Evaluation of race as a predictor of fear of falling in Black older adults

A multiple correspondence analysis of the fear of falling, sociodemographic, physical and mental health factors in older adults

Fear of falling (FoF) is a disabling condition due to different factors. The present study assessed potential FoF predictors, among sociodemographic, physical, and mental health domains, and explored their structural patterns. This cross-sectional study is part of the Physical Activity Promotion & Domestic Accidents Prevention (PAP & DAP) project, and was targeted to a sample of 229 independent older people (M 14.0%, F 86.0%) aged over 60 (mean 70.5 ± 5.96), both normal and overweight (median BMI 25.8 kg/m2, Interquartile Range 5.24). Standardized tools were used to assess the variables: the Short Falls Efficacy Scale International for the FoF; an information questionnaire for the socio-demographic variables, the presence of diseases, and previous falls; the International Physical Activity Questionnaire for the PA level; the Senior Fitness Test for physical fitness data; the Short Form 12 questionnaire for variables in the mental domain; and the Psychological Well-Being Scale 24 for the psychological well-being. Correlation/regression analyses were used to explore relationships between FoF and the considered variables. A Multiple Correspondence Analysis (MCA) was conducted to show graphical patterns projected into space dimensions. A percentage of 59.0 of the sample showed moderate/high concern of falling. The multiple regression model showed the following variables being significant predictors (p < 0.05) of the FoF: BMI (coeff 0.44, SE 0.104), musculoskeletal disease (1.55, 0.681), upper body strength (0.33, 0.117), mobility and balance (0.76, 0.320), perceived physical health (- 0.21, 0.047), and self-acceptance (- 0.52, 0.190). MCA evidenced two dimensions: the first one explained 41.8% of the variance and was described mostly by FoF (square residuals 0.721), gender (0.670), leg strength (0.617), perceived mental health (0.591), musculoskeletal diseases (0.572), and PA level (0.556); the second dimension (12.3% of the variance), was characterized mainly by perceived physical health (0.350), life objectives (0.346), education (0.301), upper body strength (0.278), and living in family/alone (0.260). The pattern elicited by MCA was characterized by older subjects with moderate/high FoF having low education or no occupation, being overweight and inactive, suffering from different diseases, having low physical fitness, and declaring low perceived physical and mental health. These results suggest that interventions aimed at reducing FoF should be addressed to this specific profile of older people.

In Their Own Words: Fears Expressed by People with Parkinson's Disease in an Online Symptom Database

Parkinson's disease (PD) carries substantial psychosocial burden. Using a database of responses by people with PD reporting up to five "most bothersome problems," we identified 225 fear-based verbatims, which were organized using the framework method into 26 categories. Commonly-reported fears included uncertainty of progression (n = 60, 26.7%), fear of future cognitive impairment (n = 24, 10.7%) and fear of becoming a burden on others (n = 23, 10.2%). Fears in PD are wide-ranging and can constitute the most bothersome aspect of the condition. These data can be used to design interventions to lessen the psychosocial burden of PD.