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Xiong W, Wang D, Ren W, Liu X, Wen R, Luo Y. The global prevalence of and risk factors for fear of falling among older adults: a systematic review and meta-analysis. BMC Geriatr 2024; 24:321. [PMID: 38580924 PMCID: PMC10998426 DOI: 10.1186/s12877-024-04882-w] [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: 09/23/2023] [Accepted: 03/08/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND As a common psychological problem among older adults, fear of falling was found to have a wide range prevalence in different studies. However, the global prevalence of it was unknown and a lack of the large sample confirmed its risk factors. OBJECTIVES To report the global prevalence of fear of falling and to explore its risk factors among older adults for further developing precise interventions to systematically manage FOF. DESIGN A systematic review and meta-analysis was conducted by PRISMA guidelines. METHODS Searches were conducted in PubMed, Web of Science, EMBASE, the Cochrane Library and the manual search in August 20, 2022, updated to September 2, 2023. Observational studies published in English were included and two researchers independently screened and extracted the data. Fixed or random effects mode was used to estimate the pooled prevalence of and risk factors for fear of falling. Heterogeneity resources were analyzed by subgroup and sensitivity analysis. Publication bias was assessed through funnel plots, Egger's test and Begg's test. RESULTS A total of the 153 studies with 200,033 participants from 38 countries worldwide were identified. The global prevalence of fear of falling was 49.60%, ranging from 6.96-90.34%. Subgroup analysis found the estimates pooled prevalence of it was higher in developing countries (53.40%) than in developed countries (46.7%), and higher in patients (52.20%) than in community residents (48.40%). In addition, twenty-eight risk factors were found a significant associations with fear of falling, mainly including demographic characteristics, physical function, chronic diseases and mental problems. CONCLUSION The global prevalence of FOF was high, especially in developing countries and in patients. Demographic characteristics, Physical function, chronic diseases and mental problems were a significant association with FOF. Policy-makers, health care providers and government officials should comprehensively evaluate these risk factors and formulate precise intervention measures to reduce FOF. TRIAL REGISTRATION The study was registered in the International Database of Prospectively Registered Systematic Reviews (PROSPERO): CRD42022358031.
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Affiliation(s)
- Wanhong Xiong
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
- Department of Oncology, Zigong First People's Hospital, Zigong, Sichuan, China
| | - Dan Wang
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Wei Ren
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Xinyi Liu
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Renhui Wen
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Yu Luo
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China.
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Hu Y, Wang K, Gu J, Huang Z, Li M. Effect of combined physical and cognitive intervention on fear of falling in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 117:105173. [PMID: 37713935 DOI: 10.1016/j.archger.2023.105173] [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: 07/05/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE Fear of falling (FOF) is common among older adults. Currently, physical exercise, cognitive intervention, and combined physical and cognitive intervention have been proven to be effective interventions. However, whether combined interventions can provide additional benefits than single interventions remains unclear. Thus, the systematic and meta-analysis was conducted to explore the immediate and retention effects of combined physical and cognitive interventions, in comparison with a single intervention. MATERIALS AND METHODS Randomized controlled trials of combined interventions on FOF in older adults were searched using Web of Science, PubMed, Cochrane Library, EMBASE, SCOPUS, CINAHL, and PsycINFO from inception to March 20, 2023. The risk of bias in included studies was evaluated using the Cochrane Collaboration Risk of Bias tool. Two independent researchers extracted the data using predetermined criteria. RESULTS 31 studies were included in the systematic review and meta-analysis. For the immediate post-intervention effect, the combined intervention was more effective than the blank/placebo/conventional intervention and the single cognitive intervention, while no additional effect was observed compared with the single physical intervention. Moreover, no additional follow-up retention effects were found when comparing the combined intervention with the single intervention. CONCLUSIONS Combined interventions had positive immediate effects on FOF in older adults, compared with single cognitive intervention, while combined interventions had a similar effect as a single physical intervention. More well-designed studies are required to explore the additional benefits of combined interventions compared with a single intervention and to investigate the follow-up effects of combined interventions.
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Affiliation(s)
- Yue Hu
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China
| | - Kun Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China
| | - Jiaxin Gu
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China
| | - Zhixuan Huang
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China
| | - Ming Li
- School of Nursing and Rehabilitation, Shandong University, Jinan, 250012, China.
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Yao S, Chen XW. The association between depressive symptoms with fear of falling and cognitive decline in older adults in the Korean community: An analysis of the Korean Longitudinal Study of Aging (KLoSA), 2006-2020. Arch Gerontol Geriatr 2024; 117:105177. [PMID: 37690256 DOI: 10.1016/j.archger.2023.105177] [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: 07/03/2023] [Revised: 08/19/2023] [Accepted: 08/31/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES This study aimed to investigate the effects of fear of falling (FOF) on cognitive decline in older adults in the Korean community, depending on the presence of accompanying depressive symptoms. METHODS A total of 6263 individuals were included in the final analysis. Based on their baseline evaluation results for depressive symptoms and FOF, the subjects were divided into four groups: "normal control" (NC, n = 3783), "depression only" (Dep-only, n = 291), "fear of falling only" (FOF-only, n = 1755), and "depression with fear of falling" (Dep-FOF, n = 434). Cognitive decline was defined as a loss of more than three points in the K-MMSE score in participants with at least two years of follow-up. We examined the association between FOF accompanied by depressive symptoms and cognitive decline using a multivariate Cox proportional hazard model. RESULTS Cognitive decline occurred in 76.3%, 68.5%, 63.9%, and 56.4% of the Dep-FOF, FOF-only, Dep-only, and NC groups, respectively. Our findings suggest that individuals with FOF do not always have cognitive decline (HR = 1.03, 95% CI = 0.95-1.12, P = 0.43) compared to individuals without FOF. Furthermore, depressive symptoms with FOF are associated with a higher risk of cognitive decline (HR = 1.23, 95% CI = 1.08-1.41, P = 0.002) in community-dwelling older adults in Korea. CONCLUSION Healthcare providers should be attentive to community-dwelling older adults who experience both depressive symptoms and FOF because our findings suggest that this unique combination increases the risk of cognitive decline.
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Affiliation(s)
- Shaoli Yao
- Department of Neurology, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region, Chengdu, Sichuan, China.
| | - Xi-Wen Chen
- Department of Neurology, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, Sichuan, China
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Vo MTH, Thonglor R, Moncatar TJR, Han TDT, Tejativaddhana P, Nakamura K. Fear of falling and associated factors among older adults in Southeast Asia: a systematic review. Public Health 2023; 222:215-228. [PMID: 36229238 DOI: 10.1016/j.puhe.2022.08.012] [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: 03/05/2022] [Revised: 07/27/2022] [Accepted: 08/14/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim of this study was to provide a comprehensive overview of the prevalence, measurement scales, related factors and interventions for fear of falling (FOF) among older adults in Southeast Asia. STUDY DESIGN This was a systematic review. METHODS Published research studies on FOF among older adults were searched using the following databases: PubMed, Cochrane Library, Scopus, ASEAN Citation Index, Thai Journal Citation Index, Malaysian Journal Citation Report and Google Scholar. All observational and experimental studies investigating FOF among community-dwelling older adults in Southeast Asia were eligible. A narrative synthesis was used to describe the findings. The Joanna Briggs Institute checklist was used to assess the quality and risk of bias of the included studies. RESULTS A total of 15 observational studies and three experimental studies were included after screening 2112 titles and abstracts. These studies, published between 2011 and 2021, were conducted in Malaysia, Singapore, Thailand and Vietnam. The FOF prevalence ranged from 21.6% to 88.2%. The most commonly used FOF assessment tool was the Falls Efficacy Scale-International. Well-reported related factors of FOF were female sex, advanced age, balance impairment and fall history. All experimental studies utilising single- or multi-component interventions comprised an exercise approach. Limited studies have considered environmental factors. CONCLUSIONS Various related factors of FOF and the interventions implemented were revealed. Public health researchers and policymakers should consider the factors related to FOF in practical FOF intervention and prevention strategies. Further evidence on FOF issues is required to understand the multidimensional characteristics of FOF, specifically the environmental aspects of older adults in Southeast Asia.
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Affiliation(s)
- M T H Vo
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; ASEAN Institute for Health Development, Mahidol University, 999 Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand
| | - R Thonglor
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; Faculty of Public Health, Naresuan University, Phitsanulok 65000, Thailand
| | - T J R Moncatar
- College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - T D T Han
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue 530000, Viet Nam
| | - P Tejativaddhana
- ASEAN Institute for Health Development, Mahidol University, 999 Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand
| | - K Nakamura
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; WHO Collaborating Centre for Healthy Cities and Urban Policy Research, Tokyo, Japan.
