Analysis of Measurement Tools of Fear of Falling for High-Risk, Community-Dwelling Older Adults

Abstract One in four older adults fall every year. Falls result in negative outcomes including decreased health-related quality of life (HRQoL). Frailty, fear of falling, depression, and HRQoL are not routinely screened in high-risk community-dwelling older adults. Continued study of modifiable fall risk factors is warranted due to varied reported prevalence rates, inconsistent definitions and the persistent high rate of falls resulting in poor HRQoL. The purpose of the study was to determine the relationship between frailty, fear of falling, and depression with physical and mental functioning and well-being measures of HRQoL in community-dwelling older adults 55 years of age and older. A cross-sectional correlational design and chart review were conducted. The sample consisted of 84 primarily African American (81%) nursing home eligible members of the Program for All-Inclusive Care for the Elderly (PACE) program. Data were analyzed with correlational statistics, multiple linear, and hierarchical regression models. Physical functioning and well-being measures were significantly decreased when compared to the general population. Increased frailty, fear of falling, and depression were associated with decreased physical and mental well-being. In the regression model, frailty and fear of falling were significant predictors of decreased physical functioning and well-being, and depression was a significant predictor of decreased mental functioning and well-being. This study provides clarification of the relationship between frailty, fear of falling, and depression with HRQoL in high-risk older adults. Screening for common modifiable risk factors can assist in the development of targeted interventions and treatments to improve HRQoL in high-risk older adults.

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Measuring fear of falling among high-risk, urban, community-dwelling older adults

Geriatric Nursing ◽

10.1016/j.gerinurse.2016.08.018 ◽

2016 ◽

Vol 37 (6) ◽

pp. 489-495 ◽

Cited By ~ 14

Author(s):

Sherry A. Greenberg ◽

Eileen Sullivan-Marx ◽

Marilyn (Lynn) S. Sommers ◽

Jesse Chittams ◽

Pamela Z. Cacchione

Keyword(s):

Older Adults ◽

High Risk ◽

Fear Of Falling ◽

Urban Community ◽

Community Dwelling ◽

Community Dwelling Older Adults

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Effect of cognitive behavior group intervention in loneliness, depression, and suicidal ideation among the community-dwelling older adults with a high risk of depression

Korean Society of Nursing Research ◽

10.34089/jknr.2019.3.2.25 ◽

2019 ◽

Vol 3 (2) ◽

pp. 25-35

Author(s):

Jung Sug Kim ◽

Young Mi Lim ◽

Jung Hee Lim

Keyword(s):

Older Adults ◽

Suicidal Ideation ◽

High Risk ◽

Group Intervention ◽

Community Dwelling ◽

Cognitive Behavior ◽

Community Dwelling Older Adults

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Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study

Physical Therapy ◽

10.1093/ptj/pzab059 ◽

2021 ◽

Author(s):

K Makino ◽

S Lee ◽

S Bae ◽

I Chiba ◽

K Harada ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Fear Of Falling ◽

Community Dwelling ◽

Cardiovascular Health Study ◽

Physical Frailty ◽

Frailty Status ◽

Community Dwelling Older Adults ◽

The Relationship

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 Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (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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The effectiveness of exergames on fear of falling in community-dwelling older adults: a systematic review

Aging & Mental Health ◽

10.1080/13607863.2021.1950615 ◽

2021 ◽

pp. 1-12

Author(s):

Lanying Ge ◽

Tai-Te Su ◽

Yu An ◽

Shannon T. Mejía

Keyword(s):

Systematic Review ◽

Older Adults ◽

Fear Of Falling ◽

Community Dwelling ◽

Community Dwelling Older Adults

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Factors influencing Fear of Falling in Community-Dwelling Older Adults in Singapore: A Cross-Sectional Study

10.21203/rs.3.rs-963330/v1 ◽

2021 ◽

Author(s):

Jacqueline Giovanna De Roza ◽

David Wei Liang Ng ◽

Blessy Koottappal Mathew ◽

Teena Jose ◽

Ling Jia Goh ◽

...

Keyword(s):

Older Adults ◽

Fear Of Falling ◽

Cross Sectional Study ◽

Community Dwelling ◽

Clinical Factors ◽

Cross Sectional ◽

Frail Older Adults ◽

History Of ◽

The Mean ◽

Community Dwelling Older Adults

Abstract BackgroundFalls in older adults is a common problem worldwide. Fear of falling (FoF) is a consequence of falls which has far-reaching implications including activity restriction, functional decline and reduced quality of life. This study aimed to determine the factors associated with FoF in a segment of Singapore’s community-dwelling older adults. MethodsThis descriptive cross-sectional study recruited a convenience sample of adults aged 65 and above from 4 primary care clinics from September 2020 to March 2021. Data were collected on demographic factors and clinical factors including history of falls and frailty as determined by the Clinical Frailty Scale (CFS). FoF was measured using the Short Falls Efficacy Scale–International (Short FES-I), cut-off score of 14 and above indicated high FoF. Logistic regression was used to determine predictors of high FoF.ResultsOut of 360 older adults, 78.1% were Chinese and 59.7% females. The mean age was 78.3 years and 76 (21.1%) had a history of falls in the past six months. Almost half (43.1%) were mildly to moderately frail and most (80.6%) had three or more chronic conditions. The mean FoF score was 15.5 (SD 5.97) and 60.8% reported high FoF. Logistic regression found that Malay ethnicity (OR = 5.81, 95% CI 1.77 – 19.13), use of walking aids (OR = 3.67, 95% CI = 1.54 – 8.77) and increasing frailty were significant predictors for high FoF. The odds of high FoF were significantly higher in pre frail older adults (OR = 6.87, 95% CI = 2.66 – 17.37), mildly frail older adults (OR =18.58, 95% CI = 4.88 – 70.34) and moderately frail older adults (OR = 144.78, 95% CI = 13.86 – 1512.60).ConclusionsFoF is a prevalent and compelling issue in community-dwelling older adults, particularly those with frailty. The demographic and clinical factors identified in this study will be helpful to develop targeted and tailored interventions for FoF.

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