Fear of Falling in Older Adults: A Scoping Review of Recent Literature

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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Cutoff values for appendicular skeletal muscle mass and strength in relation to fear of falling among Brazilian older adults: cross-sectional study

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2017.0049030517 ◽

2017 ◽

Vol 135 (5) ◽

pp. 434-443 ◽

Cited By ~ 5

Author(s):

Ricardo Aurélio Carvalho Sampaio ◽

Priscila Yukari Sewo Sampaio ◽

Luz Albany Arcila Castaño ◽

João Francisco Barbieri ◽

Hélio José Coelho Júnior ◽

...

Keyword(s):

Older Adults ◽

Skeletal Muscle ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Fear Of Falling ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Appendicular Skeletal Muscle ◽

Appendicular Skeletal Muscle Mass

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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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Prevalence of Poor Self-Rated Health and Associated Risk Factors among Older Adults in Cali, Colombia

Colombia Medica ◽

10.25100/cm.v44i4.1362 ◽

2013 ◽

pp. 224-231 ◽

Cited By ~ 12

Author(s):

Jose Mauricio Ocampo-Chaparro ◽

Helmer de Jesus Zapata-Ossa ◽

Angela M Cubides-Munévar ◽

Carmen Lucia Curcio ◽

Juan de Dios Villegas ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fear Of Falling ◽

Population Based ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Frailty Syndrome ◽

Cross Sectional ◽

Self Rated Health ◽

Modifiable Factors

Introduction: Self-rated health (SRH) has beeen considered an important marker of quality of life and an independent predictor of mortality in older adults. Objective: To determine the prevalence of poor SRH and identify risk factors associated with poor SRH among older adults residing in the Commune 18 of the city of Cali, Colombia, in 2009. Methods: A population-based cross-sectional study with a single-stage cluster sampling design. Sample included 314 persons aged 60 and older. The dependent variable, SRH was dichotomized into good (excellent, very good, good) and poor (fair, poor). Independent variables were sociodemographic, biological, mental, functional and geriatric syndromes. Logistic regression was used for multivariate statistical modeling. Results: Overall, 40.1% reported poor SRH (women 42.9%, men 35.0%). Factors independently associated with poor SRH were diabetes mellitus, depression, fear of falling and frailty syndrome (frail and pre-frail vs. non-frail). Widowed men reported poorer health than married men while other marital status (single/separated/divorced) was associated with better self rated health in women. Conclusion: Potential modifiable factors such as depression and frailty syndrome are important determinants for poor SRH in Colombian older adults.

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What does integrated care mean from an older person’s perspective? A scoping review

BMJ Open ◽

10.1136/bmjopen-2019-035157 ◽

2020 ◽

Vol 10 (1) ◽

pp. e035157

Author(s):

Michael T. Lawless ◽

Amy Marshall ◽

Manasi Murthy Mittinty ◽

Gillian Harvey

Keyword(s):

Older Adults ◽

Integrated Care ◽

Scoping Review ◽

Data Extraction ◽

Grey Literature ◽

Secondary Outcome ◽

Coordinated Care ◽

Healthcare Settings ◽

Care Relationships ◽

Integrated Or

ObjectiveTo systematically map and synthesise the literature on older adults’ perceptions and experiences of integrated care.SettingVarious healthcare settings, including primary care, hospitals, allied health practices and emergency departments.ParticipantsAdults aged ≥60 years.InterventionsIntegrated (or similarly coordinated) healthcare.Primary and secondary outcome measuresUsing scoping review methodology, four electronic databases (EMBASE, CINAHL, PubMed and ProQuest Dissertation and Theses) and the grey literature (Open Grey and Google Scholar) were searched to identify studies reporting on older adults’ experiences of integrated care. Studies reporting on empirical, interpretive and critical research using any type of methodology were included. Four independent reviewers performed study selection, data extraction and analysis.ResultsThe initial search retrieved 436 articles, of which 30 were included in this review. Patients expressed a desire for continuity, both in terms of care relationships and management, seamless transitions between care services and/or settings, and coordinated care that delivers quick access, effective treatment, self-care support, respect for patient preferences, and involves carers and families.ConclusionsParticipants across the studies desired accessible, efficient and coordinated care that caters to their needs and preferences, while keeping in mind their rights and safety. This review highlights the salience of the relational, informational and organisational aspects of care from an older person’s perspective. Findings are transferable and could be applied in various healthcare settings to derive patient-centred success measures that reflect the aspects of integrated care that are deemed important to older adults and their supporters.