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Wu S, Li G, Shi B, Ge H, He Q. The association between physical activity and fear of falling among community-dwelling older women in China: the mediating role of physical fitness. Front Public Health 2023; 11:1241668. [PMID: 37645705 PMCID: PMC10461811 DOI: 10.3389/fpubh.2023.1241668] [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: 06/17/2023] [Accepted: 07/24/2023] [Indexed: 08/31/2023] Open
Abstract
Background This study aimed to explore the association between physical activity (PA) and fear of falling (FOF) and to determine whether this relationship was mediated by physical fitness (PF) in community-dwelling older women. Methods For this cross-sectional study, a total of 1,108 older women were recruited. Moderate-to-vigorous physical activity (MVPA) and light physical activity (LPA) were objectively measured by accelerometers. Physical fitness indicators including body mass index (BMI), forced vital capacity, choice reaction time, grip strength, sit and reach, and five times sit-to-stand were measured. FOF was evaluated by the Chinese version of the activities-specific balance confidence scale. A stepwise linear regression model analysis was used for mediation analysis, and bootstrap analysis was used to verify the mediation effects. Result The Pearson correlation coefficient results suggested that MVPA was significantly and negatively correlated with FOF while LPA was not correlated with FOF. Logistic regression analysis suggested a significant association between MVPA, BMI, forced vital capacity, choice reaction time, sit and reach, grip strength, five times sit-to-stand, and FOF. The mediation analysis showed a negative relationship between MVPA and FOF. BMI completely mediated the relationship between MVPA and FOF while sit and reach, five times sit-to-stand, and forced vital capacity partially mediated the relationship between MVPA and FOF. Conclusion Accumulation of more daily MVPA was associated with reducing the odds of FOF in community-dwelling older women. PF indicators fully or partially mediate the relationship between MVPA and FOF. Therefore, more intervention efforts should focus on the promotion of MVPA to improve PF and thus reduce FOF among older women.
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Affiliation(s)
| | | | | | | | - Qiang He
- School of Physical Education, Shandong University, Jinan, China
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Kwon HJ, Oh J. Comparing Older Parents' and Adult Children's Fear of Falling and Perceptions of Age-Friendly Home Modification: An Integration of the Theories of Planned Behavior and Protection Motivation. Behav Sci (Basel) 2023; 13:bs13050403. [PMID: 37232640 DOI: 10.3390/bs13050403] [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: 04/26/2023] [Accepted: 05/08/2023] [Indexed: 05/27/2023] Open
Abstract
This study investigated how a fear of falling affects perceptions and behavioral intentions toward age-friendly home modification (AFHM) in older parents and adult children by integrating the theory of planned behavior (TPB) to explain AFHM decision-making processes and the protection motivation theory to explain the impact of a fear of falling on AFHM intention. The target population comprised older parents (≥75 years old) and adult children (45-64 years old) in Busan, South Korea (N = 600). The participants completed a self-administered questionnaire in March 2022. Independent t-test and path model analyses were conducted to compare primary constructs between older parents and adult children and analyze the relationships among a fear of falling, TPB components, and AFHM intention. Results showed that both groups had positive attitudes toward AFHM. However, adult children showed significantly higher rates of having a fear of falling, lower perceived behavioral control, and higher AFHM intention than older parents. The proposed research models were partially supported in the older-parent group and fully supported in the adult-children group. Adult children play a critical role in AFHM, along with older adults who are directly involved in an aging society. AFHM-supporting programs, including monetary and human-force assistance, education, related public advertisements, and an active AFHM market, should be expanded.
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Affiliation(s)
- Hyun Joo Kwon
- Department of Interior & Environmental Design, Pusan National University, Busan 46241, Republic of Korea
| | - Jiyoung Oh
- Research Institute of Ecology, Pusan National University, Busan 46241, Republic of Korea
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Kouchaki L, Darvishpoor Kakhki A, Safavi Bayat Z, Khan HTA. Association between fear of falling and self-care behaviours of older people with hypertension. Nurs Open 2023; 10:3954-3961. [PMID: 36824048 PMCID: PMC10170935 DOI: 10.1002/nop2.1654] [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: 08/17/2022] [Revised: 12/01/2022] [Accepted: 02/04/2023] [Indexed: 02/25/2023] Open
Abstract
AIM This study investigated the association between fear of falling and self-care behaviours of older people with hypertension. DESIGN A cross-sectional study. METHODS This study was conducted in 2019 on 301 older people with hypertension above the age of 60 years in Tehran, Iran. Data were collected using a demographic questionnaire, the Persian Falls Efficacy Scale-International, and a hypertension-related self-care behaviour questionnaire. RESULTS Analyses revealed that gender, educational level and history of falling were significant factors associated with fear of falling; and marital status, educational level and income source were significant factors associated with self-care behaviours (p < 0.05). Partial correlations controlling for education revealed a significant positive correlation showing that high fear of falling is associated with worse health promotion self-care behaviours and significant inverse correlations with psycho-emotional, social and daily self-care behaviours (p < 0.05), meaning that high fear of falling is associated with better self-care for these dimensions. PATIENT OR PUBLIC CONTRIBUTION This study involved patients in order to evaluate the validity and reliability of the questionnaires. The study was conducted on older people with hypertension referred to hypertension clinics in hospitals.
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Affiliation(s)
- Leila Kouchaki
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Darvishpoor Kakhki
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Safavi Bayat
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hafiz T A Khan
- College of Nursing, Midwifery and Healthcare, University of West London, London, UK
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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: 0] [Impact Index Per Article: 0] [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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DiGuiseppi CG, Hyde HA, Betz ME, Scott KA, Eby DW, Hill LL, Jones VC, Mielenz TJ, Molnar LJ, Strogatz D, Li G. Association of falls and fear of falling with objectively-measured driving habits among older drivers: LongROAD study. JOURNAL OF SAFETY RESEARCH 2022; 83:96-104. [PMID: 36481041 PMCID: PMC10115437 DOI: 10.1016/j.jsr.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 02/28/2022] [Accepted: 08/09/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Falls in older adults are associated with increased motor vehicle crash risk, possibly mediated by driving behavior. We examined the relationship of falls and fear of falling (FOF) with subsequent objectively measured driving habits. METHODS This multi-site, prospective cohort study enrolled 2990 active drivers aged 65-79 (53% female). At enrollment, we assessed falls in the past year and FOF (Short Falls Efficacy Scale-International). Driving outcomes included exposure, avoidance of difficult conditions, and unsafe driving during one-year follow-up, using in-vehicle Global Positioning System devices. RESULTS Past-year falls were associated with more hard braking events (HBE). High FOF was associated with driving fewer days, miles, and trips, driving nearer home and more HBE. Differences were attenuated and not significant after accounting for health, function, medications and sociodemographics. DISCUSSION Differences in objectively measured driving habits according to past-year fall history and FOF were largely accounted for by differences in health and medications. Rather than directly affecting driving, falls and FOF may serve as markers for crash risk and reduced community mobility due to age-related changes and poor health.
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Affiliation(s)
- Carolyn G DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Hailey A Hyde
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Marian E Betz
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kenneth A Scott
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - David W Eby
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA; Center for Advancing Transportation Leadership and Safety (ATLAS Center), University of Michigan, Ann Arbor, MI, USA
| | - Linda L Hill
- School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Vanya C Jones
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thelma J Mielenz
- Department of Epidemiology, Mailman School of Public Health, Columbia's Injury Control Research Center, Columbia University, New York, NY, USA
| | - Lisa J Molnar
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA; Center for Advancing Transportation Leadership and Safety (ATLAS Center), University of Michigan, Ann Arbor, MI, USA
| | - David Strogatz
- Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY, USA
| | - Guohua Li
- Department of Epidemiology, Mailman School of Public Health, Columbia's Injury Control Research Center, Columbia University, New York, NY, USA; Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY, USA
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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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11
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Melendo-Azuela EM, González-Vaca J, Cirera E. Fear of Falling in Older Adults Treated at a Geriatric Day Hospital: Results from a Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148504. [PMID: 35886360 PMCID: PMC9319707 DOI: 10.3390/ijerph19148504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/01/2022] [Accepted: 07/09/2022] [Indexed: 02/06/2023]
Abstract
(1) Background: The fear of falling (FOF) is a geriatric syndrome that causes a decrease in daily activities and personal autonomy. Its prevalence is highly variable as are the methodologies used to assess it. This study aimed at estimating the prevalence and describing the main determinants of FOF in older adults attending a geriatric day hospital. (2) Methods: Descriptive, cross-sectional study of individuals aged ≥70 years, who attended an ambulatory functional rehabilitation group in the metropolitan area of Barcelona. FOF was assessed using the Activities-Specific Balance Confidence (ABC) scale. Other recorded outcomes were: sex, age, marital status, living alone, level of education, degree of autonomy, pain, previous falls, visual acuity, and signs of depression. Prevalence was estimated overall and according to the possible determinants. (3) Results: The study included 62 individuals (66.1% women), with a prevalence of fear of falling of 38.7% (95% CI 26.2–51.2%). The identified determinants were pain (OR = 7.4, 95% CI 1.4–39.7), a history of falls (OR = 25.3, 95% CI 2.1–303.4), poor visual acuity (OR = 5.6, 95% CI 1.0–29.8), and signs of depression (OR = 19.3, 95% CI 1.4–264.3). (4) Conclusions: The prevalence and determinants of fear of falling in older adults attending geriatric day hospitals were similar to those described in those dwelling in the community.
