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Lee SC, Tzeng IS, Feng CT, Liang HW, Chien TH, Horng YS. Cross-cultural adaptation and psychometric property testing of the Taiwan Chinese version of the iconographical falls efficacy scale. J Formos Med Assoc 2024; 123:655-663. [PMID: 37996326 DOI: 10.1016/j.jfma.2023.10.023] [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: 05/14/2023] [Revised: 09/27/2023] [Accepted: 10/24/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The Iconographical Falls Efficacy Scale (Icon-FES) uses short phrases and images to depict activities. This study culturally adapted and validated the Taiwan Chinese version of the 30- and 10-item Icon-FESs (Icon-FESs [TW]) in community-dwelling older individuals. METHODS The Icon-FES (TW) was developed using forward-backward translation. A total of 120 community-dwelling older individuals were recruited. They completed the Taiwan Chinese version of the Falls Efficacy Scale-International (FES-I [TC]), the Icon-FES (TW), the Mini-Mental State Examination, and the World Health Organization Quality of Life Questionnaire Brief Version (WHOQOL-BREF) and were assessed using the Berg Balance Scale and the Short Physical Performance Battery (SPPB). The Icon-FES (TW) was recompleted 1 week later. Confirmatory factor analysis was used to evaluate the overall structure and measurement properties. RESULTS Cronbach's alpha values of 0.97 and 0.91 indicated that the 30- and 10-item Icon-FESs (TW) had high internal consistency. The 30- and 10-item Icon-FESs (TW) exhibited significantly high correlation with the FES-I (r = 0.88 and 0.84, respectively). Both versions of the Icon-FES (TW) exhibited mild correlation with the physical domain of the WHOQOL-BREF. The 30- and 10-item Icon-FESs (TW) discriminated by intensity of concern and SPPB score. Their test-retest reliability was high (intraclass correlation coefficient = 0.79 and 0.80 for the 30- and 10-item Icon-FESs (TW), respectively). Neither floor nor ceiling effects were observed. CONCLUSION The Icon-FES (TW) is a reliable and valid questionnaire useful for assessing the levels of concern regarding falling among older adults in clinical practice and research.
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Affiliation(s)
- Shu-Chun Lee
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan; International PhD Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu chi Hospital, Buddhist Tzu chi Medical Foundation, New Taipei, Taiwan
| | - Chi-Tzu Feng
- Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Huey-Wen Liang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital Hsin-Chu branch, Hsin-Chu, Taiwan
| | - Tzu-Hsuan Chien
- Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Yi-Shiung Horng
- Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan.
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García-Martínez A, García-Rosa S, Gil-Rodrigo A, Machado VT, Pérez-Fonseca C, Nickel CH, Artajona L, Jacob J, Llorens P, Herrero P, Canadell N, Rangel C, Martín-Sánchez FJ, Del Nogal ML, Miró Ò. Prevalence and outcomes of fear of falling in older adults with falls at the emergency department: a multicentric observational study. Eur Geriatr Med 2024:10.1007/s41999-024-00992-1. [PMID: 38809489 DOI: 10.1007/s41999-024-00992-1] [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: 02/17/2024] [Accepted: 05/08/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE Fear of falling (FOF) may result in activity restriction and deconditioning. The aim of the study was to identify factors associated with FOF in older patients and to investigate if FOF influenced long-term outcomes. METHODS Multicentric, observational, prospective study including patients 65 years or older attending the emergency department (ED) after a fall. Demographical, patient- and fall-related features were recorded at the ED. FOF was assessed using a single question. The primary outcome was all-cause death. Secondary outcomes included new fall-related visit, fall-related hospitalisation, and admission to residential care. Logistic regression and Cox regression models were used for statistical analyses. RESULTS Overall, 1464 patients were included (47.1% with FOF), followed for a median of 6.2 years (2.2-7.9). Seven variables (age, female sex, living alone, previous falls, sedative medications, urinary incontinence, and intrinsic cause of the fall) were directly associated with FOF whereas use of walking aids and living in residential care were inversely associated. After the index episode, 748 patients (51%) died (median 3.2 years), 677 (46.2%) had a new fall-related ED visit (median 1.7 years), 251 (17.1%) were hospitalised (median 2.8 years), and 197 (19.4%) were admitted to care (median 2.1 years). FOF was associated with death (HR 1.239, 95% CI 1.073-1.431), hospitalisation (HR 1.407, 95% CI 1.097-1.806) and institutionalisation (HR 1.578, 95% CI 1.192-2.088), but significance was lost after adjustment. CONCLUSION FOF is a prevalent condition in older patients presenting to the ED after a fall. However, it was not associated with long-term outcomes. Future research is needed to understand the influence of FOF in maintenance of functional capacity or quality of life.
