scholarly journals Fear of falling is as important as multiple previous falls in terms of limiting daily activities: a longitudinal study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Minhui Liu ◽  
Tianxue Hou ◽  
Yuxiao Li ◽  
Xiaocao Sun ◽  
Sarah L. Szanton ◽  
...  
Keyword(s):  
Older Adults ◽  
Incidence Rate Ratio ◽  
Fear Of Falling ◽  
Self Care ◽  
Community Dwelling ◽  
Daily Activities ◽  
The Past ◽  
Generalized Estimation Equation ◽  
Household Activities ◽  
Hispanic White

Abstract Background Fear of falling and previous falls are both risk factors that affect daily activities of older adults. However, it remains unclear whether they independently limit daily activities accounting for each other. Methods We used the data from Round 1 (Year 1) to Round 5 (Year 5) of the National Health and Aging Trends Study. We included a total of 864 community-dwelling participants who provided data on previous falls, fear of falling and limited activities from Year 1 to Year 5 and had no limited daily activities at Year 1 in this study. Previous falls and fear of falling were ascertained by asking participants how many falls they had in the past year and whether they had worried about falling in the last month. Limited daily activities included any difficulties with mobility (e.g., going outside), self-care (e.g., eating), and household activities (e.g., laundering). Generalized estimation equation models were used to examine whether previous falls and fear of falling independently predicted development of limited daily activities adjusting covariates. Results Participants were mainly between 65 and 79 years old (83 %), male (57 %), and non-Hispanic White (79 %). Among participants who had multiple falls in Year 1, 19.1-31 %, 21.4-52.4 %, and 11.9-35.7 % developed limitations in mobility, self-care, and household activities during Year 2 to Year 5, respectively. Among those who had fear of falling in Year 1, 22.5-41.3 %, 30.0-55.0 %, and 18.8-36.3 % developed limitations in mobility, self-care, and household activities during Year 2 to Year 4, respectively. Fear of falling independently predicted limitations in mobility (Incidence rate ratio [IRR]: 1.79, 95 % CI: 1.44, 2.24), self-care (IRR: 1.25, 95 % CI: 1.08, 1.44) and household activities (IRR: 1.39, 95 % CI: 1.08, 1.78) after adjusting for previous falls and covariates. Multiple previous falls independently predicted limitations in mobility (IRR: 1.72, 1.30, 2.27), self-care (IRR: 1.40, 95 % CI: 1.19, 1.66) and household activities (IRR: 1.36, 95 % CI: 1.01, 1.83) after adjusting fear of falling and covariates. Conclusions Fear of falling seems to be as important as multiple previous falls in terms of limiting older adults’ daily activities.

scholarly journals Fear of Falling is More Important Than Previous Falls in Terms of Limiting Activities: A Longitudinal Study

2020 ◽  
Author(s):  
Minhui Liu ◽  
Tianxue Hou ◽  
Yuxiao Li ◽  
Xiaocao Sun ◽  
Sarah L. Szanton ◽  
...  
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Self Care ◽  
Critical Factor ◽  
Community Dwelling ◽  
Daily Activities ◽  
The Past ◽  
Generalized Estimation Equation ◽  
Household Activities ◽  
Hispanic White

Abstract Background: Fear of falling and previous falls are both risk factors that affect daily activities of older adults. However, it remains unclear whether they independently limit daily activities accounting for each other. This study aims to examine whether previous falls and fear of falling independently predict limited daily activities among older adults.Methods: We used the data from Round 1 to Round 5 of the National Health and Aging Trends Study. We included a total of 866 community-dwelling participants who provided data on previous falls, fear of falling and limited activities from Round 1 to Round 5 and had no limited daily activities at Round 1 in this study. Previous falls and fear of falling were ascertained by asking participants whether they had fallen in the past year and whether they had worried about falling in the last month. Limited daily activities included any difficulties with mobility (e.g., going outside), self-care (e.g., eating), and household activities (e.g., laundering). Generalized estimation equation models were used to examine whether previous falls and fear of falling independently predicted development of limited daily activities adjusting covariates.Results: Participants were mainly between 65 and 79 years old (83%), male (57%), and non-Hispanic White (79%). Among participants who fell in Round 1, 13.2%-27.6%, 29.0%-52.0%, and 18.4%-32.9% developed limitations in mobility, self-care, household activities during Round 2 to Round 4, respectively. Among those who had fear of falling in Round 1, 22.5%-41.3%, 30.0%-55.0%, and 18.8%-36.3% developed limitations in mobility, self-care, and household activities during Round 2 to Round 4, respectively. Fear of falling independently predicted limitations in mobility (Incidence rate ratio [IRR]: 1.86, 95% CI: 1.50, 2.31), self-care (IRR: 1.32, 95% CI: 1.11, 1.62) and household activities (IRR: 1.34, 95% CI: 1.11, 1.62) after adjusting for previous falls and covariates. Previous falls only independently predicted limitations in mobility (IRR: 1.30, 1.08, 1.56) and household activities (IRR: 1.27, 95% CI: 1.05, 1.54) after adjusting fear of falling and covariates. Conclusions: While recognizing the risk factor of previous falls, fear of falling can be a more critical factor to intervene to reduce limited daily activities.