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Affiliation(s)
- Eva M. Melendo-Azuela
- The Doctoral Programme in Comprehensive Care and Health Services, University of Vic-Central University of Catalonia, 08500 Vic, Spain
- Faculty of Medicine and Health Sciences, School of Nursing, University of Barcelona, 08007 Barcelona, Spain
- Correspondence:
| | - Julia González-Vaca
- Nursing Research Group (GRIN) from the IDIBELL Translational Medicine Area, University of Barcelona, 08007 Barcelona, Spain;
| | - Eva Cirera
- Sport and Physical Activity Research Group, Center for Health and Social Research, Department of Experimental Sciences and Methodology, Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia, 08500 Vic, Spain;
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12
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Toyoda H, Hayashi C, Okano T. Associations between physical function, falls, and the fear of falling among older adults participating in a community-based physical exercise program: A longitudinal multilevel modeling study. Arch Gerontol Geriatr 2022; 102:104752. [PMID: 35724533 DOI: 10.1016/j.archger.2022.104752] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/27/2022] [Accepted: 06/10/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Exercises that target muscle strength, balance, and gait prevent falls in older people. Moreover, exercise may reduce fear of falling by improving physical function. Many studies have examined the risk factors for falls and fear of falling separately. However, few studies have examined the associations between physical function, falls, and fear of falling simultaneously. This study aimed to identify the key physical functions influencing falls and fear of falling. DESIGN Longitudinal observational study SETTING AND PARTICIPANTS: This study included 2,397 older adults (women: 82.8%, mean age: 74.3 ± 8.0 years) who participated in community-based physical exercise. METHODS Physical functions such as muscle strength, balance, gait speed, and flexibility were measured regularly during the program. A questionnaire regarding falls and fear of falling was also administered simultaneously. Multilevel modeling was used to investigate the association between physical function and falls and fear of falling. RESULTS The prevalence of falls and fear of falling at enrolment were 27.1% and 49.8%, respectively. Statistical analyses revealed that (1) falls were significantly associated with balance, age, fall history, fear of falling, and duration of participation; (2) fear of falling was significantly associated with muscle strength, balance, gait speed, age, and fall history. Long-term participation was significantly associated with an improvement in balance. CONCLUSIONS AND IMPLICATIONS The risk factors for falls and fear of falling were different. Our research showed the importance of including balance training in all prevention programs.
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Affiliation(s)
- Hiromitsu Toyoda
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka-City, Osaka 545-8585, Japan; Department of General Practice, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka-City, Osaka 545-8585, Japan.
| | - Chisato Hayashi
- Department of Preventive, Research Institute of Nursing Care for People and Community, University of Hyogo, 13-71 Kitaoji-cho, Akashi, Hyogo 673-8588, Japan
| | - Tadashi Okano
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka-City, Osaka 545-8585, Japan
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13
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Chronic pain as a moderator between fear of falling and poor physical performance among community-dwelling older adults. Geriatr Nurs 2022; 45:140-146. [DOI: 10.1016/j.gerinurse.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/04/2022]
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14
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Park GR, Kim J. Coexistent physical and cognitive decline and the development of fear of falling among Korean older adults. Int J Geriatr Psychiatry 2022; 37. [PMID: 35334126 DOI: 10.1002/gps.5705] [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: 11/09/2021] [Accepted: 03/15/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Although hand grip strength and cognitive function are associated with fear of falling (FOF), little is known about whether coexisting physical and cognitive decline is jointly related to FOF. This study examines whether grip strength and cognitive function interact to shape FOF and FOF-related activity restriction (FAR) among Korean older adults. METHODS/DESIGN This study used seven waves of the Korean Longitudinal Study of Ageing (N = 3373 older adults aged 65 or over). Grip strength was assessed by a handgrip dynamometer, and cognitive function by Korean Mini-mental State Examination (K-MMSE). Fixed effects models were estimated to account for time-invariant confounders such as genetic predispositions, innate ability, and health endowments. This study estimated a joint model that included interaction effects between grip strength and cognitive function. RESULTS Declines in grip strength and cognitive function were independently associated with FOF. Fixed effects estimates suggested that, despite some attenuation, controlling for individual heterogeneity does not confound the associations. The interaction model showed that coexistence of low grip strength and cognitive decline leads to a greater risk of FOF and FAR than having a single condition. Similar patterns were found for FAR. CONCLUSIONS This study provides evidence that coexistent cognitive and physical decline are a significant risk factor for FOF and FAR. Given the well-established adverse effects of FOF on older adults' health and well-being, results of this study lend support to interventions to target old adults with coexistent cognitive and physical decline to remove excessive concerns about FOF.
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Affiliation(s)
- Gum-Ryeong Park
- Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada.,Korea Institute for Health and Social Affairs, Sejong, Republic of Korea
| | - Jinho Kim
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea.,Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea.,Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, Wisconsin, USA
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15
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Canever JB, de Souza Moreira B, Danielewicz AL, de Avelar NCP. Are multimorbidity patterns associated with fear of falling in community-dwelling older adults? BMC Geriatr 2022; 22:192. [PMID: 35272634 PMCID: PMC8915478 DOI: 10.1186/s12877-022-02889-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/02/2022] [Indexed: 01/09/2023] Open
Abstract
Background Multimorbidity is defined as the co-occurrence of multiple chronic or acute diseases and medical conditions in the same individual and can be grouped into different patterns based on the type of disease. These patterns are associated with poorer quality of life and premature death. It is believed that these patterns entail functional limitations, which may contribute to the fear of falling; however, this association remains unknown. Identifying this possible association is fundamental for developing individual and collective care approaches aimed at preventing the different patterns of chronic diseases in older adults in order to decrease the fear of falling. The objective of this study was to investigate the association between multimorbidity patterns and fear of falling in older adults. Methods This was a cross-sectional study including 308 older adults. The exposure variables were the presence of three multimorbidity patterns (cardiopulmonary, musculoskeletal, and vascular-metabolic) and pattern association assessed by self-report of two or more similar coexisting chronic diseases. The outcome was fear of falling assessed by the Brazilian version of Falls Efficacy Scale-International (cut-off point ≥ 23 points). Multivariable logistic regression was used to analyze the association between variables. Results Older adults with cardiopulmonary, musculoskeletal, vascular-metabolic patterns and pattern association had 3.49 (95%CI 1.13; 10.78), 2.03 (95%CI 1.13; 3.64), 2.14 (95%CI 1.20; 3.82), and 4.84 (95%CI 2.19; 10.68), respectively, greater chances of presenting fear of falling when compared to older adults without the patterns. Conclusions The presence of multimorbidity patterns is associated with higher chances of reporting fear of falling. It is emphasized that the introduction of public health programs aimed at preventing multimorbidity patterns is essential to reduce possible adverse health outcomes, including fear of falling and its negative consequences for older adult health.
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Affiliation(s)
- Jaquelini Betta Canever
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil
| | | | - Ana Lúcia Danielewicz
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil
| | - Núbia Carelli Pereira de Avelar
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil.
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16
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Fundenberger H, Stephan Y, Hupin D, Barth N, Terracciano A, Canada B. Prospective associations between subjective age and fear of falling in older adults. Aging Ment Health 2022; 26:86-91. [PMID: 33291957 PMCID: PMC8978267 DOI: 10.1080/13607863.2020.1856775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Subjective age has been implicated in a range of health outcomes but its associations with Fear of Falling (FoF) are unknown. The present study examined the relation between subjective age and FoF in large national sample. METHODS Participants were drawn from the National Health and Aging Trends Study (NHATS, 2011-2017). 1,679 participants provided data on FoF, subjective age, demographic factors, depressive symptoms, prior falls, self-rated health and measures of the Short Physical Performance Battery. FoF was assessed again 7 years later. RESULTS Regression analyses revealed that an older subjective age was related to a 24% higher likelihood to develop FoF 7 years later. This association was independent of age, sex, educational attainment, race and prior falls. In addition, depressive symptoms, self-rated health, and physical inactivity mediated the associations between subjective age and FoF. CONCLUSIONS The present study showed that an older subjective age is related to the development of FoF over time, and further identified psychological and functional pathways that may explain this association. These results confirm the role of subjective age on one of the markers of frailty in the aging population.
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Affiliation(s)
- Hervé Fundenberger
- SNA EPIS, Jean Monnet University, Saint-Etienne, FRANCE,Corresponding author: Hervé Fundenberger, EA SNA EPIS 4607, Université de Lyon, Université Jean Monnet, Saint-Étienne, 42055 Saint-Etienne cedex 2, France,
| | | | - David Hupin
- SNA EPIS, Jean Monnet University, Saint-Etienne, FRANCE
| | | | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, USA
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17
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MacKay S, Ebert P, Harbidge C, Hogan DB. Fear of Falling in Older Adults: A Scoping Review of Recent Literature. Can Geriatr J 2021; 24:379-394. [PMID: 34912493 PMCID: PMC8629501 DOI: 10.5770/cgj.24.521] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Fear of falling (FOF) is prevalent among older adults and associated with adverse health outcomes. Over recent years a substantial body of research has emerged on its epidemiology, associated factors, and consequences. This scoping review summarizes the FOF literature published between April 2015 and March 2020 in order to inform current practice and identify gaps in the literature. Methods A total of 439 articles related to FOF in older adults were identified, 56 selected for full-text review, and 46 retained for data extraction and synthesis. Results The majority of included studies were cross-sectional. Older age, female sex, previous falls, worse physical performance, and depressive symptoms were the factors most consistently associated with FOF. Studies that measured FOF with a single question reported a significantly lower prevalence of FOF than those using the Falls Efficacy Scale, a continuous measure. FOF was associated with higher likelihoods of future falls, short-term mortality, and functional decline. Conclusions Comparisons between studies were limited by inconsistent definition and measurement of FOF, falls, and other characteristics. Consensus on how to measure FOF and which participant characteristics to evaluate would address this issue. Gaps in the literature include clarifying the relationships between FOF and cognitive, psychological, social, and environmental factors.
