Association between activity restriction due to fear of falling and mortality: Results from the Korean longitudinal study of aging

Background and objective: Falls in elderly cause injury, mortality, and loss of independence, making Fear of Falling (FoF) a common health problem. FoF relates to activity restriction and increased fall risk. A voluntary intervention including fall risk assessment and prevention strategies was implemented to reduce falls in elderly patients with low energy fractures (LEF). The primary purpose of this study was to evaluate FoF and the number of subsequent falls in trauma patients one year after a LEF. The secondary aim was to examine how FoF affects patients’ lives in terms of Quality of Life (QoL), mobility, and activity levels. Finally, participation in the voluntary fall prevention program (FPP) was evaluated. Materials and Methods: Observational cohort study in one Swiss trauma center. LEF patients, treated between 2012 and 2015, were analyzed one year after injury. Primary outcomes were Falls-Efficacy Score-International (FES-I) and number of subsequent falls. Secondary outcomes were EuroQoL-5-Dimensions-3-Levels (EQ5D-3L), mobility, activity levels, and participation in the FPP. Subgroup analysis was performed for different age categories. Results: 411 patients were included for analysis. Mean age was 72 ± 9.3, mean FES-I was 21.1 ± 7.7. Forty percent experienced FoF. A significant negative correlation between FoF and QoL (R = 0.64; p < 0.001) was found. High FoF correlated with lower activity levels (R= −0.288; p < 0.001). Six percent visited the FPP. Conclusions: At follow-up, 40% suffered from FoF which seems to negatively affect patients’ QoL. Nevertheless, participation in the FPP was low. Simply informing patients about their susceptibility to falls and recommending participation in FPPs seems insufficient to motivate and recruit patients into FPPs. We suggest implementing repeated fall risk- and FoF screenings as standard procedures in the follow-up of LEF, especially in patients aged over 75 years.

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Participation in Two Evidence-Based Falls Prevention Programs by Adults Aging With a Long-Term Disability: Case-Control Study of Reach and Effectiveness

Journal of Aging and Health ◽

10.1177/0898264318808918 ◽

2018 ◽

Vol 31 (10_suppl) ◽

pp. 39S-67S ◽

Cited By ~ 1

Author(s):

Thomas J. Eagen ◽

Salom M. Teshale ◽

Angelica P. Herrera-Venson ◽

Anne Ordway ◽

Joe Caldwell

Keyword(s):

Older Adults ◽

Fear Of Falling ◽

Prevention Programs ◽

Preliminary Evidence ◽

Case Control ◽

Falls Prevention ◽

Evidence Based ◽

Activity Restriction ◽

Increased Risk

Objective: Adults aging with a long-term disability (LTD) are at an increased risk for falls. The Older Americans Act Title III-D and Prevention and Public Health Fund (PPHF) support several organizations to deliver falls prevention evidence-based programs designed to reduce risk factors; however, little is understood about the reach and effectiveness of these fall prevention programs for those with LTD compared to those without LTD. This study compared the reach and effectiveness of two evidence-based falls prevention programs between older adults with and without LTD. Method: Using a matched case-control design, 105 LTD older adults enrolled in A Matter of Balance (AMOB) or Stepping On were matched to 315 non-LTD older adults on age, sex, race, and education. Results: On average, LTD older adults attended a higher number of class sessions and were significantly more likely to complete the program compared with the matched-sample of non-LTD older adults. LTD older adults were equally likely as non-LTD older adults to report significant reductions in self-reported fear of falling, falls-related activity restriction, and improvement in falls self-efficacy following completion of the programs. Discussion: These findings provide preliminary evidence for the effectiveness of these evidence-based falls prevention programs for LTD older adults; however, more research is needed to extend these findings.

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223SELF-REPORTED UNSTEADINESS PREDICTS FEAR OF FALLING AND ACTIVITY RESTRICTION AT TWO YEARS FOLLOW-UP

Age and Ageing ◽

10.1093/ageing/afw159.40 ◽

2016 ◽

Vol 45 (suppl 2) ◽

pp. ii1.40-ii12

Author(s):

Orna Donoghue ◽

Annalisa Setti ◽

Neil O'Leary ◽

Rose Anne Kenny

Keyword(s):

Fear Of Falling ◽

Activity Restriction

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328 An Integrated Approach to Fear of Falling

Age and Ageing ◽

10.1093/ageing/afz103.212 ◽

2019 ◽

Vol 48 (Supplement_3) ◽

pp. iii17-iii65

Author(s):

