Fear of falling and related factors in older adults in the city of Kashan in 2017

The global prevalence of and risk factors for fear of falling among older adults: a systematic review and meta-analysis

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.

The Prevalence and Associated Risk Factors of Fear of Fall in the Elderly: A Hospital-Based, Cross-Sectional Study

Background

Falls are one of the most common but serious health issues faced by the elderly population. Falls-related injuries not only add to the morbidity and economic burden they also have a significant negative impact on psychological health and the quality of life of the elderly. In this study, we assess the prevalence of fear of falling among the geriatric population and the risk factors associated with fear of falling.

Methodology

This prospective, cross-sectional study was conducted among geriatric patients aged more than 60 years attending the medical outpatient department of a tertiary care hospital in Uttarakhand, India. This study aimed to determine the prevalence of fear of falling among the geriatric population and compare various demographic and clinical parameters in elderly patients with and without fear of falling. Fear of fall was assessed using a questionnaire by asking the elderly if they had fear of falling, how often they had fear of falling, and under which circumstances did they have fear of falling. Information regarding demographics, history of daily activities, and chronic diseases was collected and assessed from all geriatric patients with and without fear of falls.

Results

Almost half (334; 42%) of the geriatric population had a history of fear of falling. Demographic parameters such as age over 80 years, female gender, living alone, and rural background were significantly associated with fear of falling. Similarly, a history of chronic diseases such as stroke, hypertension, and history of visual and motility impairment was significantly related to fear of falls among geriatric patients. Around 70% (571) of geriatric patients aged over 60 years had associated health problems.

Conclusions

This study reinstates that fear of falls is a significant health issue in the elderly age group. It also highlights multiple risk factors related to fear of falling which if controlled can significantly improve the quality of life of the geriatric population.

Fear of falling and associated factors among older people living in Bahir Dar City, Amhara, Ethiopia- a cross-sectional study

BACKGROUND

Fear of falling (FOF) is the most common public health problem, which can lead to loss of confidence, reducing physical and social activities, depression, loss of mobility, increased risk of falls, physical weakness, and strong negative impact on an older people's quality of life. However, studies in developing country were lacking, particularly in the study area. Therefore, the aim of the current study was to fill this gap in the study area in particular and the country in general. The purpose of the current study was to assess the prevalence and associated factors with fear of falling among older people 60 years and older who were living in Bahir Dar city, Ethiopia.

METHODS

A community based cross sectional study design was conducted with a total sample size of 527 participants and multistage random sampling technique was used to select the study participants. The fall efficacy scale tool was used to develop the questionnaire. Data were coded, cleaned and entered into SPSS version 23 for analysis. Multi-collinearity and model fitting were checked. In bivariate logistic regression analyses, variables with p-value< 0.25 were considered as potential candidates for multivariable logistic regression analyses. A variable with p-value< 0.05 at 95% CI was considered as statistically significant. Finally, the odds ratio and 95% confidence interval were estimated and interpreted.

RESULTS

A total of 481 participants was included in this study. The prevalence of fear of falling among the older people was 59.9% (95% CI; 55.7-64.4). Fear of falling was significantly associated with the following variables:- advanced age (AOR = 4.01, 95% CI; 1.65-9.74), female (AOR = 4.25, 95% CI; 2.25-8.01), lower education level (AOR = 2.77, 95% CI; 1.12-6.82), anxiety [AOR = 9.03, 95% CI; 4.78-17.07), confirmed medical conditions (AOR = 2.01, 95% CI; 1.03-3.91) and walking aids used (AOR = 13.82; 95% CI; 5.21-36.63).

CONCLUSIONS

A moderate prevalence of fear of falling was observed. The major associated factors were advanced age, being female, lower educational level, anxiety, confirmed medical conditions and walking aids used. Hence, we recommend the need of rehabilitation programs that enable healthy aging and further rigor research is recommended.

The effect of fear of falling on balance and dual task performance in the elderly

BACKGROUND/AIM

Fear of falling frequently reported by older individuals and is an important health problem. The aim of this study was to investigate the effect of fear of falling on balance, dual task performance, physical activity level and the quality of life on the aged people.

SETTING

Elderly care facilities.

PARTICIPANTS

60 elderly individuals aged 65 and over were included. 30 individuals with fear of falling were included in the study group and 30 individuals without fear of falling were included in the control group.

MEASUREMENTS

Fall Efficiency Scale International (FESI) was used to determine the fear of falling. Balance tests i.e. Berg Balance Scale (BBS), Tinetti Performance Oriented Mobility Assessment (POMA), Time Up and Go Test (TUG) were applied to all individuals. Dual-task performance was evaluated by asking each person to perform motor (TUG_motor) and cognitive tasks (TUG_cognitive) simultaneously with TUG. Evaluation of physical activity was conducted by the Physical Activity Scale for the Elderly (PASE) and assessment of the quality of life was determined by the EuroQol-5 Dimension Questionnaire (EQ-5D).

RESULTS

The scores of BBS, TUG, PASE, EQ-5D and POMA (balance and gait subscores) of the aged who have a fear of falling were significantly different from the control group (p < 0.001). Additionally, the completion time of both TUG_motor and TUG_cognitive test of the aged who have a fear of falling was significantly longer than the control group (p < 0.001).

CONCLUSION

There were in deterioration in balance, dual task performance and quality of life and a decrease in physical activity level in elderly individuals in elderly with fear of falling.