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Affiliation(s)
- Scott MacKay
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary
| | - Patricia Ebert
- Department of Psychology, University of Calgary, Calgary.,Hotchkiss Brain Institute, University of Calgary, Calgary.,Specialized Geriatric Services, Calgary Regional Health Authority, Calgary
| | - Cathy Harbidge
- Specialized Geriatric Services, Calgary Regional Health Authority, Calgary
| | - David B Hogan
- Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB
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18
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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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19
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Baixinho CL, Dixe MDA, Henriques MA, Marques-Vieira C, Sousa L. The fear of falls in the caregivers of institutionalized elders. ACTA ACUST UNITED AC 2021; 42:e20200258. [PMID: 34287601 DOI: 10.1590/1983-1447.2021.20200258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 12/11/2020] [Indexed: 11/21/2022]
Abstract
AIMS To understand how the fear of falls emerges and manifests itself in caregivers of institutionalized elders. METHOD It is a qualitative study, based on the Grounded Theory and carried out with 24 informal caregivers, 5 nurses, 2 physicians and 2 directors of two Portuguese nursing homes. Data collection took place through interviews, participant observation, and documentation analysis, between October 2016 and January 2018. Data was collected and analyzed simultaneously, following the stages of open, axial, and selective coding. RESULTS The comparative analysis of the findings identified the conceptual category "Fear of falls in the caregivers of institutionalized elders". The main category is associated with the categories: maintaining safety, hidden fear of falls, the perceived self-efficacy in the prevention of falls, falls and interpersonal relations, previous experiences, and team support. CONCLUSIONS The fear has an influence on the self-efficacy perceived in the prevention of falls; the quality of the teamwork, in turn, is affected by previous negative experiences and by the support of the team.
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Affiliation(s)
- Cristina Lavareda Baixinho
- Escola Superior de Enfermagem de Lisboa (ESEL), Lisboa, Portugal.,Politécnico de Leiria, Escola Superior de Saúde, Center for Innovative Care and Health Technology. Leiria, Portugal
| | - Maria Dos Anjos Dixe
- Politécnico de Leiria, Escola Superior de Saúde, Center for Innovative Care and Health Technology. Leiria, Portugal.,Politécnico de Leiria. Leiria, Portugal
| | - Maria Adriana Henriques
- Escola Superior de Enfermagem de Lisboa (ESEL), Lisboa, Portugal.,Politécnico de Leiria, Escola Superior de Saúde, Center for Innovative Care and Health Technology. Leiria, Portugal
| | - Cristina Marques-Vieira
- Universidade Católica Portuguesa (UCP), Instituto de Ciências da Saúde, Centro de Investigação Interdisciplinar em Saúde. Lisboa, Portugal
| | - Luis Sousa
- Universidade de Évora, Comprehensive Health Research Centre. Évora, Portugal
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20
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Chen WC, Li YT, Tung TH, Chen C, Tsai CY. The relationship between falling and fear of falling among community-dwelling elderly. Medicine (Baltimore) 2021; 100:e26492. [PMID: 34190176 PMCID: PMC8257838 DOI: 10.1097/md.0000000000026492] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 06/09/2021] [Indexed: 01/04/2023] Open
Abstract
Researchers have repeatedly examined the relationship between a previous experience of a fall and subsequent fear of falling (FOF); however, few studies have investigated the effects of falling along various timelines among older adults. The objective of this study was to determine whether experiencing a fall in the previous month or the previous year led to FOF among the elderly.The National Health and Aging Trends Study (NHATS) in the U.S. collected information indicative of basic trends in the behavior of individuals aged 65 years and older. In the current study, we applied multiple logistic regression analysis of results from round 7 of the NHATS with the aim of identifying the risk factors associated with FOF among 5559 participants aged 65 years or older.FOF was reported by 48.8% of those who experienced a fall in the previous year and 46.8% experienced a fall in the previous month. The results of regression analysis revealed that after adjusting for sex, age, related chronic disease, activities of daily living, and instrumental activities of daily living, FOF was significantly associated with experiencing a fall during the previous month (OR = 2.29, 95% CI: 1.78-2.95) or during the previous year (OR = 2.60, 95% CI: 2.16-3.14).Our results indicate that experiences of falling during the previous month or the previous year were both significantly associated with a fear of falling, and caregivers should keep this in mind when dealing with community-living elderly individuals.
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Affiliation(s)
- Wei-Cheng Chen
- Taiwan Stipendiary Co., Ltd., Kaohsiung
- Institute of Health Policy and Management, National Taiwan University
| | - Yang-Tzu Li
- Department of Long Term Care, National Taipei University of Nursing and Health Science
| | - Tao-Hsin Tung
- Taiwan Association of Health Industry Management and Development, Taipei, Taiwan
| | - Chieh Chen
- Institute of Medical Sciences, Tzu Chi University, Hualien
| | - Ching-Yao Tsai
- Department of Ophthalmology, Taipei City Hospital
- Institute of Public Health, National Yang-Ming University
- MS Program in Transdisciplinary Long Term Care and Bachelor's Program in Business Management, Fu Jen Catholic University, New Taipei City, Taiwan
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21
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Zhang H, Si W, Pi H. Incidence and risk factors related to fear of falling during the first mobilisation after total knee arthroplasty among older patients with knee osteoarthritis: A cross-sectional study. J Clin Nurs 2021; 30:2665-2672. [PMID: 33655557 DOI: 10.1111/jocn.15731] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 01/13/2021] [Accepted: 02/02/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The factors that lead to the fear of falling among older people after total knee arthroplasty (TKA) are poorly understood. The present study aims to examine the fear of falling among such patients and to determine the factors that are associated with that fear. METHODS A total of 285 patients aged ≥65 with knee osteoarthritis who underwent TKA at an orthopaedic hospital between November 2019 and May 2020 completed surveys about their own first mobilisation after TKA. They were asked to indicate whether they were afraid of falling by asking a single question, and what their pain level was on a visual analogue scale. They also completed the General Anxiety Disorder scale, the Geriatric Depression Scale-Short Form and the Social Support Rating Scale. Multivariate logistic regression was used to identify risk factors for fear of falling during the first mobilisation after TKA. This study was reported in compliance with the STROBE checklist for cross-sectional studies (see Supplementary File S1). RESULTS Just over half (56.5%) of participants reported being afraid of falling. Multivariate logistic regression identified three independent risk factors that explained a total of 31% of the variance in the fear of falling: female sex (odds ratio (OR) = 4.21, 95% confidence interval (CI) = 2.35-7.55), higher body mass index (OR =3.93, 95% CI =1.53-10.10) and higher anxiety (OR = 1.56, 95% CI = 1.37-1.78). CONCLUSIONS Many older patients fear falling when they begin to move after TKA, particularly women and those with higher body mass index or anxiety. These subgroups may merit special attention from healthcare professionals to mitigate their fears and optimise recovery after TKA.
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Affiliation(s)
- Huaguo Zhang
- Department of Nursing, Chinese PLA General Hospital, Beijing, China
| | - Wenteng Si
- Zhengzhou Orthopaedics Hospital, Zhengzhou, China
| | - Hongying Pi
- Department of Nursing, Chinese PLA General Hospital, Beijing, China
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22
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Makino K, Lee S, Bae S, Chiba I, Harada K, Katayama O, Shinkai Y, Makizako H, Shimada H. Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study. Phys Ther 2021; 101:6131766. [PMID: 33561290 DOI: 10.1093/ptj/pzab059] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 10/06/2020] [Accepted: 01/03/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. METHODS A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48 ± 2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to "Are you afraid of falling?") at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. RESULTS Multivariable logistic regression showed that prefrailty or frailty increase the risk of not only future falls (odds ratio [OR]: 1.57; 95% CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95% CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95% CI = 1.04-1.68). CONCLUSIONS Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. IMPACT Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high risk not only for falls but also for FOF.
