using the Falls Efficacy Scale International-Brazil (FES-I Brazil). It was found that being female and having a higher number of self-reported morbidities, worse physical performance, and a higher number of depressive symptoms were directly associated with greater fear of falling. Regarding indirect associations, physical inactivity, mediated by a greater number of morbidities, worse physical performance, and a greater number of depressive symptoms, was associated with greater fear of falling. In addition, worse self-rated health, mediated by a greater number of depressive symptoms, as well as older age, mediated by worse physical performance, were associated with the outcome. This study provides information on the predictors directly and indirectly associated with fear of falling, expanding current understanding of this relationship.
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Affiliation(s)
- Elane Priscila Rosa dos Santos
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Daniela Gonçalves Ohara
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
| | - Lislei Jorge Patrizzi
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
- Postgraduate Program in Physical Therapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no30, Abadia, Uberaba 38025-180, Brazil
| | - Isabel Aparecida Porcatti de Walsh
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
- Postgraduate Program in Physical Therapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no30, Abadia, Uberaba 38025-180, Brazil
| | - Caroline de Fátima Ribeiro Silva
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - José Ribeiro da Silva Neto
- Postgraduate Program in Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km–02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Nayara Gomes Nunes Oliveira
- Department of Nursing in Education and Community Health, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
| | - Areolino Pena Matos
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
- Postgraduate Program in Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km–02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Natalia Camargo Rodrigues Iosimuta
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
- Postgraduate Program in Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km–02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Ana Carolina Pereira Nunes Pinto
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Maycon Sousa Pegorari
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
- Postgraduate Program in Physical Therapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no30, Abadia, Uberaba 38025-180, Brazil
- Postgraduate Program in Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km–02, Jardim Marco Zero, Macapá 68903-419, Brazil
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12
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Nascimento MDM, Gouveia ÉR, Gouveia BR, Marques A, França C, Freitas DL, Campos P, Ihle A. Exploring Mediation Effects of Gait Speed, Body Balance, and Falls in the Relationship between Physical Activity and Health-Related Quality of Life in Vulnerable Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14135. [PMID: 36361009 PMCID: PMC9655035 DOI: 10.3390/ijerph192114135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
The present study aimed to examine whether gait speed (GS), body balance (BB), and falls mediated the relationship between physical activity (PA) and health-related quality of life (HRQoL) in community-dwelling older adults. This is a cross-sectional study that included 305 men and 314 women (69.5 ± 5.6 years), residing in the Autonomous Region of Madeira, Portugal. HRQoL and PA were assessed using the SF-36 and Baecke Questionnaires, respectively. While BB was obtained by the Fullerton Advance Balance (FAB) scale, GS by the 50-foot (15 m) walk test, and the frequency of falls was obtained by self-report. According to the analyses, when GS and BB were placed concomitantly as mediators, the direct effect revealed by the model revealed a non-significant relationship between PA and falls. Thus, in the context of falls, GS and BB partially mediated the association between PA and HRQoL in approximately 29.7%, 56%, and 49.2%, respectively. The total HRQoL model explained a variance of 36.4%. The results can help to understand the role that GS, BB, and falls play in the relationship between PA and HRQoL of the vulnerable older adult population.
