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Prevalence and Associates of Fear of Falling among Community-Dwelling Older Adults

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

We aimed to study the prevalence of fear of falling (FOF), and its association with physical performance, functionality, frailty, sarcopenia, and a variety of geriatric syndromes including cognitive impairment, depression, quality of life and hearing.

Design

Retrospective, cross-sectional study.

Setting

Community-dwelling older adults applied to the geriatric outpatient clinic of a university hospital.

Participants

A total of 1021community-dwelling older adults >= 60 years of age applying to the geriatric outpatient clinic of a university hospital.

Measurements

We screened for falls and FOF by single close-ended questions. We performed screening and assessment of probable sarcopenia by SARC-F test and handgrip strength evaluation according to EWGSOP2. We used timed up and go test (TUG), usual gait speed (UGS) for physical performance, and Katz- activities of daily living (ADL) and Lawton-Brody instrumental activities of daily living (IADL) for functional evaluation. We screened anxiety with the Generalized Anxiety Disorder-7 scale.

Results

The prevalence of FOF was 44.6% and falls, 37.7%. Prevalence of FOF in sarcopenia screening positive participants was 30.1%; in probable sarcopenic (35/20 kg) participants, 43.9%; in those with undernutrition, 45.7%; in fallers, 51.1%; in females, 80.4%; and in prefrail/frail was 74.7% Multivariate regression analyses revealed that female sex (OR=4.1, 95%CI= 2.0–8.4, p<0.001), anxiety (OR=2.7, 95%CI= 1.1–6.5, p=0.03) and ADL limitation (OR=2.5, 95%CI= 1.03–6.3, p=0.04) were independent associates of FOF.

Conclusion

FOF accompanied by fall experience or not is prevalent in community-dwelling older adults. It is associated with anxiety and ADL limitations apart from the female sex.

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References

  1. Curcio CL, Gomez F, Reyes-Ortiz CA. Activity restriction related to fear of falling among older people in the Colombian Andes mountains: are functional or psychosocial risk factors more important? J Aging Health. 2009;21(3):460–479.

    PubMed  Google Scholar 

  2. Scheffer AC, Schuurmans MJ, van Dijk N, van der Hooft T, de Rooij SE. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing. 2008;37(1):19–24.

    PubMed  Google Scholar 

  3. Auais M, French S, Alvarado B, Pirkle C, Belanger E, Guralnik J. Fear of falling predicts incidence of functional disability 2 years later: a perspective from an international cohort study. J Gerontol A Biol Sci Med Sci. 2018;73(9):1212–1215.

    PubMed  Google Scholar 

  4. Chang HT, Chen HC, Chou P. Fear of falling and mortality among community-dwelling older adults in the Shih-Pai study in Taiwan: a longitudinal follow-up study. Geriatr Gerontol Int. 2017;17(11):2216–2223.

    PubMed  Google Scholar 

  5. Lavedan A, Viladrosa M, Jurschik P, et al. Fear of falling in communitydwelling older adults: a cause of falls, a consequence, or both? PLoS One. 2018;13(3):e0194967.

    PubMed  PubMed Central  Google Scholar 

  6. Oude Voshaar RC, Banerjee S, Horan M, et al. Fear of falling more important than pain and depression for functional recovery after surgery for hip fracture in older people. Psychol Med. 2006;36(11):1635–1645.

    PubMed  Google Scholar 

  7. Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age Ageing. 1997;26(3):189–193.

    CAS  PubMed  Google Scholar 

  8. Deshpande N, Metter EJ, Lauretani F, Bandinelli S, Guralnik J, Ferrucci L. Activity restriction induced by fear of falling and objective and subjective measures of physical function: a prospective cohort study. J Am Geriatr Soc. 2008;56(4):615–620.

    PubMed  PubMed Central  Google Scholar 

  9. Gaxatte C, Nguyen T, Chourabi F, et al. Fear of falling as seen in the multidisciplinary falls consultation. Ann Phys Rehabil Med. 2011;54(4):248–258.

    CAS  PubMed  Google Scholar 

  10. Kruisbrink M, Delbaere K, Kempen G, et al. Intervention characteristics associated with a reduction in fear of falling among community-dwelling older people: a systematic review and meta-analysis of randomized controlled trials. Gerontologist. 2020;gnaa021. https://doi.org/10.1093/geront/gnaa021. Online ahead of print.

  11. Esbri-Victor M, Huedo-Rodenas I, Lopez-Utiel M, et al. Frailty and fear of falling: the FISTAC study. J Frailty Aging. 2017;6(3):136–140.

    CAS  PubMed  Google Scholar 

  12. Sahadevan S, Lim PiPJ, Tan NJL, Chan SP. Diagnostic performance of two mental status tests in the older Chinese: influence of education and age on cut-off values. 2000;15(3):234–241.