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Affiliation(s)
- Ana García-Martínez
- Emergency Department, IDIBAPS, Hospital Clínic, University of Barcelona, Villarroel, 170, 08036, Barcelona, Spain.
| | | | - Adriana Gil-Rodrigo
- Emergency Department, Short Stay Unit and Hospitalization at Home Unit, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General de Alicante, Universidad Miguel Hernández, Alicante, Spain
| | - Victoria Torres Machado
- Emergency Department, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Lourdes Artajona
- Emergency Department, IDIBAPS, Hospital Clínic, University of Barcelona, Villarroel, 170, 08036, Barcelona, Spain
| | - Javier Jacob
- Emergency Department, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Pere Llorens
- Emergency Department, Short Stay Unit and Hospitalization at Home Unit, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General de Alicante, Universidad Miguel Hernández, Alicante, Spain
| | - Pablo Herrero
- Emergency Department, Hospital Central de Asturias, Oviedo, Spain
| | - Naila Canadell
- Emergency Department, IDIBAPS, Hospital Clínic, University of Barcelona, Villarroel, 170, 08036, Barcelona, Spain
| | - Carolina Rangel
- Emergency Department, IDIBAPS, Hospital Clínic, University of Barcelona, Villarroel, 170, 08036, Barcelona, Spain
| | | | | | - Òscar Miró
- Emergency Department, IDIBAPS, Hospital Clínic, University of Barcelona, Villarroel, 170, 08036, Barcelona, Spain
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Peng W, Mo C, Luo Y, Tang S, Liu M. Demographics moderated the association of symptom burden with falls and fall-related outcomes. Arch Gerontol Geriatr 2024; 117:105190. [PMID: 37713934 DOI: 10.1016/j.archger.2023.105190] [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: 06/07/2023] [Revised: 08/06/2023] [Accepted: 09/06/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVES To examine whether (1) prior-year symptom burden predicted later-year falls and fall-related outcomes and (2) demographics moderated the longitudinal effects of symptom burden on falls and fall-related outcomes among community-dwelling older adults. METHODS We used 2011-2018 National Health and Aging Trends Study data that included 9,060 community-dwelling older adults (contributed 34,327 observations). Falls and fall-related outcomes included self-reported falls, multiple falls, fear of falling (FOF), and FOF limiting activity. Symptom burden was defined as the presence of pain, insomnia, breathing difficulty, depressive symptoms, anxiety, and fatigue, and calculated the number of symptoms (range from 0 to 6). Binomial logistic regression was used to examine the associations between symptom burden and falls and fall-related outcomes and the moderation effects of demographic factors. RESULTS The majority of the sample were aged between 65 and 79 years old (57.7%), non-Hispanic White (70.5%), and female (58.4%). Each additional symptom was associated with an increased risk of falls (Adjusted Odds Ratio [AOR]: 1.13, 95% CI: 1.10-1.15), multiple falls (AOR: 1.15, 95% CI: 1.12-1.18), FOF (AOR: 1.20, 95% CI: 1.18-1.23), and FOF limiting activity (AOR: 1.24, 95% CI: 1.20-1.28). Age, race/ethnicity, education, and living arrangement statistically significantly moderated the relationships between symptom burden and falls and fall-related outcomes. CONCLUSIONS Symptom burden predicted falls, multiple falls, FOF and FOF limiting activity, and demographics may differentially modify this risk. Individually tailored symptom assessment and management plans should be incorporated into fall risk assessment and interventions for community-dwelling older adults living.
