Abstract
Aim
The present paper aims to understand the fear of falling (FOF) and risk factors associated with FOF in community-dwelling individuals aged over 60 years in Pune, India.
Subjects and methods
The study examined a random sample of 351 community-dwelling older adults. Data on demographic characteristics, health conditions, history of falls, and psychological factors were collected using a pre-tested, structured questionnaire. The Falls Efficacy Scale International (FES-I) was used to measure FOF. Univariate and bivariate logistic regression analyses were carried out to examine associations between various factors and FOF.
Results
A high FES-I score was significantly associated with older age, females, unmarried status, education less than 6 years, living alone, unstable balance and gait, hypertension, arthritis, previous falls, self-reported loss of confidence, and depression. Adults older than 70 years of age (odds ratio, OR = 2.411), those with a history of falls (OR = 2.285), those reporting loss of confidence in the past 6 months (OR = 6.766), who had answered yes to the direct question of FOF (OR = 4.632), and had unstable balance (OR = 2.522) were also more likely to have higher FES-I values.
Conclusion
A large number of older adults expressed concerns about falling and we also found several factors to be associated with developing FOF, supporting the need for screening. Thus, further research is needed in order to understand the relationship between severity of FOF and actual fall events for developing preventive measures which can be implemented before FOF becomes a problem.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Denkinger MD, Lukas A, Nikolaus T, Hauer K (2015) Factors associated with fear of falling and associated activity restriction in community-dwelling older adults: a systematic review. Am J Geriatr Psychiatry 23(1):72–86. https://doi.org/10.1016/j.jagp.2014.03.002
Dhargave P, Sendhilkumar R (2016) Prevalence of risk factors for falls among elderly people living in long-term care homes. J Clin Gerontol Geriatr 7(3):99–103. https://doi.org/10.1016/j.jcgg.2016.03.004
Dionyssiotis Y (2012) Analyzing the problem of falls among older people. Int J Gen Med 5:805–813. https://doi.org/10.2147/IJGM.S32651
Franse CB, Rietjens JA, Burdorf A, van Grieken A, Korfage IJ, van der Heide A, Mattace Raso F, van Beeck E, Raat H (2017) A prospective study on the variation in falling and fall risk among community-dwelling older citizens in 12 European countries. BMJ Open 7(6):e015827. https://doi.org/10.1136/bmjopen-2017-015827
Gagnon N, Flint AJ, Naglie G, Devins GM (2005) Affective correlates of fear of falling in elderly persons. Am J Geriatr Psychiatry 13(1):7–14. https://doi.org/10.1176/appi.ajgp.13.1.7
Hadjistavropoulos T, Carleton RN, Delbaere K, Barden J, Zwakhalen S, Fitzgerald B, Ghandehari OO, Hadjistavropoulos H (2012) The relationship of fear of falling and balance confidence with balance and dual tasking performance. Psychol Aging 27(1):1–13. https://doi.org/10.1037/a0024054
Halil M, Ulger Z, Cankurtaran M, Shorbagi A, Yavuz BB, Dede D, Ozkayar N, Ariogul S (2006) Falls and the elderly: is there any difference in the developing world?: A cross-sectional study from Turkey. Arch Gerontol Geriatr 43(3):351–359. https://doi.org/10.1016/j.archger.2005.12.005
Hauer K, Yardley L, Beyer N, Kempen G, Dias N, Campbell M, Becker C, Todd C (2010) Validation of the Falls Efficacy Scale and Falls Efficacy Scale International in geriatric patients with and without cognitive impairment: results of self-report and interview-based questionnaires. Gerontology 56(2):190–199. https://doi.org/10.1159/000236027
Hoang OTT, Jullamate P, Piphatvanitcha N, Rosenberg E (2017) Factors related to fear of falling among community-dwelling older adults. J Clin Nurs 26(1–2):68–76
Jagnoor J, Keay L, Ivers R (2013) A slip and a trip? Falls in older people in Asia. Injury 44(6):701–702. https://doi.org/10.1016/j.injury.2013.03.009
Jørgensen V, Forslund EB, Opheim A, Franzén E, Wahman K, Hultling C, Seiger Å, Ståhle A, Stanghelle JK, Roaldsen KS (2017) Falls and fear of falling predict future falls and related injuries in ambulatory individuals with spinal cord injury: a longitudinal observational study. J Physiother 63(2):108–113. https://doi.org/10.1016/j.jphys.2016.11.010
Jung DY, Shin KR, Kang YH, Kang JS, Kim KH (2008) A study on the falls, fear of falling, depression, and perceived health status among the older adults. Korean J Adult Nurs 20(1):91–101
Keay L, Praveen D, Salam A, Rajasekhar KV, Tiedemann A, Thomas V, Jagnoor J, Sherrington C, Ivers RQ (2018) A mixed methods evaluation of yoga as a fall prevention strategy for older people in India. Pilot Feasibility Stud 4:74. https://doi.org/10.1186/s40814-018-0264-x