  13. Belloni G, Bula C, Santos-Eggimann B, Henchoz Y, Seematter-Bagnoud L. A single question as a screening tool to assess fear of falling in young-old community-dwelling persons. J Am Med Dir Assoc. 2020;S1525–8610(20)30139–0. https://doi.org/10.1016/j.jamda.2020.01.101.

    Google Scholar 

  14. Meyer F, König H-H, Osteoporosis HA. Fear of falling, and restrictions in daily living: evidence from a nationally representative sample of communitydwelling older adults. Front Endocrinol (Lausanne). 2019;10:646.

    Google Scholar 

  15. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging. 2012;16(7):601–608.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Merchant RA, Chen MZ, Tan LWL, Lim MY, Ho HK, van Dam RM. Singapore Healthy Older People Everyday (HOPE) Study: prevalence of frailty and associated factors in older adults. J Am Med Dir Assoc. 2017;18:734. e9-734.e14.

    PubMed  Google Scholar 

  17. Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc. 2013;14(8):531–532.

    PubMed  Google Scholar 

  18. Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21:300–307.e2.

    PubMed  Google Scholar 

  19. Shelkey M, Wallace M. Katz index of Independence in activities of daily living. J Gerontol Nurs. 1999;25(3):8–9.

    CAS  PubMed  Google Scholar 

  20. Weyerer S, Killmann U, Ames D, Allen N. The even briefer assessment scale for depression (EBAS DEP): its suitability for the elderly in geriatric care in English- and German-speaking countries. 1999;14(6):473–180.

  21. Lubben J, Blozik E, Gillmann G, et al. Performance of an abbreviated version of the Lubben Social Network Scale among three European communitydwelling older adult populations. Gerontologist. 2006;46(4):503–513.

    PubMed  Google Scholar 

  22. Herdman M, Gudex C, Lloyd A, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20 (10):1727–1736.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Abellan van Kan G, Rolland Y, Andrieu S, et al. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging. 2009;13(10):881–889.

    CAS  PubMed  Google Scholar 

  24. Bourne R, Price H, Taylor H, et al. New systematic review methodology for visual impairment and blindness for the 2010 global burden of disease study. Ophthalmic Epidemiol. 2013;20(1):33–39.

    PubMed  PubMed Central  Google Scholar 

  25. Malini FM, Lourenco RA, Lopes CS. 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. 2016;16(3):336–344.

    PubMed  Google Scholar 

  26. Oh E, Hong GS, Lee S, Han S. Fear of falling and its predictors among community-living older adults in Korea. Aging Ment Health. 2017;21(4):369–378.

    PubMed  Google Scholar 

  27. Choi K, Ko Y. Characteristics associated with fear of falling and activity restriction in south Korean older adults. J Aging Health. 2015;27(6):1066–1083.

    PubMed  Google Scholar 

  28. Yamada M, Nishiguchi S, Fukutani N, et al. Prevalence of sarcopenia in community-dwelling Japanese older adults. J Am Med Dir Assoc. 2013;14(12):911–915.

    PubMed  Google Scholar 

  29. Gadelha AB, Neri SGR, Oliveira RJ, et al. Severity of sarcopenia is associated with postural balance and risk of falls in community-dwelling older women. Exp Aging Res. 2018;44(3):258–269.

    PubMed  Google Scholar 

  30. Kim M, Won CW. Sarcopenia in Korean community-dwelling adults aged 70 years and older: application of screening and diagnostic tools from the Asian Working Group for Sarcopenia 2019 update. J Am Med Dir Assoc. 2020;21(6):752–758.

    PubMed  Google Scholar 

  31. Morley JE, Adams EV. Rapid geriatric assessment. J Am Med Dir Assoc. 2015;16(10):808–812.

    PubMed  Google Scholar 

  32. Chou KL, Chi I. Reciprocal relationship between fear of falling and depression in elderly Chinese primary care patients. Aging Ment Health. 2008;12(5):587–594.

    PubMed  Google Scholar 

  33. Rivasi G, Kenny RA, Ungar A, Romero-Ortuno R. Predictors of incident fear of falling in community-dwelling older adults. J Am Med Dir Assoc. 2019;21:615–620.

    PubMed  Google Scholar 

  34. Painter JA, Allison L, Dhingra P, Daughtery J, Cogdill K, Trujillo LG. Fear of falling and its relationship with anxiety, depression, and activity engagement among community-dwelling older adults. Am J Occup Ther. 2012;66(2):169–176.

    PubMed  Google Scholar 

  35. Friedman SM, Munoz B, West SK, Rubin GS, Fried LP. Falls and fear of falling: which comes first? a longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc. 2002;50(8):1329–1335.

    PubMed  Google Scholar 

  36. Reelick MF, van Iersel MB, Kessels RP, Rikkert MG. The influence of fear of falling on gait and balance in older people. Age Ageing. 2009;38(4):435–440.