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Affiliation(s)
- Wenting Peng
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Cen Mo
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yuqian Luo
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Minhui Liu
- Xiangya School of Nursing, Central South University, Changsha, China.
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Moon S, Oh E, Chung D, Hong GRS. Changes in instrumental activities daily living limitations and their associated factors according to gender in community-residing older adults: A longitudinal cohort study. PLoS One 2024; 19:e0296796. [PMID: 38206920 PMCID: PMC10783775 DOI: 10.1371/journal.pone.0296796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/19/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Increases in dependence among older adults cause increases in care needs and social care burden. Instrumental activities of daily living (IADL) are often used to assess the independence of older adults residing in communities. Various factors affect IADL limitations, but few studies confirm gender differences in IADL limitations in older adults. This study explored the changes in incidence of IADL limitations across 14 years and identified the factors associated with IADL limitations according to gender among older adults in Korea. METHOD This study uses secondary data analysis with 2006-2020 data from the Korean Longitudinal Study of Aging (KLoSA), a longitudinal cohort study. Among the total 10,254 participants, 1,230 adults aged 65 years and over who met the criteria were included in the final analysis. For each IADL item, a limitation was defined when the response was partial or complete dependence. Multivariate logistic regression was performed to identify the factors (in 2006) associated with IADL limitations in 2020. RESULTS The mean age of the participants at baseline was 69.64 years (SD 3.93), and 61.0% of participants were female. Total scores for IADL limitations increased gradually across 14 years in all participants, and observed changes were statistically significant. The top three ranked items of IADL limitations differed according to gender in 2020: the top limitations in men were preparing meals, laundry, and using public transportation, and the top limitations in women were using public transportation, going out, and handling money. Factors associated with total IADL limitations were grip strength in men and age, dementia, fear of fall, and grip strength in women. Factors associated with the top three ranked items of IADL limitations differed according to gender. CONCLUSION The incidence of IADL limitations gradually increased in all participants over a 14-year period. In older adults in Korea, gender differences were confirmed in the factors associated with IADL limitations, as well as in the main limited activities. To minimize IADL limitations in community-residing older adults, it is necessary to plan tailored interventions.
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Affiliation(s)
- SeolHwa Moon
- Department of Nursing, Hoseo University, Cheonan, Republic of Korea
| | - Eunmi Oh
- Research Institute of Nursing Science, Hanyang University, Seoul, Republic of Korea
| | - Daum Chung
- College of Nursing, Hanyang University, Seoul, Republic of Korea
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Lee E, Jun SS. Trajectories of Disability and Related Factors in Korean Adults Aged ≥75 years. J Appl Gerontol 2023; 42:1953-1964. [PMID: 37077170 DOI: 10.1177/07334648231170148] [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] [Indexed: 04/21/2023] Open
Abstract
This study aimed to identify distinct trajectories of activities of daily living (ADL) disability in older adults aged ≥75 years over 6 years. A growth mixture model and the multinomial logistic regression analysis were used to identify different disability trajectories and to investigate each trajectory. Four distinct disability trajectories were identified: low, moderate, high, and progressive. Activity restriction due to fear of falling, being underweight, impaired vision, and impaired cognition were highly associated with the progressive groups, compared with the low disability group. Activity restriction due to fear of falling, depression, impaired cognition, and poor subjective health status were associated with moderate and high disability. These findings contribute to increasing the understanding of ADL disability among older adults.