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Affiliation(s)
- Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Petrolina 56304-917, Brazil
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
| | - Bruna R. Gouveia
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Regional Directorate of Health, Secretary of Health of the Autonomous Region of Madeira, 9004-515 Funchal, Portugal
- Saint Joseph of Cluny Higher School of Nursing, 9050-535 Funchal, Portugal
| | - Adilson Marques
- CIPER, Faculty of Human Kinetics, University of Lisbon, 1495-751 Lisbon, Portugal
- ISAMB, Faculty of Medicine, University of Lisbon, 1649-020 Lisbon, Portugal
| | - Cíntia França
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal
| | - Duarte L. Freitas
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Pedro Campos
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal
- Department of Informatics Engineering and Interactive Media Design, University of Madeira, 9020-105 Funchal, Portugal
| | - Andreas Ihle
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
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13
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Shiratsuchi D, Makizako H, Nakai Y, Bae S, Lee S, Kim H, Matsuzaki-Kihara Y, Miyano I, Ota H, Shimada H. Associations of fall history and fear of falling with multidimensional cognitive function in independent community-dwelling older adults: findings from ORANGE study. Aging Clin Exp Res 2022; 34:2985-2992. [PMID: 36050582 DOI: 10.1007/s40520-022-02235-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/18/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Falls and fear of falling (FoF) inhibit healthy longevity and have been suggested to be associated with cognitive function. However, the domains of cognitive function that are associated with them remain controversial. It is speculated that clarifying this will help in the assessment of health status and interventions in the community. AIM To analyse the associations between fall history and FoF and multidimensional cognitive function in independent community-dwelling older adults. METHODS The data from 9759 (73.3 ± 5.4 years, 59.9% women) older individuals enrolled in the cross-sectional ORANGE study were analysed. Simple questions were used to assess fall history in the past year and current FoF. Assessments of multidimensional cognitive function were performed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool (NCGG-FAT) to evaluate memory, attention, executive function, and processing speed. The independent associations of fall history and FoF with multidimensional cognitive function were assessed using multivariate linear regressions adjusted for potential confounding variables. RESULTS A total of 18.3% and 35.4% of participants presented with fall history and FoF, respectively. Fall history (p = 0.008) and FoF (p = 0.002) were significantly associated with memory. FoF, but not fall history was associated with attention (p = 0.004), executive function (p < 0.01), and processing speed (p < 0.01). CONCLUSION In independent community-dwelling older adults, fall history was associated only with the memory domain; in contrast, fear of falling was associated with multidimensional cognitive function. This study provides weak evidence suggesting the need to assess falls and FoF in all situations involving independent community-dwelling older adults.
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Affiliation(s)
- Daijo Shiratsuchi
- Graduate School of Health Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.,Department of Rehabilitation, Japan Community Health Care Organization Kumamoto General Hospital, 10-10 Toricho, Yatsushiro, Kumamoto, 866-8660, Japan
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Yuki Nakai
- Department of Mechanical Systems Engineering, Faculty of Engineering, Daiichi Institute of Technology, 1-10-2 Kokubuchuo, Kagoshima, 899-4395, Japan
| | - Seongryu Bae
- Department of Health Care and Science, Dong-A University, 37 Nakdong-Daero 550beon-gil Saha-Gu, Busan, 604-714, Korea
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi , Tokyo, 173-0015, Japan
| | - Yuriko Matsuzaki-Kihara
- Department of Rehabilitation, Japan Health Care College, 11-1-50 Tsukisamuhigashi3jo, Toyohira, Sapporo, Hokkaido, 062-0053, Japan
| | - Ichiro Miyano
- Department of Public Health, Kochi Medical School, Kochi University, Oko, Nankoku, Kochi, 783-8505, Japan
| | - Hidetaka Ota
- Advanced Research Center for Geriatric and Gerontology, Akita University, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan
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14
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Associations between objectively measured pattern of physical activity, sedentary behavior and fear of falling in Chinese community-dwelling older women. Geriatr Nurs 2022; 46:80-85. [DOI: 10.1016/j.gerinurse.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 11/19/2022]
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15
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Belloni G, Büla C, Santos-Eggimann B, Henchoz Y, Fustinoni S, Seematter-Bagnoud L. Fear of falling and all-cause mortality among young-old community-dwelling adults: a 6-year prospective study. Eur J Ageing 2022; 19:293-300. [PMID: 35663911 PMCID: PMC9156588 DOI: 10.1007/s10433-021-00635-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/30/2022] Open
Abstract
This study investigated whether fear of falling (FOF) measured by two different instruments, the Falls Efficacy Scale-International (FES-I) and the single question on FOF and activity restriction (SQ-FAR), is associated with mortality at 6-year follow-up. Participants (n = 1359, 58.6% women) were community-dwelling persons enrolled in the Lausanne cohort 65 + , aged 66 to 71 years at baseline. Covariables assessed at baseline included demographic, cognitive, affective, functional and health status, while date of death was obtained from the office in charge for population registration. Unadjusted Kaplan Meyer curves were performed to show the survival probability for all-cause mortality according to the degree of FOF reported with FES-I and SQ-FAR, respectively. Bivariable and multivariable Cox regression analyses were performed to assess hazard ratios, using time-in-study as the time scale variable and adjusting for variables significantly associated in bivariable analyses. During the 6-year follow-up, 102 (7.5%) participants died. Reporting the highest level of fear at FES-I (crude HR 3.86, 95% CI 2.37-6.29, P < .001) or "FOF with activity restriction" with SQ-FAR (crude HR 2.42, 95% CI 1.44-4.09, P = .001) were both associated with increased hazard of death but these associations did not remain significant once adjusting for gender, cognitive, affective and functional status. As a conclusion, although high FOF and related activity restriction, assessed with FES-I and SQ-FAR, identifies young-old community-dwelling people at increased risk of 6-year mortality, this association disappears when adjusting for potential confounders. As a marker of negative health outcomes, FOF should be screened for in order to provide personalized care and reduce subsequent risks.
