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Longitudinal Relationship between Mobility Device Use, Falls and Fear of Falling (FOF) Differed by Frailty Status among Community-Dwelling Older Adults

  • Original Research
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The journal of nutrition, health & aging

Abstract

Objectives

This study examined the longitudinal relationship between mobility device use, falls and fear of falling (FOF) among community-dwelling older adults by frailty status over a one-year follow-up.

Design

A longitudinal cohort study.

Setting

Communities in the United States.

Participants

Community-dwelling older adults from the National Health and Aging Trends Study, a nationally representative survey of Medicare Beneficiaries in the United States (N=5,896).

Measurements

Based on yes or no response to the corresponding items for the variables, fall-related outcomes were determined separately including falls and FOF. Falls were assessed by asking participants whether they had a fall and if they had fallen down more than one time. FOF was measured by asking participants whether they worried about falling and if this worry ever limited activities. Mobility device use was determined by asking whether participants used any type of mobility devices and the number of devices used, including cane, walker, wheelchair and scooter. Frailty was assessed using the frailty phenotype. Multinomial logistic regression models were conducted to examine the association between mobility device use and fall-related outcomes among older adults by frailty status.

Results

At Year 1, 28.6% of participants reported using mobility devices. Among robust participants, using one mobility device had 3.58 times higher risks of FOF with fear-related activity restriction (FAR) than non-device users (95% CI: 1.10–11.65). Cane-only robust users had 5.94 and 2.18 times higher risks of FOF with and without FAR (95% CI: 1.80–19.57; 95% CI: 1.12–4.22) than non-device users. Among pre-frail participants, using one mobility device was associated with recurrent falls and FOF with FAR (RRR=2.02, 95% CI: 1.30–3.14; RRR=2.13, 95% CI: 1.25–3.63). Using ≥2 devices was associated with one fall (RRR=2.08, 95% CI: 1.30–3.33), recurrent falls (RRR=2.92, 95% CI: 1.62–5.25) and FOF with FAR (RRR=2.84, 95% CI: 1.34–6.02). Pre-frail cane-only users were more likely to have one fall (RRR=1.57, 95% CI: 1.06–2.32), recurrent falls (RRR=2.36, 95% CI: 1.48–3.77) and FOF with FAR (RRR=2.08, 95% CI: 1.12–3.87) than non-device users. The number of mobility device used and the use of canes failed to be significantly associated with fall-related outcomes among frail participants.

Conclusion

The number of mobility devices used and the only use of canes were associated with fall-related outcomes among robust and pre-frail individuals. Further research is needed to develop targeted strategies for preventing falls and FOF among older adults with mobility device use, particularly for those in the early stages of frailty.

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Acknowledgements

The publication of this manuscript was supported by the Youth Grant from the National Natural Science Foundation of China (Grant No. 72004237).

Funding

This work was supported by blinded for peer review.

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Authors and Affiliations

  1. Xiangya School of Nursing, Central South University, Changsha, China

    Minhui Liu, C. Mo, Y. Luo, W. Peng & S. Tang

Authors
  1. Minhui Liu
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Correspondence to Minhui Liu.

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

Ethical standards: The study complies with the current laws of the country in which it was performed.

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Liu, M., Mo, C., Luo, Y. et al. Longitudinal Relationship between Mobility Device Use, Falls and Fear of Falling (FOF) Differed by Frailty Status among Community-Dwelling Older Adults. J Nutr Health Aging 27, 673–679 (2023). https://doi.org/10.1007/s12603-023-1952-7

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  • DOI: https://doi.org/10.1007/s12603-023-1952-7

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