    PubMed  Google Scholar 

  37. Uemura K, Shimada H, Makizako H, et al. A lower prevalence of selfreported fear of falling is associated with memory decline among older adults. Gerontology. 2012;58(5):413–418.

    PubMed  Google Scholar 

  38. Mendes da Costa E, Pepersack T, Godin I, Bantuelle M, Petit B, Levêque A. Fear of falling and associated activity restriction in older people: results of a cross-sectional study conducted in a Belgian town. Arch Public Health. 2012;70(1):1.

    PubMed  PubMed Central  Google Scholar 

  39. Pohl P, Ahlgren C, Nordin E, Lundquist A, Lundin-Olsson L. Gender perspective on fear of falling using the classification of functioning as the model. Disabil Rehabil. 2015;37(3):214–222.

    PubMed  Google Scholar 

  40. Merchant RA, Liu SG, Lim JY, Fu X, Chan YH. Factors associated with social isolation in community-dwelling older adults: a cross-sectional study. Qual Life Res. 2020. https://doi.org/10.1007/s11136-020-02493-7. Online ahead of print.

  41. Landi F, Onder G, Cesari M, et al. Psychotropic medications and risk for falls among community-dwelling frail older people: an observational study. J Gerontol A Biol Sci Med Sci. 2005;60(5):622–626.

    PubMed  Google Scholar 

  42. Guthrie DM, Fletcher PC, Berg K, Williams E, Boumans N, Hirdes JP. The role of medications in predicting activity restriction due to a fear of falling. J Aging Health. 2012;24(2):269–286.

    PubMed  Google Scholar 

  43. Kumar A, Delbaere K, Zijlstra GAR, et al. Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis. Age Ageing. 2016;45(3):345–352.

    PubMed  Google Scholar 

  44. Sattin RW, Easley KA, Wolf SL, Chen Y, Kutner MH. Reduction in fear of falling through intense tai chi exercise training in older, transitionally frail adults. J Am Geriatr Soc. 2005;53(7):1168–1178.

    PubMed  Google Scholar 

  45. Chua CHM, Jiang Y, Lim S, Wu VX, Wang W. Effectiveness of cognitive behaviour therapy-based multicomponent interventions on fear of falling among community-dwelling older adults: a systematic review and meta-analysis. J Adv Nurs. 2019;75(12):3299–3315.

    PubMed  Google Scholar 

  46. Wollesen B, Mattes K, Schulz S, et al. Effects of dual-task management and resistance training on gait performance in older individuals: a randomized controlled trial. Front Aging Neurosci. 2017;9:415.

    PubMed  PubMed Central  Google Scholar 

  47. Dent E, Morley JE, Cruz-Jentoft AJ, et al. International clinical practice guidelines for sarcopenia (ICFSR): screening, diagnosis and management. J Nutr Health Aging. 2018;22(10):1148–1161.

    CAS  PubMed  Google Scholar 

  48. Delbaere K, Close JC, Mikolaizak AS, Sachdev PS, Brodaty H, Lord SR. The Falls Efficacy Scale International (FES-I): a comprehensive longitudinal validation study. Age Ageing. 2010;39(2):210–216.

    PubMed  Google Scholar 

  49. Lachman ME, Howland J, Tennstedt S, Jette A, Assmann S, Peterson EW. Fear of falling and activity restriction: the survey of activities and fear of falling in the elderly (SAFE). J Gerontol B Psychol Sci Soc Sci. 1998;53(1): P43–P50.

    CAS  PubMed  Google Scholar 

  50. Curl A, Fitt H, Tomintz M. Experiences of the built environment, falls and fear of falling outdoors among older adults: an exploratory study and future directions. Int J Environ Res Public Health. 2020;17(4)

    Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University Capa, Istanbul, Turkey

    Gülistan Bahat Öztürk, C. Kiliç, M. E. Bozkurt & M. A. Karan

Authors
  1. Gülistan Bahat Öztürk
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  2. C. Kiliç
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  3. M. E. Bozkurt
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  4. M. A. Karan
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Contributions

Author Contributions: Study concept and design: Bahat and Karan.

Corresponding author

Correspondence to Gülistan Bahat Öztürk.

Ethics declarations

Financial Disclosure: none.

Conflict of Interest: The authors declare no conflict of interest.

Additional information

Acquisition of data: Kilic, Bozkurt.

Data analysis: Bahat.

Data interpretation: All authors.

Preparation and content of manuscript: All authors.

Sponsor’s Role: None.

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Bahat Öztürk, G., Kiliç, C., Bozkurt, M.E. et al. Prevalence and Associates of Fear of Falling among Community-Dwelling Older Adults. J Nutr Health Aging 25, 433–439 (2021). https://doi.org/10.1007/s12603-020-1535-9

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  • DOI: https://doi.org/10.1007/s12603-020-1535-9

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