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Affiliation(s)
- Giulia Belloni
- Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Centre, Mont-Paisible 16, CH-1011 Lausanne, Switzerland
- Health Services Unit, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Christophe Büla
- Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Centre, Mont-Paisible 16, CH-1011 Lausanne, Switzerland
| | - Brigitte Santos-Eggimann
- Health Services Unit, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Yves Henchoz
- Health Services Unit, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Sarah Fustinoni
- Health Services Unit, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Laurence Seematter-Bagnoud
- Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Centre, Mont-Paisible 16, CH-1011 Lausanne, Switzerland
- Health Services Unit, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Quantifying fear of falling by utilizing objective body sway measures: A 360° virtual video study. Gait Posture 2022; 93:160-165. [PMID: 35180684 DOI: 10.1016/j.gaitpost.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/13/2022] [Accepted: 02/09/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Fear of falling (FOF) is a psychological condition that can lead to increased morbidity and mortality in the elderly population. However, the subjective and multidimensional nature of FOF results in limitations of existing FOF measurement tools, which could influence the generalization of the findings from various studies. An objective measure of FOF could address those limitations. The present study aimed to identify the feasibility of using center of pressure (COP) parameters to quantify FOF. RESEARCH QUESTION (1) Are 360º roller coaster videos effective to induce FOF? And (2) Which COP parameter(s) is/are feasible to quantify FOF? METHODS Nineteen young, healthy adults (24 ± 2.47 years) were recruited in the present study. Subjects were required to watch three 360º videos: one control video and two roller coaster videos, through virtual reality goggles during standing and sitting. Six trials (3 during standing and 3 during sitting) with video were performed. Subjects were required to rate their FOF on a visual analogue scale after watching each video. COP mean power frequency, COP root mean square, and COP range were measured. The Friedman test was used to assess differences in COP parameters under different video conditions, and Spearman's correlation analysis was used to assess the relationship between FOF and COP parameters. RESULTS Similar COP changes were observed in sitting and standing conditions. With increased FOF, participants demonstrated decreased COP mean power frequency and increased COP root mean square in the medial-lateral direction during both sitting and standing. SIGNIFICANCE Our study provided evidence that 360º roller coaster videos are effective tools to induce FOF and change in COP parameters. The relationship between FOF and COP parameters suggests that the measurement of body sway may be an objective way to quantify FOF. More research are needed to solidify the evidence.
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de Souza LF, Canever JB, Moreira BDS, Danielewicz AL, de Avelar NCP. Association Between Fear of Falling and Frailty in Community-Dwelling Older Adults: A Systematic Review. Clin Interv Aging 2022; 17:129-140. [PMID: 35173427 PMCID: PMC8843349 DOI: 10.2147/cia.s328423] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/25/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND/OBJECTIVE Fear of falling (FoF) and frailty are common problems in older adults. FoF can lead to self-imposed restriction of activities and then further decline in physical capacities that predispose older adults to frailty. Evaluating the association of these two geriatric syndromes may be the first step for understanding their complex relationship and might ultimately lead to establishing therapeutic goals and guiding treatments for older adults with frailty. This systematic review was conducted to provide evidence regarding the association between FoF and frailty. METHODS All the articles that provided information on the association between FoF and frailty were selected from PubMed, Scopus, CINAHL, and EMBASE in search of relevant papers. Articles reporting information on the association between FoF (exposure) and frailty (outcome), with older adults (age ≥60 years) living in the community (ie, living either at home or in places of residence that do not provide nursing care or rehabilitation) were included. Only original articles with observational design (cross-sectional or longitudinal/cohort) were included. The methodological quality of included articles was evaluated independently by the two assessors through the Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute (JBI) critical appraisal checklist for longitudinal and cross-sectional studies, respectively. RESULTS The initial searches found 4,342 articles, of which 10 articles were included in this review: 7 cross-sectional and 2 longitudinal studies, and 1 study with cross-sectional and longitudinal analyses. The total sample was composed of 6,294 community-dwelling older adults (61.8% women). Among the longitudinal studies, adjusted odds ratios ranged from 1.18 (95% CI = 1.02; 1.36) to 9.87 (95% CI = 5.22; 18.68), while the adjusted odds ratios of the cross-sectional studies ranged from 1.04 (95% CI = 1.02; 1.07) to 7.16 (95% CI = 2.34; 21.89). CONCLUSION FoF increases the risk of frailty in community-dwelling older adults. The knowledge of this association is of utmost importance in clinical practice, since it can help health professionals in the development of rehabilitation, prevention, and health promotion protocols. In addition, these findings can contribute to the development of public health policies and actions aimed at reducing the FoF and consequently the frailty. PROSPERO CRD42021276775.