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Neighborhood Characteristics and Frailty: A Scoping Review

The Gerontologist ◽

10.1093/geront/gnz072 ◽

2019 ◽

Vol 60 (4) ◽

pp. e270-e285 ◽

Cited By ~ 1

Author(s):

Heather Fritz ◽

Malcolm P Cutchin ◽

Jamil Gharib ◽

Neehar Haryadi ◽

Meet Patel ◽

...

Keyword(s):

Conceptual Model ◽

Scoping Review ◽

Frailty Index ◽

Later Life ◽

Included Study ◽

Neighborhood Characteristics ◽

Cross Sectional ◽

Adverse Health Outcomes ◽

Index Approach ◽

Study Characteristics

Abstract Background and Objectives Frailty is highly prevalent in later life and associated with early mortality and adverse health outcomes. The neighborhood has been identified as an important contributor to individual health, and neighborhood characteristics may contribute to frailty development. A scoping review was conducted of the peer-reviewed literature to better understand how physical and social neighborhood characteristics contribute to frailty. Research Design and Methods Following an established scoping review methodology, we searched four peer-reviewed databases for relevant studies published from January 1, 2008, to December 31, 2018. Data extracted from studies included study characteristics, operationalization of neighborhood, the conceptual model of the neighborhood–frailty relationship, operationalization of frailty, and study findings for associations among neighborhood variables and frailty indicators. Results A total of 522 articles were identified and 13 articles were included in the final data charting. Existing studies suggest that neighborhood characteristics are associated with frailty in later life. Few studies articulated a conceptual model identifying exact mechanisms through which neighborhood factors affected frailty. Studies designs were mostly cross-sectional. Longitudinal studies did not measure neighborhood characteristics over time. Studies varied considerably in how they operationalized the neighborhood. Frailty was most commonly assessed using a 5-point phenotype or a frailty index approach. Discussion and Implications Findings indicate that research on the relationship between neighborhood characteristics and frailty is an emerging area of inquiry. Additional studies are needed to more definitely explicate mechanisms through which neighborhoods contribute to, or protect older adults from, frailty.

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Sedentary Behavior Research in the Chinese Population: A Systematic Scoping Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103576 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3576 ◽

Cited By ~ 1

Author(s):

Ran Bao ◽

Si-Tong Chen ◽

Yanlei Wang ◽

Jun Xu ◽

Lei Wang ◽

...

Keyword(s):

Older Adults ◽

Sedentary Behavior ◽

Longitudinal Studies ◽

Scoping Review ◽

Chinese Population ◽

Grey Literature ◽

Journal Articles ◽

Cross Sectional ◽

Measurement Tools ◽

Clinical Populations

Background: The negative effects of sedentary behavior (SB) on public health have been extensively documented. A large number of studies have demonstrated that high prevalence of SB is a critical factor of all-cause mortality. Globally, the frequency of SB research has continued to rise, but little is known about SB in the Chinese population. Therefore, this review was conducted to scope the research situation and to fill the gaps related to the effects of SB in the Chinese population. Methods: Using a scoping review based on York methodology, a comprehensive search of published journal articles and grey literature was carried out through 12 databases. The literature research was conducted by two authors in July 2019, and included journal articles that targeted on the Chinese population were published between 1999 and 2019. The two authors screened the records independently and included those research topics related to SB in the Chinese population. Results: The number of included studies increased from 1 to 29 per year during the analyzed period, during which, a remarkable climb happened from 8 in 2013 to 19 in July 2019. Out of the 1303 screened studies, a total of 162 studies (81 English and 81 Chinese journal articles) met the inclusion criteria in this review. Most of the included studies (66.0%) reported the overall estimated prevalence of SB, in which, 43.2% of studies reported the average time of SB, and 40.0% of studies reported the cutoff point of SB. Besides this, 54.9% and 23.5% of studies focused on the outcomes and correlates/determinants of SB, and the proportions of studies based on testing the validation of measurement tools and on interventions were 3.7% and 4.9%, respectively. Nearly all of the reviewed articles used data from cross-sectional studies (75.9%) and longitudinal studies (13.6%), while intervention trials are less developed. The majority of the studies (64.8%) used self-reported surveys, and only 3.7% studies used device-based measurement tools. Furthermore, 35.8% of the included studies were focused on children and adolescents, while only a few studies investigated infants/toddlers and older adults. Both female and male were examined in most studies, and non-clinical populations were investigated in the context of SB in a relatively large number of studies. Conclusions: The number of research articles on SB in the Chinese population published per year has increased year by year, indicating a growing interest in this research area. More studies using population subgroup samples are needed, particularly among infants/toddlers, older adults, and clinical populations. To provide stronger evidence of the determinants and outcomes of SB, longitudinal studies using device-based measures of SB are required.