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Affiliation(s)
- Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Seongryu Bae
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ippei Chiba
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Yohei Shinkai
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hyuma Makizako
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.,Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
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23
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Aburub AS, Phillips SP, Aldughmi M, Curcio CL, Guerra RO, Auais M. Fear of Falling Among Community-Dwelling Older Adults with Heart Disease: Findings from an International Mobility in Aging Study (IMIAS). Physiother Theory Pract 2021; 38:2038-2051. [PMID: 33726620 DOI: 10.1080/09593985.2021.1901327] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background: Older adults with heart disease (HD) are more likely to report a higher prevalence of falls compared to those without HD. A knowledge gap currently exists regarding the factors associated with fear of falling (FOF) among older adults with HD. Therefore, this study aimed to estimate FOF and identify factors associated with FOF among older adults with HD. Methods: Data came from a secondary analysis of the International Mobility in Aging Study (IMIAS) baseline (2012) data. FOF was measured using the Falls Efficacy Scale-International (FES-I). Stepwise linear regression was used to identify factors associated with FOF. Results: A total of 429 participants identified themselves as having heart disease diagnosed by their physician (mean age 69.5 ± 2.9). Older adults with HD reported on average (25.6) higher FOF than those without HD. For older adults with HD, FES-I increased significantly by 1.3, 1.0, and 0.6 points, when the Short Physical Performance Battery, the Leganes Cognitive Test, and QOL total scores decreased by one point. FES-I also significantly increased by 3.2 when income was insufficient compared to sufficient or very sufficient income. Discussion: FOF is multifactorial, and our findings provide a base for developing future management rehabilitation intervention programs aimed at decreasing FOF among older adults with HD.
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Affiliation(s)
- Ala' S Aburub
- Physical Therapy Department, Faculty of Allied Medical Sciences, Isra University, Amman, Jordan
| | - Susan P Phillips
- Department of Family Medicine, Queen's University, Kingston, ON, Canada
| | - Mayis Aldughmi
- School of Rehabilitation Sciences, Department of Physical Therapy, University of Jordan, Amman, Jordan
| | - Carmen-Lucia Curcio
- Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, Universidad De Caldas, Manizales, Colombia
| | | | - Mohammad Auais
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
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Bahat Öztürk G, Kılıç C, Bozkurt ME, Karan MA. Prevalence and Associates of Fear of Falling among Community-Dwelling Older Adults. J Nutr Health Aging 2021; 25:433-439. [PMID: 33786559 DOI: 10.1007/s12603-020-1535-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES We aimed to study the prevalence of fear of falling (FOF), and its association with physical performance, functionality, frailty, sarcopenia, and a variety of geriatric syndromes including cognitive impairment, depression, quality of life and hearing. DESIGN Retrospective, cross-sectional study. SETTING Community-dwelling older adults applied to the geriatric outpatient clinic of a university hospital. PARTICIPANTS A total of 1021community-dwelling older adults >= 60 years of age applying to the geriatric outpatient clinic of a university hospital. MEASUREMENTS We screened for falls and FOF by single close-ended questions. We performed screening and assessment of probable sarcopenia by SARC-F test and handgrip strength evaluation according to EWGSOP2. We used timed up and go test (TUG), usual gait speed (UGS) for physical performance, and Katz- activities of daily living (ADL) and Lawton-Brody instrumental activities of daily living (IADL) for functional evaluation. We screened anxiety with the Generalized Anxiety Disorder-7 scale. RESULTS The prevalence of FOF was 44.6% and falls, 37.7%. Prevalence of FOF in sarcopenia screening positive participants was 30.1%; in probable sarcopenic (35/20 kg) participants, 43.9%; in those with undernutrition, 45.7%; in fallers, 51.1%; in females, 80.4%; and in prefrail/frail was 74.7% Multivariate regression analyses revealed that female sex (OR=4.1, 95%CI= 2.0-8.4, p<0.001), anxiety (OR=2.7, 95%CI= 1.1-6.5, p=0.03) and ADL limitation (OR=2.5, 95%CI= 1.03-6.3, p=0.04) were independent associates of FOF. CONCLUSION FOF accompanied by fall experience or not is prevalent in community-dwelling older adults. It is associated with anxiety and ADL limitations apart from the female sex.
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Affiliation(s)
- G Bahat Öztürk
- Prof.Dr. Gülistan Bahat Öztürk, Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University Capa, Istanbul, Turkey, , +90532 796 9748
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Marques-Vieira CMA, Sousa LMMD, Baixinho CRSL, Reis MGMD, Pérez-Rivas FJ, Sousa LMRD. VALIDATION OF THE INTERNATIONAL 7-ITEM FALLS EFFICACY SCALE IN PORTUGUESE COMMUNITY-DWELLING OLDER ADULTS. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2019-0243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective to determine the psychometric properties of the international 7-item Falls Efficacy Scale. Method a psychometric study. Convenience sample consisting of 170 older adults living in the Madeira Autonomous Region, Portugal. A two-part instrument was used (sociodemographic characterization and the Falls Efficacy Scale-International-Portugal). The starting point was the translation and transcultural adaptation already carried out for the Falls Efficacy Scale - International (16 items). Construct validity (factorial analysis and discriminant validity) and the reliability (Cronbach's α) of the 7-item scale were evaluated. Previous authorization was obtained from the Ethics Commission and from the people involved. Results in the exploratory factorial analysis, the International 7-item Falls Efficacy Scale presents an explained variance of 65.8%. The Spearman's correlation between the score obtained based on the 7 items and the score obtained based on the 16 items is significant and very strong (r=0.987, p<0.0001). Internal consistency was 0.958. Conclusion the validity and reliability study of the International 7-item Falls Efficacy Scale revealed that it is an adequate scale for the evaluation of the fear of falling in the community-dwelling older adults.
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Lee S, Hong GRS. The predictive relationship between factors related to fear of falling and mortality among community-dwelling older adults in Korea: analysis of the Korean longitudinal study of aging from 2006 to 2014. Aging Ment Health 2020; 24:1999-2005. [PMID: 31512495 DOI: 10.1080/13607863.2019.1663490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study was conducted to identify the predictive relationship between factors related to fear of falling (FOF) and mortality among community-dwelling older adults in Korea. METHOD Data were obtained from the Korean Longitudinal Study of Aging (KLoSA). Hierarchical Cox proportional hazards regression analyses were conducted to identify factors related to FOF and correlations of these factors with mortality. RESULTS During the eight-year follow-up period, 964 participants (23.5%) died. Death was more likely to occur in males (hazard ratio [HR], 2.55; 95% confidence interval [95% CI], 2.17-3.00), those 75 years old or older (HR, 2.76; 95% CI, 2.40-3.17), those without education (HR, 1.27; 95% CI, 1.05-1.52), and those living without a spouse (HR, 1.30; 95% CI, 1.11-1.51). Those afraid of falling (HR, 1.41; 95% CI, 1.17-1.70), limiting their activities due to FOF (HR, 1.40; 95% CI, 1.21-1.62), showing symptoms of depression (HR, 1.34; 95% CI, 1.16-1.54), and having low life satisfaction (HR, 1.34; 95% CI, 1.13-1.59) were also more likely to experience decreased lifespans. CONCLUSION These results suggest that early management and prevention of factors related to FOF should be an effective approach to reducing mortality in older adults.
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Affiliation(s)
- Sieun Lee
- College of Nursing, Baekseok Culture University, Cheonan-si, Chungcheongnam-Do, South Korea
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Lee S, Lee C, Rodiek S. Outdoor exposure and perceived outdoor environments correlated to fear of outdoor falling among assisted living residents. Aging Ment Health 2020; 24:1968-1976. [PMID: 31364392 DOI: 10.1080/13607863.2019.1647139] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Fear of falling is a major health concern among older adults. Although several studies have addressed general fear of falling in relation to personal factors, little is known about the specific relationship between fear of outdoor falling and perceptions of the outdoor environments. PURPOSE This study is to identify perceived environmental factors and outdoor exposure associated with fear of outdoor falling among assisted living residents aged 65 or older stratified by the amount of time spent outdoors. METHODS This study used survey data collected from a multiregional study conducted in 2007 that surveyed residents in 68 assisted living facilities in Houston, Texas; Chicago, Illinois; and Seattle, Washington. Out of 1,043 total participants, this study used a subset of 907 residents who used outdoor areas at least five minutes a day. Multivariate logistic regression was used after controlling for covariates. RESULTS Approximately 31% of the participants reported having worried about falling while using the outdoor areas in their assisted living community. Multivariate analyses showed that adequately designed walkways (OR = 0.614, 95% CI = 0.405-0.931), comfort levels in using outdoor areas (OR = 0.657, 95% CI = 0.437-0.989), and frequency of outdoor usage (OR = 0.538, 95% CI = 0.368-0.787) were associated with decreased fear of outdoor falling after adjusting for individual factors (i.e. age, sex, health condition, fall history, vision problems, mobility aids). CONCLUSION Improved walkways and comfort levels when using outdoor areas, as well as the amount of time spent outdoors, would be helpful in reducing fear of outdoor falling, which can help promote healthy lifestyle among assisted living residents.