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Affiliation(s)
- Larissa Franciny de Souza
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Jaquelini Betta Canever
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Bruno de Souza Moreira
- René Rachou Institute, Oswaldo Cruz Foundation (Fiocruz Minas), Belo Horizonte, Minas Gerais, Brazil
| | - Ana Lúcia Danielewicz
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Núbia Carelli Pereira de Avelar
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
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18
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Yang JM, Kim JH. Association between activity restriction due to fear of falling and mortality: Results from the Korean longitudinal study of aging. Geriatr Gerontol Int 2021; 22:168-174. [PMID: 34964247 DOI: 10.1111/ggi.14336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/19/2021] [Accepted: 12/04/2021] [Indexed: 11/30/2022]
Abstract
AIM To analyze the correlation between activity restriction due to fear of falling and mortality among Koreans aged ≥45 years. METHODS After excluding missing values, the data of 411 participants from the first to sixth waves of the Korean Longitudinal Study of Aging were analyzed using the χ2 -test, log-rank tests and Cox proportional hazards model. RESULTS In model 1, which did not include activity restriction due to fear of falling as an independent variable, the death rate increased by 1.024-fold (hazard ratio 1.024, 95% confidence interval 1.000-1.050, P = 0.0498) as the number of falls increased by one. In model 2, which included activity restriction due to fear of falling as an independent variable, participants with experience of activity restriction showed 1.993-fold higher mortality (hazard ratio 1.993, 95% confidence interval 1.112-3.572, P = 0.0205) than those without such experience. In addition, as the number of falls in the group with chronic diseases increased by one, the mortality rate increased by 1.028-fold (hazard ratio 1.028, 95% confidence interval 1.001-1.057, P = 0.043). CONCLUSIONS There was a close relationship between activity restriction due to fear of falling and mortality. Therefore, this study can serve as the foundation for policies and institutional measures to reduce the mortality rate of groups with activity restrictions due to fear of falling. Geriatr Gerontol Int 2021; ••: ••-••.
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Affiliation(s)
- Jeong Min Yang
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Korea.,Institute for Digital Life Convergence, Dankook University, Cheonan, Korea
| | - Jae Hyun Kim
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Korea.,Institute for Digital Life Convergence, Dankook University, Cheonan, Korea
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How Much Time in Sedentary Behavior Should Be Reduced to Decrease Fear of Falling and Falls in Community-Dwelling Older Adults? J Aging Phys Act 2021; 30:806-812. [PMID: 34911037 DOI: 10.1123/japa.2021-0175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 09/30/2021] [Accepted: 11/17/2021] [Indexed: 11/18/2022]
Abstract
Fear of falling and history of falls are frequent situations in older adults, which can be aggravated by sedentary behavior (SB). The objective was to establish SB cutoff values which discriminate falls and fear of falling in older adults and verify the association between these conditions. This was a cross-sectional study including 308 community-dwelling older adults. The SB was assessed by International Physical Activity Questionnaire. The outcomes were history of falling in the last 12 months and fear of falling (higher or equal than 23 points in Falls Efficacy Scale International-Brazil). The cutoff points found were >4.14 (area under curve = 0.60, 95% confidence intervals [CIs] [0.54, 0.65]) and >3.90 hr per day (area under curve = 0.59, 95% CI [0.53, 0.64]) for fear of falling and history of falls, respectively. Older adults with SB had 1.71 (95% CI [1.03, 2.84]) and 1.75 (95% CI [1.06, 2.89]) greater odds of having greater fear of falling and suffering falls, respectively.