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Affiliation(s)
- Eunyoung Lee
- College of Nursing, Pusan National University, Busan, Republic of Korea
| | - Seong Sook Jun
- College of Nursing, Pusan National University, Busan, Republic of Korea
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Sawa R, Doi T, Tsutsumimoto K, Nakakubo S, Kurita S, Kiuchi Y, Nishimoto K, Shimada H. Overlapping status of frailty and fear of falling: an elevated risk of incident disability in community-dwelling older adults. Aging Clin Exp Res 2023; 35:1937-1944. [PMID: 37337077 DOI: 10.1007/s40520-023-02474-z] [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: 03/04/2023] [Accepted: 06/11/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Although overlapping frailty and fear of falling (FoF) are likely to increase with population aging, the combined effect of frailty and FoF on incident disability is not yet well understood. AIMS The purpose of this study is to examine whether frailty combined with FoF increased the risk of incident disability in older adults. Our secondary purpose was to clarify the synergistic effect of frailty and FoF on incident disability. METHODS This is a prospective study. Participants were 9372 older adults (mean age 73.5 years). Frailty status was assessed using the Japanese Cardiovascular Health Study index, and FoF was measured using two closed questions. Incident disability was prospectively monitored by their long-term care insurance records. RESULTS During the follow-up period (mean duration 23.4 months), 487 (5.2%) participants developed disability. The proportion of incident disability linearly increased according to FoF level regardless of baseline frailty status. Frail participants with FoF had a higher risk of incident disability than those with frailty only or neither (adjusted hazard ratio [HR] 2.63, 95% confidence interval [CI] 1.95-3.54). Frailty in combination with excessive FoF further increased the risk of incident disability (adjusted HR 4.30, 95% CI 2.56-7.23) although no synergistic effect was observed (relative excessive risk due to interaction 1.69, 95% CI - 0.55, 3.93). CONCLUSION The overlapping status of frailty and FoF, especially excessive FoF, increases the risk of incident disability in older adults.
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Affiliation(s)
- Ryuichi Sawa
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, 3-2-12 Hongo Bunkyo-Ku, Tokyo, 113-0033, Japan.
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan.
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Yuto Kiuchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Kazuhei Nishimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
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Prieto-Contreras L, Martínez-Arnau FM, Sancho-Cantus D, Cubero-Plazas L, Pérez-Ros P. Fear of Falling Score Is a Predictor of Falls in Community-Dwelling Pre-Frail and Frail Older People. Healthcare (Basel) 2023; 11:2132. [PMID: 37570373 PMCID: PMC10419298 DOI: 10.3390/healthcare11152132] [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: 06/30/2023] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
Identifying frail older people at risk of falling is a priority in order to apply preventive strategies. This cross-sectional study included community-dwelling pre-frail and frail people (Fried's criteria) aged 70 years and older to assess the prevalence of falls and identify screening strategies based on comprehensive geriatric assessments to detect an increased risk of falling and recurrent falling in community-dwelling frail and pre-frail old people. Of the 229 participants, 121 (54.9%) had fallen in the previous 12 months, and 20 of these (16.5%) were recurrent fallers (≥2 falls). A score of 20 points or more on the Falls Efficacy Scale International was predictive of falling (area under the receiver-operating characteristics curve 0.67, 95% confidence interval: 0.61-0.74, p < 0.001) with a sensitivity of 51.7% and a specificity of 73.9%. Polypharmacy, Short Physical Performance Battery score of 8 points or less, and Falls Efficacy Scale International score of 20 points or more show an area under the curve of 0.78 (95% confidence interval: 0.67-0.89, p < 0.001) for recurrent falling.