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Affiliation(s)
- Sungmin Lee
- Department of Plant Science and Landscape Architecture, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, CT, USA
| | - Chanam Lee
- Department of Landscape Architecture & Urban Planning, College of Architecture, Texas A&M University, College Station, TX, USA
| | - Susan Rodiek
- Department of Architecture, College of Architecture, Texas A&M University, College Station, TX, USA
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Hajek A, König HH. What are the psychosocial consequences when fear of falling starts or ends? Evidence from an asymmetric fixed effects analysis based on longitudinal data from the general population. Int J Geriatr Psychiatry 2020; 35:1028-1035. [PMID: 32363790 DOI: 10.1002/gps.5325] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 04/19/2020] [Accepted: 04/25/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The purpose of this study was to identify whether the onset and the end of fear of falling (FOF) are associated with psychosocial consequences (in terms of depressive symptoms, loneliness, social isolation, autonomy, and subjective well-being). METHODS/DESIGN Longitudinal data for this study were taken from the nationally representative German Ageing Survey which included community-dwelling individuals ≥40 years (wave 5 and wave 6). Psychosocial outcome measures were assessed using widely established and well-validated scales. The presence of FOF was used as the main explanatory variable. It was adjusted for age, family status, labor force participation, self-rated health, physical functioning, as well as the number of chronic conditions. RESULTS Linear fixed effects regressions revealed that FOF was associated with adverse psychosocial outcomes (increased depressive symptoms, lower life satisfaction, lower positive affect, higher negative affect, and lower perceived autonomy). Asymmetric fixed effects regressions analysis showed that the onset of FOF was associated with reduced life satisfaction as well as reduced autonomy, whereas the end of FOF was associated with reduced depressive symptoms, decreased loneliness scores, as well as decreased negative affect. CONCLUSIONS The study findings suggest that future studies should analyze the consequences of FOF differently (onset and end of FOF) which has practical important implications. More specifically, while strategies to avoid the onset of FOF may help to maintain satisfaction with life and autonomy, strategies to end FOF may contribute to avoid increased loneliness, feelings of negative affect, as well as increased depressive symptoms. J Am Geriatr Soc 68:-, 2020.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Merchant RA, Chen MZ, Wong BLL, Ng SE, Shirooka H, Lim JY, Sandrasageran S, Morley JE. Relationship Between Fear of Falling, Fear‐Related Activity Restriction, Frailty, and Sarcopenia. J Am Geriatr Soc 2020; 68:2602-2608. [DOI: 10.1111/jgs.16719] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Reshma Aziz Merchant
- Division of Geriatric Medicine, Department of Medicine National University Hospital Singapore Singapore
- Department of Medicine Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Matthew Zhixuan Chen
- Division of Geriatric Medicine, Department of Medicine National University Hospital Singapore Singapore
| | - Beatrix Ling Ling Wong
- Division of Geriatric Medicine, Department of Medicine National University Hospital Singapore Singapore
| | - Shu Ee Ng
- Division of Geriatric Medicine, Department of Medicine National University Hospital Singapore Singapore
| | - Hidehiko Shirooka
- Division of Geriatric Medicine, Department of Medicine National University Hospital Singapore Singapore
| | - Jia Yi Lim
- Department of Medicine Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Surein Sandrasageran
- Division of Geriatric Medicine, Department of Medicine National University Hospital Singapore Singapore
| | - John E. Morley
- Division of Geriatric Medicine Saint Louis University School of Medicine St Louis Missouri USA
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Kim T, Choi SD, Xiong S. Epidemiology of fall and its socioeconomic risk factors in community-dwelling Korean elderly. PLoS One 2020; 15:e0234787. [PMID: 32559206 PMCID: PMC7304594 DOI: 10.1371/journal.pone.0234787] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 06/02/2020] [Indexed: 11/19/2022] Open
Abstract
Although falls in older people are a major public health problem globally, to date there are scarce reports on socioeconomic risk factors for falls. The aim of the present study was to investigate the epidemiology of fall, its associated socioeconomic risk factors and relative importance among community-dwelling Korean elderly. Secondary analysis of national survey data with 31,684 community-dwelling Korean elderly was performed. Eleven socioeconomic factors (age, gender, household type, marital status, education level, current occupation, past occupation, income, wealth, number of children, and relationship satisfaction) were selected for analysing their associations with the epidemiology of fall through complex sample analysis and logistic regressions. Results showed that 15.9%~25.1% of community-dwelling Korean elderly experienced fall yearly. The groups with significantly higher fall risks were identified as older aged, being female, not married or widowed, less educated, unemployed, and having lower relationship satisfaction. Gender (adjusted odds ratio-AOR = 1.548) and relationship satisfaction (AOR = 1.276) were the utmost important fall risk factors, indicating being older female with lower relationship satisfaction were the foremost socioeconomic characteristics for risk of falling. These findings could contribute to better understanding of the socioeconomic fall risk profiles among Korean elderly and effective strategies for fall prevention.
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Affiliation(s)
- Taekyoung Kim
- Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Yuseong-gu, Daejoen, Republic of Korea
| | - Sang D. Choi
- Department of Occupational and Environmental Safety and Health, University of Wisconsin, Whitewater, Wisconsin, United States of America
| | - Shuping Xiong
- Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Yuseong-gu, Daejoen, Republic of Korea
- * E-mail:
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31
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Zapparoli L, Sacheli LM, Seghezzi S, Preti M, Stucovitz E, Negrini F, Pelosi C, Ursino N, Banfi G, Paulesu E. Motor imagery training speeds up gait recovery and decreases the risk of falls in patients submitted to total knee arthroplasty. Sci Rep 2020; 10:8917. [PMID: 32488010 PMCID: PMC7265300 DOI: 10.1038/s41598-020-65820-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/29/2020] [Indexed: 01/01/2023] Open
Abstract
With Motor imagery (MI), movements are mentally rehearsed without overt actions; this procedure has been adopted in motor rehabilitation, primarily in brain-damaged patients. Here we rather tested the clinical potentials of MI in purely orthopaedic patients who, by definition, should maximally benefit of mental exercises because of their intact brain. To this end we studied the recovery of gait after total knee arthroplasty and evaluated whether MI combined with physiotherapy could speed up the recovery of gait and even limit the occurrence of future falls. We studied 48 patients at the beginning and by the end of the post-surgery residential rehabilitation program: half of them completed a specific MI training supported by computerized visual stimulation (experimental group); the other half performed a non-motoric cognitive training (control group). All patients also had standard physiotherapy. By the end of the rehabilitation, the experimental group showed a better recovery of gait and active knee flexion-extension movements, and less pain. The number of falls or near falls after surgery was significantly lower in the experimental group. These results show that MI can improve gait abilities and limit future falls in orthopaedic patients, without collateral risks and with limited costs.
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Affiliation(s)
- Laura Zapparoli
- Psychology Department and NeuroMI - Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy. .,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
| | - Lucia Maria Sacheli
- Psychology Department and NeuroMI - Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Silvia Seghezzi
- Psychology Department and NeuroMI - Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.,PhD Program in Neuroscience, School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Matteo Preti
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | | | - Catia Pelosi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,University Vita e Salute San Raffaele, Milan, Italy
| | - Eraldo Paulesu
- Psychology Department and NeuroMI - Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy. .,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
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Aburub AS, P Phillips S, Curcio CL, Guerra RO, Auais M. Fear of falling in community-dwelling older adults diagnosed with cancer: A report from the International Mobility in Aging Study (IMIAS). J Geriatr Oncol 2019; 11:603-609. [PMID: 31653454 DOI: 10.1016/j.jgo.2019.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 08/29/2019] [Accepted: 09/04/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The incidence of fear of falling (FOF) is high among people with cancer. However, factors that are associated with FOF in people with cancer has not yet been investigated. Therefore, the objective of this study was to identify the associated factors with FOF in people with cancer. METHOD This is a secondary analysis of the International Mobility in Aging Study (IMIAS) study. A total of 175 people self-identified as patients with cancer (mean age: 69.3 years, women: 50.2%) and 177 healthy age-matched group. FOF measured using the Falls Efficacy Scale-International (FES-I) was the primary outcome. Potential variables/factors for consistency known to be associated with FOF (cognitive status, depression, physical performance, the number of falls in the last year, visual acuity and grip strength) were assessed. Simple linear regression was used to identify factors associated with FOF. Variables with p-value <0.05 were then included in a multiple linear regression adjusted for the study confounders (study site, sex, and age). RESULTS For people with cancer, FES-I was significantly associated with the Leganes Cognitive Test, The Short Physical Performance Battery (SPPB) total scores and the number of falls reported in the past 12 months (P-value <0.05). For the healthy group, FOF was only associated with depression and SPPEB. CONCLUSION FOF is multifactorial in people with cancer and it is associated with cognitive status, physical performance and number of falls in the last year. Healthcare providers for patients with cancer should evaluate all potential factors associated with FOF and manage it.