Kumar et al. (2008) Relationship between fear of falling, balance impairment and functional mobility in community dwelling elderly. Indian Journal of Physical Medicine and Rehabilitation 19(2):48–52
Kumar A, Carpenter H, Morris R, Iliffe S, Kendrick D (2014) Which factors are associated with fear of falling in community-dwelling older people? Age Ageing 43(1):76–84. https://doi.org/10.1093/ageing/aft154
Lopes KT, Costa DF, Santos LF, Castro DP, Bastone AC (2009) Prevalence of fear of falling among a population of older adults and its correlation with mobility, dynamic balance, risk and history of falls. Braz J Phys Ther 13(3):223–229. https://doi.org/10.1590/S1413-35552009005000026
Malini FM, Lourenço RA, Lopes CS (2016) Prevalence of fear of falling in older adults, and its associations with clinical, functional and psychosocial factors: the Frailty in Brazilian Older People-Rio de Janeiro study. Geriatr Gerontol Int 16(3):336–344. https://doi.org/10.1111/ggi.12477
Mane AB, Sanjana T, Patil PR, Sriniwas T (2014) Prevalence and correlates of fear of falling among elderly population in urban area of Karnataka, India. J Midlife Health 5(3):150–155. https://doi.org/10.4103/0976-7800.141224
McMichael KA, Vander Bilt J, Lavery L, Rodriguez E, Ganguli M (2008) Simple balance and mobility tests can assess falls risk when cognition is impaired. Geriatr Nurs 29(5):311–323. https://doi.org/10.1016/j.gerinurse.2007.10.016
Miller WC, Barry Deathe A, Speechley M, Koval J (2001) The influence of falling, fear of falling, and balance confidence on prosthetic mobility and social activity among individuals with a lower extremity amputation. Arch Phys Med Rehabil 82(9):1238–1244. https://doi.org/10.1177/0309364611418874
Nagarkar A, Gadhave S, Kulkarni S (2014) Development and preliminary validation of a new scale to assess functional ability of older population in India. Arch Gerontol Geriatr 58(2):263–268. https://doi.org/10.1016/j.archger.2013.10.002
Painter JA, Allison L, Dhingra P, Daughtery J, Cogdill K, Trujillo LG (2012) Fear of falling and its relationship with anxiety, depression, and activity engagement among community-dwelling older adults. Am J Occup Ther 66(2):169–176. https://doi.org/10.5014/ajot.2012.002535
Payette MC, Bélanger C, Léveillé V, Grenier S (2016) Fall-related psychological concerns and anxiety among community-dwelling older adults: systematic review and meta-analysis. PLoS One 11(4):e0152848. https://doi.org/10.1371/journal.pone.0152848
Rochat S, Büla CJ, Martin E, Seematter-Bagnoud L, Karmaniola A, Aminian K, Piot-Ziegler C, Santos-Eggimann B (2010) What is the relationship between fear of falling and gait in well-functioning older persons aged 65 to 70 years? Arch Phys Med Rehabil 91(6):879–884. https://doi.org/10.1016/j.apmr.2010.03.005
Schepens S, Sen A, Painter JA, Murphy SL (2012) Relationship between fall-related efficacy and activity engagement in community-dwelling older adults: a meta-analytic review. Am J Occup Ther 66(2):137–148. https://doi.org/10.5014/ajot.2012.001156
Sirohi A, Kaur R, Goswami AK, Mani K, Nongkynrih B, Gupta SK (2017) A study of falls among elderly persons in a rural area of Haryana. Indian J Public Health 61(2):99–104. https://doi.org/10.4103/ijph.IJPH_102_16
Thiamwong L, Suwanno J (2017) Fear of falling and related factors in a community-based study of people 60 years and older in Thailand. Int J Gerontol 11(2):80–84. https://doi.org/10.1016/j.ijge.2016.06.003
Tomita Y, Arima K, Tsujimoto R, Kawashiri SY, Nishimura T, Mizukami S, Okabe T, Tanaka N, Honda Y, Izutsu K, Yamamoto N, Ohmachi I, Kanagae M, Abe Y, Aoyagi K (2018) Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults. Medicine 97(4):e9721. https://doi.org/10.1097/MD.0000000000009721
Yardley L, Smith H (2002) A prospective study of the relationship between feared consequences of falling and avoidance of activity in community-living older people. The Gerontologist 42(1):17–23
Acknowledgements
We thank Savitribai Phule Pune University for its support. We would also like to acknowledge the efforts of Amruta Kulkarni and Anuprita Ahire in the data collection.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Headline contribution: Fear of falling is a common concern for community-dwelling older adults in India and there are various risk factors which contribute towards it. The study revealed that risk factors such as older age above 70 years, history of falling, loss of confidence, and postural sway were significantly associated with fear of falling.
Rights and permissions
About this article
Cite this article
Kulkarni, S., Gadkari, R. & Nagarkar, A. Risk factors for fear of falling in older adults in India. J Public Health (Berl.) 28, 123–129 (2020). https://doi.org/10.1007/s10389-019-01061-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10389-019-01061-9