scholarly journals Older adults, falls and technologies for independent living: a life space approach

2011 ◽  
Vol 31 (5) ◽  
pp. 829-848 ◽  
Author(s):  
CATHY BAILEY ◽  
TIMOTHY G. FORAN ◽  
CLIODHNA NI SCANAILL ◽  
BEN DROMEY
Keyword(s):  
Older Adults ◽  
Independent Living ◽  
Fear Of Falling ◽  
Research Programme ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Daily Activities ◽  
Life Space ◽  
Risky Behaviour ◽  
Fear Of Falls

ABSTRACTThis paper draws attention to the need for further understanding of the fine details of routine and taken-for-granted daily activities and mobility. It argues that such understanding is critical if technologies designed to mitigate the negative impacts of falls and fear-of-falling are to provide unobtrusive support for independent living. The reported research was part of a large, multidisciplinary, multi-site research programme into responses to population ageing in Ireland, Technologies for Independent Living (TRIL). A small, exploratory, qualitative life-space diary study was conducted. Working with eight community-dwelling older adults with different experiences of falls or of fear-of-falls, data were collected through weekly life-space diaries, daily-activity logs, two-dimensional house plans and a pedometer. For some participants, self-recording of their daily activities and movements revealed routine, potentially risky behaviour about which they had been unaware, which may have implications for falls-prevention advice. The findings are presented and discussed around four key themes: ‘being pragmatic’, ‘not just a faller’, ‘heightened awareness and blind spots’ and ‘working with technology’. The findings suggest a need to think creatively about how technological and other solutions best fit with people's everyday challenges and needs and of critical importance, that their installation does not reduce an older adult to ‘just a faller’ or a person with a fear-of-falls.

scholarly journals RACE AND GENDER DIFFERENCES IN PHYSICAL FUNCTIONING AMONG COMMUNITY-DWELLING OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S780-S780
Author(s):  
Chanee D Fabius ◽  
Lauren J Parker ◽  
Roland J Thorpe Jr.
Keyword(s):  
Older Adults ◽  
Black Women ◽  
Physical Functioning ◽  
Self Care ◽  
Community Dwelling ◽  
Race And Gender ◽  
Formal Caregivers ◽  
Representative Study ◽  
Household Activities ◽  
And Gender

Abstract Prior work has demonstrated that there are race and gender disparities in the prevalence of need for assistance with tasks such as self-care, mobility, and household activities. Research has historically shown that older black Americans and women experience greater prevalence of physical functioning declines. It is unclear whether these differences persist among those receiving assistance. Using data from the 2015 National Health and Aging Trends Study (NHATS), a nationally representative study of Medicare beneficiaries aged 65 and older, and after adjusting for covariates, black men received less assistance with self-care and mobility activities, and white and black women received more help with mobility and household activities, compared to white men. Findings are critical to advancing our understanding of the needs of vulnerable older adults receiving assistance. More research is needed to understand the implications of these differences on long-term services and supports provided by both informal and formal caregivers.

scholarly journals Racial/Ethnic Differences in the Longitudinal Effects of Fear of Falling on Falls

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 874-874
Author(s):  
Tuo Yu Chen ◽  
Giyeon Kim
Keyword(s):  
Older Adults ◽  
Ethnic Differences ◽  
Fear Of Falling ◽  
Educational Programs ◽  
Community Dwelling ◽  
The Past ◽  
Longitudinal Effects ◽  
Race Ethnicity ◽  
Community Dwelling Older Adults ◽  
Racial Ethnic