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Affiliation(s)
- Ala' S Aburub
- Physical Therapy Department, Faculty of Allied Medical Sciences, Isra University, Amman, Jordan.
| | - Susan P Phillips
- Department of Family Medicine, Queen's University, Kingston, ON, Canada
| | - Carmen-Lucia Curcio
- Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Manizales, Colombia
| | | | - Mohammad Auais
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
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Pena SB, Guimarães HCQCP, Lopes JL, Guandalini LS, Taminato M, Barbosa DA, Barros ALBLD. Medo de cair e o risco de queda: revisão sistemática e metanálise. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900062] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Verificar se o medo de cair é fator de risco em pessoas idosas que vivem na comunidade. Métodos Foi realizada uma revisão sistemática com metanálise baseada na Preferred Reporting Items for Systematic Reviews and MetaAnalyses. Utilizou-se a estratégia de busca PECOS: Paciente - pessoa idosa com 60 anos, ou mais, que vive em comunidade com história pregressa de quedas; Exposição- medo de cair, Comparação -grupo sem medo de cair, o “Outcome” - o desfecho queda e o “Studies”- foram incluídos os estudos observacionais comparativos. As buscas foram realizadas em maio de 2018 nos seguintes bancos de dados eletrônicos CINAHL, Medline, Cochrane, Embase, Lilacs, PsycINFO e PEDro, por meio dos seguinte descritores: “aged”, “elderly”, older adults, fear, fear of falling, accidental falls, fall, fallls. Foram também realizadas buscas de referências cruzadas e literatura cinzenta. Dois revisores realizaram a identificação, seleção, elegibilidade e inclusão dos estudos de maneira independente. A qualidade metodológica dos estudos foram efetuada pela aplicação do instrumento STROBE. Para a metanálise, utilizou-se o Programa ReviewMananger 5.3®. Resultados De 4.891 publicações, cinco estudos possibilitaram a metanálise com 3.112 idosos. Evidenciou-se uma chance de queda de 12,15 vezes maior para o grupo de idosos com medo de cair. Conclusão O medo de cair foi identificado como fator de risco de queda na população idosa que vive na comunidade e que possui história pregressa de queda, torna-se necessário a investigação pelos profissionais da ara da saúde afim de estabelecer medidas preventivas.
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Oh J, Choi CK, Kim SA, Kweon SS, Lee YH, Nam HS, Park KS, Ryu SY, Choi SW, Shin MH. Association of Falls and Fear of Falling with Mortality in Korean Adults: The Dong-gu Study. Chonnam Med J 2019; 55:104-108. [PMID: 31161122 PMCID: PMC6536433 DOI: 10.4068/cmj.2019.55.2.104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/21/2019] [Accepted: 03/26/2019] [Indexed: 11/10/2022] Open
Abstract
This study evaluated the association between falls and the fear of falling (FOF) with the risk of all-cause mortality in Korean adults. The study enrolled 4,386 subjects aged 50 years and over who participated in the Dong-gu Study. Falls in the past year were categorized as yes or no. Injurious falls were defined as falls that resulted in fractures, head injuries, sprains or strains, bruising or bleeding, or other unspecified injuries. FOF was classified as low or high. The associations of falls and fall-related characteristics with mortality were assessed using Cox proportional hazards models. The average follow-up was 7.8 years. During this period, 255 men and 146 women died. In a fully adjusted model, falls in the past year were not associated with an increased risk of all-cause mortality (hazard ratio [HR] 1.16, 95% confidence interval [CI] 0.85–1.58), but a history of injurious falls was associated with an increased risk of mortality (HR 1.36, 95% CI 1.04–1.79). Compared with subjects without a FOF, subjects who were moderately or very afraid of falling had a higher mortality rate (HR 1.26, 95% CI 0.97–1.63). In conclusion, injurious falls and a high FOF increased the risk of all-cause mortality in Koreans. This study suggests that injurious falls and FOF can predict mortality in the general population.
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Affiliation(s)
- Jinkyu Oh
- Department of Public Health, Graduate School Chonnam National University Medical School, Gwangju, Korea
| | - Chang Kyun Choi
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sun A Kim
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young-Hoon Lee
- Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Korea
| | - Hae-Sung Nam
- Department of Preventive Medicine, Chungnam National University Medical School, Daejeon, Korea
| | - Kyeong-Soo Park
- Cardiocerebrovascular Center, Mokpo Jung-Ang Hospital, Mokpo, Korea
| | - So-Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Seong-Woo Choi
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
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Objectively Measured Physical Activity and Falls in Well-Functioning Older Adults: Findings From the Baltimore Longitudinal Study of Aging. Am J Phys Med Rehabil 2019; 97:255-260. [PMID: 28915202 DOI: 10.1097/phm.0000000000000830] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Previous work demonstrates the consequences of falling in older adults and the potential of physical activity (PA) to reduce falls, but few studies have used accelerometer-measured PA to compare overall and time-of-day activity patterns of nonfallers, fallers, or subgroups of fallers. METHODS In 840 participants (mean age, 66.7; s = 13.2; range, 26-97) of the Baltimore Longitudinal Study of Aging between 2007 and 2014, PA was measured objectively with Actiheart accelerometers and falling status (faller/nonfaller) was assessed during an in-person interview. Differences in daily PA and PA by time-of-day were assessed using multiple linear regression. Differences in PA (multiple linear regression), and functional status (χ) were further examined in subgroups of "risky" or "normal" fallers. RESULTS Overall, fallers and nonfallers exhibited similar daily (β = 22.6, P = 0.48) and time-specific PA; however, those who fell doing risky activities were more active overall (β = 243.8, P = 0.002), during the morning (β = 77.3, P = 0.004), afternoon (β = 78.4, P = 0.001), and late afternoon/evening (β = 56.3, P = 0.006) than those who fell doing normal activities. Risky fallers were significantly higher functioning than normal fallers. CONCLUSIONS Persons who fell while engaging in normal activities exhibited lower PA overall and throughout most of the day, and were of lower functional status than persons who fell while engaging in risky or unusual activities, suggesting that engagement in risky or unusual PA is associated with higher functional ability and lower falls risk in older persons.
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Both psychological factors and physical performance are associated with fall-related concerns. Aging Clin Exp Res 2018; 30:1079-1085. [PMID: 29264814 PMCID: PMC6096850 DOI: 10.1007/s40520-017-0882-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 12/13/2017] [Indexed: 10/30/2022]
Abstract
BACKGROUND Fall-related concern strongly correlates to activity avoidance in older people. In this complex phenomenon, different terminology and instruments are often used interchangeably. Three main concepts make up fall-related concerns: fear of falling, consequence concern, and falls self-efficacy. It is suggested that fall-related concerns are mediated by psychological and physical factors. AIMS Our aims were to describe the prevalence of fall-related concerns and find explanatory factors for its most studied concept-falls self-efficacy-in an older population. METHODS We executed a cross-sectional study on a random sample of 153 community-dwelling older people (70 years or older). We used validated and reliable instruments as well as structured interviews to gather data on the three concepts of fall-related concerns and possible mediating factors. We then calculated descriptive statistics on prevalence and regression models for the total group, and men and women, separately. RESULTS 70% of the total sample (80% of women and 53% of men) reported at least one of the three concepts of fall-related concern. For the total sample, fear of falling, morale, and physical performance were associated factors with falls self-efficacy. For women, the number of prescription medications was added. For men, physical performance and concerns for injury were associated. CONCLUSION Fall-related concern is prevalent in large proportions with higher prevalence for women than for men. Important factors are fear of falling, morale, and physical performance. Gender differences in the emergence and variance of fall-related concern and the relation between physical performance and fall-related concern should be targeted in future research endeavors.
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Chippendale T, Lee CD. Characteristics and fall experiences of older adults with and without fear of falling outdoors. Aging Ment Health 2018; 22:849-855. [PMID: 28393552 DOI: 10.1080/13607863.2017.1309639] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Using a theoretical model that combines an ecological perspective and Bandura's theory of self-efficacy as a guide, we sought to compare experiences and characteristics of community dwelling older adults with and without concern about falling outdoors. METHOD A survey of randomly selected community dwelling older adults across NYC (N = 120) was conducted using the outdoor falls questionnaire. Descriptive quantitative analyses of participant characteristics were conducted for all participants and for those with and without concern about falling outside. Conventional content analysis using two coders was employed to examine outdoor fall experiences for each group. A mixed methods matrix was used to integrate qualitative and quantitative findings. RESULTS Some participant characteristics were more common among those with a concern about falling outside such as decreased functional status, female gender, and number of prior outdoor falls. As per descriptions of outdoor fall experiences, participants with concern were more likely to report a fall while climbing stairs or stepping up a curb, describe an intrinsic factor as a cause of their fall, use an injury prevention strategy during the fall, sustain a moderate to severe injury, seek medical attention, have had an ambulance called, require help to get up, and describe implementation of a behavioral change after the fall. CONCLUSIONS Differences exist in participant characteristics and outdoor fall experiences of those with and without concern about falling outside. The proposed model can be used to understand fear of falling outdoors and can help to inform the target population and content of intervention programs.
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Affiliation(s)
- Tracy Chippendale
- a Department of Occupational Therapy , New York University, Steinhardt School of Culture, Education, and Human Development , New York , NY , USA
| | - Chang Dae Lee
- a Department of Occupational Therapy , New York University, Steinhardt School of Culture, Education, and Human Development , New York , NY , USA
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Lee S, Oh E, Hong GRS. Comparison of Factors Associated with Fear of Falling between Older Adults with and without a Fall History. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E982. [PMID: 29757960 PMCID: PMC5982021 DOI: 10.3390/ijerph15050982] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 11/26/2022]
Abstract
Background: Although fear of falling (FOF) has been studied since FOF has negative consequences for the elderly, there is limited information about the risk factors of FOF, including the environment. The purpose of this study was to describe individual and environmental factors of FOF between those with and without a fall history from an ecological aspect and to examine whether individual and environmental factors differently affect the FOF according to the state of fall history in community-dwelling older adults in Korea. Methods: Data from the 2014 Survey of Living Conditions and Welfare Needs of Korean Older Adults were used. Participants were 7730 older adults. Hierarchical logistic regression analysis was conducted to examine the predictors of FOF. Results: According to the ecological model, female and discomfort with the neighborhood environment were significantly associated with greater odds of reporting FOF in both older adults with fall history and those without. A significant interaction was not observed between any variable of FOF in participants with and without a fall history. Conclusions: An ecological model including individual and environmental factors should be considered when conducting research and designing programs and decision policies related to FOF for older adults with and without a history of falling.