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Affiliation(s)
- Lucía Prieto-Contreras
- Nursing Department, Universidad Católica de Valencia San Vicente Mártir, Espartero 7, 46007 Valencia, Spain; (L.P.-C.); (D.S.-C.); (L.C.-P.)
| | - Francisco M. Martínez-Arnau
- Department of Physiotherapy, University of Valencia, Gascó Oliag 5, 46010 Valencia, Spain
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain;
| | - David Sancho-Cantus
- Nursing Department, Universidad Católica de Valencia San Vicente Mártir, Espartero 7, 46007 Valencia, Spain; (L.P.-C.); (D.S.-C.); (L.C.-P.)
| | - Laura Cubero-Plazas
- Nursing Department, Universidad Católica de Valencia San Vicente Mártir, Espartero 7, 46007 Valencia, Spain; (L.P.-C.); (D.S.-C.); (L.C.-P.)
| | - Pilar Pérez-Ros
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain;
- Department of Nursing, University of Valencia, Menéndez Pelayo s/n, 46010 Valencia, Spain
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8
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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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Jun SS, Lee E. A longitudinal study of disability in activities of daily living and activity restriction‐induced fear of falling among Korean older people. Nurs Open 2022; 10:2946-2959. [PMID: 36480315 PMCID: PMC10077370 DOI: 10.1002/nop2.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 10/31/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
AIM This study examined the effects of the fear of falling (FOF) alone and fear-associated activity restriction (FAR) on future activities of daily living (ADL) disability and analysed predictors of ADL disability among community-dwelling older people with and without FAR. DESIGN This prospective study involved secondary data analysis of the Korean Longitudinal Study of Aging. METHODS We obtained data from 5074 community-dwelling older adults. Generalized estimating equations were used to identify the predictors of changes in ADL disability between 2008 and 2018. RESULTS Compared with FOF alone, FAR was significantly related to changes in ADL disability. Being older, living with others and having poor self-rated health status were associated with future ADL disability in participants without FAR. Weakened grip strength and social engagement were associated with future ADL disability in those with FAR. Nurses must consider the impact of FAR on future ADL decline and implement tailored interventions. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Seong Sook Jun
- College of Nursing, Pusan National University Yangsan‐si Gyeongsangnam‐do South Korea
| | - Eunyoung Lee
- College of Nursing, Pusan National University Yangsan‐si Gyeongsangnam‐do South Korea
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10
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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: 1] [Impact Index Per Article: 0.5] [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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Kruisbrink M, Crutzen R, Kempen GIJM, Zijlstra GAR. Assessing avoidance behavior due to concerns about falling: Psychometric properties of the FES-IAB in a sample of older adults of an online panel. Arch Gerontol Geriatr 2021; 97:104469. [PMID: 34298258 DOI: 10.1016/j.archger.2021.104469] [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: 01/21/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES The Falls Efficacy Scale-International (FES-I) and its shorter version (Short FES-I) are widely used measures of concerns about falling (CaF) and have consistently demonstrated good psychometric properties. The FES-I Avoidance Behavior (FES-IAB) and Short FES-IAB were developed to gain insight into activity avoidance due to CaF and add a question to each item of the FES-I and Short FES-I. The objective was to assess the psychometric properties of the FES-IAB and Short FES-IAB in community-dwelling older people. METHODS A community-dwelling sample of the Dutch population (n = 744) aged 60 and over completed the FES-IAB twice with one month in between (with a follow-up response rate of 92.2%). RESULTS Confirmatory factor analysis confirmed the unidimensionality of the FES-IAB, with high factor loadings and very good fit. The scale correlated strongly with the FES-I, and moderately with ADL disability and 1-item questions of activity avoidance and CaF. The FES-IAB discriminated well between groups based on age, sex, fall history. Internal consistency and test-retest reliability were high (Cronbach's alpha: 0.92, intraclass correlation coefficient: 0.85). FES-IAB scores were positively skewed; 343 people (46.1%) had the lowest possible score of 16. The psychometric properties of the Short FES-IAB were comparable. No problems were identified with the feasibility of the FES-IAB and Short FES-IAB. DISCUSSION Overall, the FES-IAB and Short FES-IAB demonstrated good psychometric properties in assessing activity avoidance due to CaF in community-dwelling older people. These instruments may help researchers and clinicians to investigate the behavioral consequences of CaF.
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Affiliation(s)
- Marlot Kruisbrink
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Gertrudis I J M Kempen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - G A Rixt Zijlstra
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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