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Fear of falling in older adults living at home: associated factors

Revista da Escola de Enfermagem da USP ◽

10.1590/s1980-220x2016223703215 ◽

2017 ◽

Vol 51 (0) ◽

Cited By ~ 5

Author(s):

Luciano Magalhães Vitorino ◽

Carla Araujo Bastos Teixeira ◽

Eliandra Laís Vilas Boas ◽

Rúbia Lopes Pereira ◽

Naiana Oliveira dos Santos ◽

...

Keyword(s):

Older Adults ◽

Linear Regression ◽

Multiple Linear Regression ◽

Older Adult ◽

Linear Models ◽

Fear Of Falling ◽

Multiple Linear Regression Model ◽

Cross Sectional ◽

Modifiable Factors ◽

At Home

Abstract OBJECTIVE To identify the factors associated with the fear of falling in the older adultliving at home. METHOD Cross-sectional study with probabilistic sampling of older adultenrolled in two Family Health Strategies (FHS). The fear of falling was measured by the Brazilian version of the Falls Efficacy Scale-International and by a household questionnairethat contained the explanatory variables. Multiple Linear Regression using the stepwise selection technique and the Generalized Linear Models were used in the statistical analyses. RESULTS A total of170 older adultsparticipated in the research, 85 from each FHS. The majority (57.1%) aged between 60 and 69; 67.6% were female; 46.1% fell once in the last year. The majority of the older adults(66.5%) had highfear of falling. In the final multiple linear regression model, it was identified that a higher number of previous falls, female gender, older age, and worse health self-assessment explained 37% of the fear of falling among the older adult. CONCLUSION The findings reinforce the need to assess the fear of falling among the older adultliving at home, in conjunction with the development and use ofstrategies based on modifiable factors by professionalsto reduce falls and improve health status, which may contribute to the reduction of the fear of falling among the older adult.

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Sleep and physical functioning in family caregivers of older adults with memory impairment

International Psychogeriatrics ◽

10.1017/s1041610209991153 ◽

2009 ◽

Vol 22 (2) ◽

pp. 306-311 ◽

Cited By ~ 20

Author(s):

Adam P. Spira ◽

Leah Friedman ◽

Sherry A. Beaudreau ◽

Sonia Ancoli-Israel ◽

Beatriz Hernandez ◽

...

Keyword(s):

Older Adults ◽

Physical Functioning ◽

Functional Decline ◽

Sleep Onset ◽

Poor Sleep ◽

Cross Sectional ◽

Sf 36 ◽

With Memory ◽

Functioning Subscale ◽

Physical Functioning Subscale

ABSTRACTBackground:Sleep disturbance is common in caregivers of older adults with memory disorders. Little is known, however, about the implications of caregivers’ poor sleep with regard to their physical functioning.Methods:In this cross-sectional study, we investigated the association between objectively measured sleep and self-reported physical functioning in 45 caregivers (mean age = 68.6 years) who completed the Beck Depression Inventory-II, the Medical Outcomes Study SF-36, and the Mini-mental State Examination, and wore an actigraph for at least three days. Our primary predictors were actigraphic sleep parameters, and our outcome was the SF-36 Physical Functioning subscale.Results:In multivariate-adjusted linear regression analyses, each 30-minute increase in caregivers’ total sleep time was associated with a 2.2-point improvement in their Physical Functioning subscale scores (unstandardized regression coefficient (B) = 2.2, 95% confidence interval (CI) 1.0–3.4,p= 0.001). In addition, each 10-minute increase in time awake after initial sleep onset was associated with a 0.5-point decrease on the Physical Functioning subscale, although this was not statistically significant (B= −0.5, 95% CI −1.1, 0.1,p= 0.09).Conclusions:Our findings suggest that shorter sleep duration is associated with worse self-reported physical functioning in caregivers. Longitudinal studies are needed to determine whether poor sleep predicts functional decline in caregivers.