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Affiliation(s)
- Seonhye Lee
- Department of Nursing, Gyeongnam National University of Science and Technology, #33 Dongjinro, Jinju, Gyeongnam 52725, Korea.
| | - Eunmi Oh
- School of Nursing, Hanyang University, #222 Wangsimliro, Sungdong-gu, Seoul 04763, Korea.
| | - Gwi-Ryung Son Hong
- School of Nursing, Hanyang University, #222 Wangsimliro, Sungdong-gu, Seoul 04763, Korea.
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Lavedán A, Viladrosa M, Jürschik P, Botigué T, Nuín C, Masot O, Lavedán R. Fear of falling in community-dwelling older adults: A cause of falls, a consequence, or both? PLoS One 2018; 13:e0194967. [PMID: 29596521 PMCID: PMC5875785 DOI: 10.1371/journal.pone.0194967] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 03/14/2018] [Indexed: 11/19/2022] Open
Abstract
Background Despite the number of studies that have tried to demonstrate that there is an association between previous falls and the fear of falling, the relationship between these two variables remains a matter of controversy. Objectives Our objective was to investigate whether the fear of falling is a cause of falls, a consequence, or both in community-dwelling adults aged ≥ 75 years old. Methods A descriptive, longitudinal, prospective study was performed. A total of 640 individuals were interviewed between 2009 and 2011. Sociodemographic data, health status, history of falls and fear of falling were assessed at baseline and at 24 months. Results The prevalence of falls at baseline was 25% as opposed to 35.2% at 24 months. The prevalence of the fear of falling was 41.5% at baseline. Logistic regression analysis showed a significant association between a history of falls and the fear of falling. Other factors associated with the fear of falling were female gender, comorbidity, depressive symptoms, and disability. In total, 41.7% of the subjects who had reported a fear of falling at baseline had suffered at least one fall 24 months later. Unadjusted Cox regression analysis revealed that the fear of falling was a risk factor for falls. According to the final model adjusted for other covariates, the only reliable predictor was female gender. The Cox model stratified by gender failed to show a crude association between fear of falling and falls. Conclusion A previous history of falls in the previous year was a good predictor of the fear of falling; but the fear of falling was a predictor of falls during follow-up only in the unadjusted model, pointing to strong gender turns out as an effect modifier of the association of FOF and subsequent falls. Nursing staff working in elderly care should not only routinely assess patients’ previous history of falls, but also evaluate their fear of falling and its associated factors.
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Affiliation(s)
- Ana Lavedán
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Maria Viladrosa
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- University Hospital Arnau de Vilanova, Lleida, Spain
| | - Pilar Jürschik
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Teresa Botigué
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- * E-mail:
| | - Carmen Nuín
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Olga Masot
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Raquel Lavedán
- University Clinical Hospital Lozano Blesa, Zaragoza, Spain
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Hajek A, Bock JO, König HH. Psychological correlates of fear of falling: Findings from the German Aging Survey. Geriatr Gerontol Int 2017; 18:396-406. [PMID: 29143433 DOI: 10.1111/ggi.13190] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/20/2017] [Accepted: 08/27/2017] [Indexed: 11/28/2022]
Abstract
AIM The aim of the present study was to identify general psychological factors related to fear of falling. METHODS Data drawn from national probability sampling of the German population aged ≥40 years were used (German Aging Survey; n = 7779). The fear of falling and the psychological factors of loneliness, life satisfaction, positive affect, negative affect, optimism, self-efficacy, self-esteem, self-regulation and perceived stress were collected in self-administered questionnaires. Multiple logistic regression models controlling for sociodemographic, lifestyle and health-related variables were used to determine the psychological correlates of fear of falling. RESULTS The prevalence of fear of falling was 18% for all individuals. All psychological factors showed strong bivariate associations with fear of falling. In the multiple regression analyses, higher levels of loneliness, lower life satisfaction, lower positive affect and higher negative affect, as well as lower levels of optimism, self-efficacy, self-esteem, self-regulation and more perceived stress, were associated with increased fear of falling after controlling for sociodemographic factors, various lifestyle factors and morbidity. CONCLUSIONS The psychological factors considered in the present study are important for characterizing people with fear of falling. Because effective interventions to treat the fear of falling are available, our study might help to address this target group more accurately. Geriatr Gerontol Int 2018; 18: 396-406.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens-Oliver Bock
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hajek A, König HH. Falls and subjective well-being. Results of the population-based German Ageing Survey. Arch Gerontol Geriatr 2017; 72:181-186. [PMID: 28692833 DOI: 10.1016/j.archger.2017.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 05/04/2017] [Accepted: 06/23/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of the current study was to determine the relationship between falling in the past 12 months and subjective well-being in a broader sense. METHODS Cross-sectional data were gathered from a representative sample of community-dwelling individuals in the second half of life (40 to 95 years; n=7808) in Germany. While life satisfaction was quantified using the Satisfaction with Life Scale (SWLS), positive and negative affect was measured using the Positive and Negative Affect Schedule (PANAS). RESULTS The prevalence of falling in the preceding 12 months was 17.6%. After controlling for sociodemographic factors, various lifestyle factors, self-rated health, and morbidity, multiple linear regression analysis revealed that falling in the past 12 months was associated with higher negative affect (β=0.08, p<0.001), lower positive affect (β=-0.04, p<0.05) as well as lower life satisfaction (β=-0.12, p<0.001). CONCLUSION The present study stresses the relationship between falls and subjective well-being. Future longitudinal studies are needed to validate the findings of the present cross-sectional study and to better understand the nature of this relationship.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany.
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Moreira BDS, Sampaio RF, Diz JBM, Bastone ADC, Ferriolli E, Neri AL, Lourenço RA, Dias RC, Kirkwood RN. Factors associated with fear of falling in community-dwelling older adults with and without diabetes mellitus: Findings from the Frailty in Brazilian Older People Study (FIBRA-BR). Exp Gerontol 2017; 89:103-111. [DOI: 10.1016/j.exger.2017.01.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 12/23/2016] [Accepted: 01/02/2017] [Indexed: 11/29/2022]
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Lee S, Hong GRS. Predictors of Depression Among Community-Dwelling Older Women Living Alone in Korea. Arch Psychiatr Nurs 2016; 30:513-20. [PMID: 27654230 DOI: 10.1016/j.apnu.2016.05.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 01/01/2023]
Abstract
This study examined the prevalence and predicting factors of depression among community-dwelling older women living alone in Korea. Of the 2054 older women living alone in this study, 42.9% (881) were experiencing depression. Factors associated with a higher prevalence of depression were overall difficulty with living alone, taking more than six medications, limitations of instrumental activities of daily living, limitations of muscle strength, limitations of exercise performance in upper extremities, trouble with hearing, and perceptions of poor health status. These results provide a basis for designing preventive interventional programs to decrease depression among older women living alone in Korea.
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Affiliation(s)
- SiEun Lee
- College of Nursing, Hanyang University, Seoul, South Korea.
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Chang HT, Chen HC, Chou P. Factors Associated with Fear of Falling among Community-Dwelling Older Adults in the Shih-Pai Study in Taiwan. PLoS One 2016; 11:e0150612. [PMID: 26933882 PMCID: PMC4775068 DOI: 10.1371/journal.pone.0150612] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/16/2016] [Indexed: 11/29/2022] Open
Abstract
Background Fear of falling is an important risk indicator for adverse health related outcomes in older adults. However, factors associated with fear of falling among community-dwelling older adults are not well-explored. Objectives To explore the quality of life and associated factors in fear of falling among older people in the Shih-Pai area in Taiwan. Methods This community-based survey recruited three thousand eight hundred and twenty-four older adults aged ≥ 65 years. The measurements included a structured questionnaire, including quality of life by using Short-Form 36, and information of fear of falling, fall history, demographics, medical conditions, insomnia, sleep quality, depression and subjective health through face-to-face interviews. Results A total of 53.4% of participants reported a fear of falling. The rate of fear of falling was higher in female subjects. Subjects with fear of falling had lower Short Form-36 scores both for men and women. Falls in the previous year, older age, insomnia, depression and worse subjective health were correlates of fear of falling for both sexes. Male-specific associations with fear of falling were the accessibility of medical help in an emergency, diabetes mellitus and stroke. In parallel, cardiovascular diseases were a female-specific correlate for fear of falling. Conclusions Fear of falling is prevalent among community-dwelling older adults. It is seems that there are gender differences in fear of falling with respect to the prevalence and associated factors in older adults. Gender differences should be considered when planning prevention and intervention strategies for fear of falling among older people.
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Affiliation(s)
- Hsiao-Ting Chang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Pesus Chou
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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