Eleanor Murphy ◽

Petra McLoughlin ◽

Fiona O'Sullivan ◽

Ciara Connellan

Keyword(s):

Older Persons ◽

Fear Of Falling ◽

Exercise Program ◽

Integrated Approach ◽

Home Exercise ◽

Activity Restriction ◽

Home Based ◽

Increased Risk ◽

Occupational Therapy Interventions ◽

The Impact

Abstract Background Fear of falling (FOF) is a known risk factor for falls and subsequent activity restriction which has implications for quality of life and frailty level in older persons.1 The Integrated Care Team for Older Persons in Sligo provides home-based rehabilitation for the acutely frail older adult. We noted that fear of falling was a commonly identified problem in our referral group following comprehensive geriatric assessment (CGA). Our study aims to characterise interventions required. Methods Descriptive study from CGA of acutely frail older adults with a FOF in all referrals to ICTOP from June to December 2018. Results Of the 52 patients studied, 67% reported a FOF with a higher incidence in females (81% vs 45%). Increasing age was associated with a greater likelihood of FOF with 0% reported at 70-74years (n=4) and 86% at 90-95 years (n=7). There was a 1.6 times increased risk of FOF associated with cerebral vascular disease and 1.26 with mental health issues. The median Rockwood Clinical Frailty score was 6 with a median TUG of 28 seconds. Of those with a FOF, 100% received falls education, a home exercise program and advice on acquiring a pendant alarm. A mobility aid was provided in 63% and additional functional aids in 71%. Major housing adaption advice was given in 50% and additional equipment signposting and purchasing advice in 66%. Transport advice was provided in 49% of cases and onward referrals to ophthalmology and orthotics were provided in 9% and 11% respectively. There were only 2 readmissions with a fall within 30 days. Conclusion A significant cohort of ICTOP referrals report a fear of falling. Specific physiotherapy and occupational therapy interventions aim to reduce the impact of this and our low rate of readmissions due to falls indicates the success of this program.

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Self-Reported Unsteadiness Predicts Fear of Falling, Activity Restriction, Falls, and Disability

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2017.01.022 ◽

2017 ◽

Vol 18 (7) ◽

pp. 597-602 ◽

Cited By ~ 10

Author(s):

Orna A. Donoghue ◽

Annalisa Setti ◽

Neil O'Leary ◽

Rose Anne Kenny

Keyword(s):

Fear Of Falling ◽

Activity Restriction

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PARTICIPATION IN TWO EVIDENCE-BASED FALLS PREVENTION PROGRAMS AMONG OLDER ADULTS WITH AND WITHOUT A DISABILITY

Innovation in Aging ◽

10.1093/geroni/igz038.452 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S123-S124

Author(s):

Thomas J Eagen ◽

Ellen McGough ◽

Tracy Mroz ◽

Deborah Kartin ◽

Anjum Hajat ◽

...

Keyword(s):

Older Adults ◽

Program Effectiveness ◽

Fear Of Falling ◽

Prevention Programs ◽

Falls Prevention ◽

Original Research ◽

Evidence Based ◽

National Council ◽

Activity Restriction ◽

Using Data

Abstract Older adults with a disability are at greater risk for falls and injury due to falling compared to those without a disability. Evidence-based falls prevention programs (EBFPPs) have been developed and disseminated broadly, however individuals with disabilities were excluded from original research on effectiveness. Using data from the National Falls Prevention Database from the National Council on Aging, we compared the reach and effectiveness of two EBFPPs, A Matter of Balance (MOB) or Stepping On, between those with and without a disability. Program reach was measured using attendance percentage. Program effectiveness was measured using change in fear of falling (FOF), fall-related activity restriction (FAR), and falls self-efficacy (FSE) post-program. A total of 12,667 participants were analyzed. Participants were, on average, 76 years old (M = 76.18, SD = 9.86), largely female (75%), well educated (80% some college or higher), and white (90%). Nearly half self-reported a disability (40%). Older adults with a disability were as likely to attend (M = 0.88, SD = 0.14) the program compared to those without a disability (M = 0.88, SD = 0.14, p =.30). Older adults with a disability reported greater FOF and FAR and lower FSE compared to participants without a disability at baseline. Significant improvements were made across effectiveness measures, irrespective of disability status. MOB and Stepping On are effective programs, well attended by older adults with and without disabilities, however older adults with a disability continued to report higher FOF and FAR, and lower FSE compared to those without a disability.

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