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Oxidative stress, telomere length, and frailty in an old age population

10.1101/414680 ◽

2018 ◽

Author(s):

José Darío Martínez-Ezquerro ◽

Aleida Rodriguez-Castañeda ◽

Mauricio Ortiz-Ramirez ◽

Sergio Sanchez-Garcia ◽

Haydee Rosas-Vargas ◽

...

Keyword(s):

Oxidative Stress ◽

Older Adults ◽

Telomere Length ◽

Old Age ◽

Cross Sectional Study ◽

Frailty Phenotype ◽

Cross Sectional ◽

Adverse Health Outcomes ◽

Biomarkers Of Aging ◽

Dichlorofluorescin Diacetate

AbstractBackgroundA global aging population requires focusing on the risk factors for unhealthy aging, preventive medicine, and chronic disease management. The identification of adverse health outcomes in older adults has been addressed by the characterization of frailty as a biological syndrome. On the other hand, oxidative stress and telomere length have been suggested as biomarkers of aging.ObjectiveTo study the association of oxidative stress, telomere length, and frailty in an old age population.MethodsThis was a cross-sectional study based on 2015 data from 202 members from a cohort of older adults (n=202; gender F/M ratio: 133/69; mean age: 69.89 ± 7.39 years). Reactive oxygen species (ROS) were measured by dichlorofluorescin diacetate, and lipid peroxidation by malondialdehyde. Telomere length was determined using qPCR with SYBR Green Master Mix.ResultsStatistical analysis showed an association between telomere length and frailty but no association between oxidative stress on telomere length or frailty.ConclusionsTelomere length could eventually be used as a marker to discriminate between healthy and unhealthy aging as expressed by frailty phenotype. However, oxidative stress seems as just a biological process of aging.

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Functional Status among Polymedicated Geriatric Inpatients at Discharge: A Population-Based Hospital Register Analysis

Geriatrics ◽

10.3390/geriatrics6030086 ◽

2021 ◽

Vol 6 (3) ◽

pp. 86

Author(s):

Filipa Pereira ◽

Boris Wernli ◽

Armin von Gunten ◽

María del Rio Carral ◽

Maria Manuela Martins ◽

...

Keyword(s):

Functional Status ◽

Hospital Discharge ◽

Functional Decline ◽

Population Based ◽

Cross Sectional ◽

Adverse Health Outcomes ◽

Lengths Of Stay ◽

General Mobility ◽

Body Care ◽

Geriatric Inpatients

This study explored and compared the functional status of polymedicated and non-polymedicated geriatric inpatients at hospital discharge. We used a cross-sectional registry of geriatric patients’ hospital records from a multi-site public hospital center in Switzerland. The analysis included all inpatients aged 65 years old or more admitted between 1 January 2015 and 31 December 2017 (n = 53,690), of whom 67.5% were polymedicated at hospital discharge, 52.1% were women (n = 18,909), and 42.7% were 75–84 years old (n = 15,485). On average, the polymedicated patients’ hospital lengths of stay were six days longer, they presented with more than three comorbidities, and they were prescribed more than nine medications at hospital discharge (p < 0.001). They showed more frequent general mobility decline (43.2% vs. 41.9%), gait disorders (46.2% vs. 43%), fatigue (48.6% vs. 43.4%) and dependence on lower-body care (49.7% vs. 47.6%), and presented a higher malnutrition risk (OR = 1.411; 95%CI 1.263–1.577; p < 0.001). However, the non-polymedicated inpatients had proportionally more physical and cognitive impairments. The comparison of the functional status of polymedicated and non-polymedicated geriatric inpatients at hospital discharge is important for clinicians trying to identify and monitor those who are most vulnerable to functional decline, and to design targeted strategies for the prevention of functional impairment and related adverse health outcomes.

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