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20
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Experiences of falling and depression: Results from the Korean Longitudinal Study of Ageing. J Affect Disord 2021; 281:174-182. [PMID: 33321383 DOI: 10.1016/j.jad.2020.12.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/08/2020] [Accepted: 12/05/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study estimates the association between fall experiences during the last two years and risk of depression. METHODS Data from 9,355 subjects of the Korean Longitudinal Study of Ageing from 2006 to 2016 were included with baseline at 2006. To analyze the association between fall experiences during the last two years and depression, a generalized estimating equation (GEE) model and chi-square tests were used. RESULTS At baseline 2006, the odds ratio (OR) of depressive symptoms in those with fall experiences was 1.36 times higher (p < .0001) than those with non-fall experience. In those 64 years or younger and 65 years or older, the OR of depressive symptoms in fall experience was 1.45 times higher (p =0.003) and 1.34 times higher (p =0.000) than those with non-fall experience, respectively. In males and females, the OR of depressive symptoms in those with fall experience was 1.47 times higher (p 0.008) and 1.34 times higher (p =0.000) than those with non-fall experience, respectively. CONCLUSION Fall experiences during the last two years are associated with depressive symptoms. Therefore, self-reported screening for fall experiences might aid in population-based prevention strategies for depressive symptoms.
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21
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Alcolea-Ruiz N, Alcolea-Ruiz S, Esteban-Paredes F, Beamud-Lagos M, Villar-Espejo MT, Pérez-Rivas FJ. [Prevalence of fear of falling and related factors in community-dwelling older people]. Aten Primaria 2021; 53:101962. [PMID: 33446358 PMCID: PMC7910690 DOI: 10.1016/j.aprim.2020.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 11/29/2022] Open
Abstract
Objetivo El objetivo general del estudio es conocer la prevalencia de la preocupación a caer en personas mayores, independientes para la deambulación, que viven en la comunidad, según la versión reducida del FES-I y los factores asociados que influyen en esta preocupación. Diseño Estudio descriptivo transversal. Emplazamiento Centro de Salud El Greco (Getafe), Gerencia Asistencial de Atención Primaria de Madrid. Participantes Ciento ochenta y nueve pacientes ≥ 70 años independientes o con dependencia funcional leve-moderada (índice de Barthel ≥ 60) e independientes para la deambulación (camina 45 min sin ayuda o con bastón). El estudio se ofreció a 328 personas: 217 aceptaron y rechazaron 111. Mediciones principales La variable dependiente, miedo a caerse (MC), fue evaluada mediante el cuestionario Short FES-I, considerando como punto de corte para el cribado positivo del MC una puntuación ≥ 11. Como variables independientes se consideraron: índice de Barthel, escala Downton, prueba de fragilidad Short Physical Performance Battery (SPPB), caídas en el último año, lesiones asociadas a las caídas, tiempo desde la última caída, déficit sensorial, uso de dispositivos de la marcha, comorbilidad y tratamiento farmacológico. Resultados La prevalencia del MC fue del 42,9% (IC 95%: 35,5-50,2). Los factores asociados al MC en el análisis multivariante final fueron: sexo femenino, vivir solo, alto riesgo de caídas, presencia de fragilidad, uso de hipotensores y lesiones asociadas a caídas previas. Conclusiones La prevalencia del miedo a caer en personas mayores es elevada. Los profesionales de atención primaria deben sistematizar el cribado de este problema de salud, priorizando especialmente en las personas que presentan los siguientes factores de riesgo: ser mujer, vivir solo, tener una puntuación baja en el SPPB (como indicador de fragilidad) o presentar un elevado riesgo de caídas.
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Affiliation(s)
- Nuria Alcolea-Ruiz
- Centro de Salud Sector 3 (Getafe), Gerencia Asistencial de Atención Primaria del Servicio Madrileño de Salud, Madrid, España.
| | | | - Francisco Esteban-Paredes
- Centro de Salud El Greco (Getafe), Gerencia Asistencial de Atención Primaria del Servicio Madrileño de Salud, Madrid, España
| | - Milagros Beamud-Lagos
- Centro de Salud Paseo Imperial, Gerencia Asistencial de Atención Primaria del Servicio Madrileño de Salud, Madrid, España; Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, España
| | - María Teresa Villar-Espejo
- Centro de Salud Reyes Magos (Alcalá de Henares), Gerencia Asistencial de Atención Primaria del Servicio Madrileño de Salud, Madrid, España
| | - Francisco Javier Pérez-Rivas
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, España
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