Abstract Research suggests that the effects of fear of falling on falls may differ by race/ethnicity. We investigated whether race/ethnicity (White, Black, and Hispanic) moderated the longitudinal effects of fear of falling on the incidence of falling and having a repeated fall among community-dwelling older adults. We used data from 2011-2018 of the National Health and Aging Trends Study (NHATS). These included a total of 19,516 person-intervals from 5,113 respondents. Self-reported any fall in the past year was the outcome variable with baseline fear of falling as the predictor and race/ethnicity as the moderator. Known risk factors for falls were included as covariates. Results showed that among respondents without the experience of falling at baseline, baseline fear of falling significantly increased the odds of a new-onset of fall at 1-year follow-up among Blacks, compared to Whites. Among respondents who already fell at baseline, baseline fear of falling significantly increased the odds of having a repeated fall later on among Hispanics, compared to Whites. Clear evidence of racial/ethnic differences was found in the relationship between fear of falling and falls among community-dwelling older adults in the U.S. Special attention should be paid to Black older adults with a fear of falling but have not fallen down recently and Hispanics with fear of falling and have fallen in the past year. Readily available educational programs should be actively advertised to older adults to reduce the fear of falling and culturally tailored educational programs should be developed for older adults from racial/ethnic minority backgrounds.

Multiple Physical Symptoms of Community-Dwelling Older People in Western China: Prevalence and Its Association with Frailty

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Shuli Jia ◽  
Wanyu Zhao ◽  
Yan Zhang ◽  
Lisha Hou ◽  
Xin Xia ◽  
...  
Keyword(s):  
Older Adults ◽  
Multinomial Logistic Regression ◽  
Physical Symptoms ◽  
Community Dwelling ◽  
Western China ◽  
Musculoskeletal Symptoms ◽  
Frailty Phenotype ◽  
The Past ◽  
Organ Systems ◽  
Multiple Symptoms

<b><i>Introduction:</i></b> Physical symptoms and frailty are common in older adults. A previous study has reported that multiple somatic symptoms are associated with frailty. In this study, we aimed to describe the picture of physical symptoms in older adults in western China and examine the relationship of multiple physical symptoms and frailty, as well as the sex difference of this relationship. <b><i>Methods:</i></b> Cross-sectional analyses were based on the West China Health and Aging Trend (WCHAT) study comprising 4,106 community-dwelling older adults (60–95 years). Frailty was assessed using the physical frailty phenotype (PFP). Participants’ experience of 28 different physical symptoms in the past 4 weeks was assessed. Physical symptoms were divided into several categories according to organ systems. Multinomial logistic regression analyses were performed to examine the association between frailty and multiple physical symptoms. <b><i>Results:</i></b> Nearly half of the subjects reported experiencing at least 1 physical symptom during the past 4 weeks. Musculoskeletal symptoms were the most prevalent symptoms. More than 5 physical symptoms were more likely to be frailty, even when all covariates were controlled. A significant association between multiple musculoskeletal symptoms and frailty also was found after adjusted for all covariates and multiple symptoms of other organ systems. Similar results were obtained for multiple cardiopulmonary symptoms. Furthermore, there were sex differences in these relationships. <b><i>Conclusion:</i></b> Multiple physical symptoms appear to have a detrimental impact on frailty in older adults. Compared with counting total symptoms, multiple symptoms of the same organ system may have a greater impact on frailty. Effective interventions and management of multiple physical symptoms are warranted to prevent frailty.

scholarly journals Bidirectional Relationship Between Subjective Age and Frailty: Findings From the NHATS

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 271-271
Author(s):  
Yuxiao Li ◽  
Minhui Liu ◽  
Christina Miyawaki ◽  
Xiaocao Sun ◽  
Tianxue Hou ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Syndrome ◽  
Community Dwelling ◽  
Chronological Age ◽  
Subjective Age ◽  
Bidirectional Relationship ◽  
Study Participants ◽  
Community Dwelling Older Adults ◽  
The Relationship ◽  
Hispanic White

Abstract Frailty is a clinical syndrome that becomes increasingly common as people age. Subjective age refers to how young or old individuals experience themselves to be. It is associated with many risk factors of frailty, such as increased depression, worse cognitive function, and poorer psychological wellbeing. In this study, we examined the relationship between subjective age and frailty using the 2011-2015 waves of the National Health and Aging Trends Study. Participants were community-dwelling older adults without frailty in the initial wave (N=1,165). Subjective age was measured by asking participants, “What age do you feel most of the time?” Based on the Fried five phenotypic criteria: exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength, frailty was categorized into robust=0, pre-frail=1 or 2; frail=3 or more criteria met. Participants were, on average, 74.1±6.5 years old, female (52%), and non-Hispanic White (81%). Eighty-five percent of the participants felt younger, and 3% felt older than their chronological age, but 41% of them were pre-frail/frail. Generalized estimating equations revealed that an “older” subjective age predicted a higher likelihood of pre-frailty and frailty (OR, 95%CI= 1.01, 1.01-1.02). In contrast, frailty predicted an “older” subjective age (OR, 95%CI= 2.97, 1.65-5.35) adjusting for demographics and health conditions. These findings suggest a bidirectional relationship between subjective age and frailty. Older people who feel younger than their chronological age are at reduced risk of becoming pre-frail/frail. Intervention programs to delay frailty progression should include strategies that may help older adults perceive a younger subjective age.

scholarly journals The Association Between Personality and Homebound Status in Older Adults: Results From the NHATS

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 233-233
Author(s):  
Xiaocao Sun ◽  
Minhui Liu ◽  
Christina E Miyawaki ◽  
Yuxiao Li ◽  
Tianxue Hou ◽  
...  
Keyword(s):  
Older Adults ◽  
Personality Traits ◽  
Personality Assessment ◽  
Rating Scale ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Health Related ◽  
Community Dwelling Older Adults ◽  
Ordinal Logistic Regression Model ◽  
Hispanic White

Abstract Personality is associated with predictors of homebound status like frailty, incident falls, and depression. It has been rarely investigated whether personality predicts homebound status among older adults. Using the combining cross-sectional data of the Year 2013 and Year 2014 data from the National Health and Aging Trends Study (NHATS), this study examined the association between personality traits and homebound status in a sample of community-dwelling older adults aged 65 years and older (N=2,788). Homebound status (non-homebound, semi-homebound, and homebound) was determined by the frequency, difficulty, and help of outdoor mobility. Personality traits, including conscientiousness, agreeableness, openness, extraversion, and neuroticism were assessed using the 10-item Midlife Development Inventory on a rating scale from 1 (not at all) to 4 (a lot). Each personality trait was included as a predictor in an ordinal logistic regression model to examine its association with homebound status after adjusting demographic and health-related covariates. The sample was on average 79±7.53 years old, non-Hispanic White (72.0%), female (58.6%), living alone (35.4%) or with spouse/partner only (37.4%). Seventy-four percent, 18%, and 8% of participants were non-homebound, semi-homebound, and homebound, respectively. Homebound participants tended to be less-educated older females. The average scores of conscientiousness, agreeableness, openness, extraversion, and neuroticism were 3.19±0.75, 3.57±0.56, 2.81±0.83, 3.13±0.75, and 2.22±0.86, respectively. Among these five personality traits, high conscientiousness (OR=1.34, p&lt;0.001) and extraversion (OR=1.16, p=.03) were associated with a reduced likelihood of being homebound. These findings provided a basis for potential personality assessment to identify and protect individuals with high homebound risk.

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

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.

scholarly journals Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049926
Author(s):  
Sandra Angelika Mümken ◽  
Paul Gellert ◽  
Malte Stollwerck ◽  
Julie Lorraine O'Sullivan ◽  
Joern Kiselev
Keyword(s):  
Older Adults ◽  
Construct Validity ◽  
Outcome Measures ◽  
Total Sample ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Life Space ◽  
Cross Sectional ◽  
The Past ◽  
Community Dwelling Older Adults

ObjectivesTo develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults.DesignCross-sectional validation study.SettingTwo study centres in urban and rural German outpatient hospital settings.ParticipantsIn total, N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 years (SD=5.4); 49.4% men).Primary and secondary outcome measuresThe final version of the translated LSA-D was related to limitations in activities and instrumental activities of daily living (ADL/iADL) as primary outcome measure (primary hypothesis); and with sociodemographic factors, functional mobility, self-rated health, balance confidence and history of falls as secondary outcome measures to obtain construct validity. Further descriptive measurements of health included hand grip strength, screening of cognitive function, comorbidities and use of transportation. To assess construct validity, correlations between LSA-D and the primary and secondary outcome measures were examined for the total sample, and urban and rural subsamples using bivariate regression and multiple adjusted regression models. Descriptive analyses of LSA-D included different scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure.ResultsIn the multiple adjusted model for the total sample, number of ADL/iADL limitations (β=−0.26; 95% CI=−0.42 to −0.08), Timed Up and Go Test (β=−0.37; 95% CI=−0.68 to −0.14), shared living arrangements (β=0.22; 95% CI=0.01 to 0.44) and history of falls in the past 6 months (β=−0.22; 95% CI=−0.41 to −0.05) showed significant associations with the LSA-D composite score, while living in urban area (β=−0.19; 95% CI=−0.42 to 0.03) and male gender (β=0.15; 95% CI=−0.04 to 0.35) were not significant.ConclusionThe LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past 4 weeks in ambulant urban and rural settings.Trial registration numberDRKS00019023.

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