Prospective Study of the Impact of Fear of Falling on Activities of Daily Living, SF-36 Scores, and Nursing Home Admission
TLDR
Fear of falling has serious consequences for older people and interventions that successfully reduce fear of falling and improve fall-related self-efficacy are likely to have major health benefits.Abstract:
Background. The aim of this study was to assess the impact of fear of falling on the health of older people. Methods. A total of 528 subjects (mean age 77 years) were recruited from two hospitals in Sydney, Australia, and followed for approximately 12 months. Eighty-five subjects died during follow-up, and 31 were admitted to an aged care institution. Tinetti’s Falls Efficacy Scale (FES) was successfully administered to 418 subjects as part of the baseline assessment. Among those with baseline FES scores, ability to perform 10 activities of daily living (ADLs) was assessed at baseline and follow-up in 307 subjects, and SF-36 scores were assessed at baseline and follow-up in 90 subjects recruited during the latter part of the study. Falls during follow-up were identified using a monthly falls calendar. Results. Compared with those with a high fall-related self-efficacy (FES score 5 100), those with a low fall-related self-efficacy (FES score # 75) had an increased risk of falling (adjusted relative risk 2.09, 95% confidence interval [CI] 1.31‐3.33). Those with poorer fall-related self-efficacy had greater declines in ability to perform ADLs ( p , .001): the total ADL score decreased by 0.69 activities among persons with low FES scores ( # 75) but decreased by only 0.04 activities among persons with FES scores of 100. Decline in ADLs was not explained by the higher frequency of falls among persons with low FES scores. SF-36 scores (particularly scores on the Physical Function and Bodily Pain subscales) tended to decline more among persons with poor fall-related self-efficacy. Nonfallers who said they were afraid of falling had an increased risk of admission to an aged care institution. Conclusions. Fear of falling has serious consequences for older people. Interventions that successfully reduce fear of falling and improve fall-related self-efficacy are likely to have major health benefits.read more
Citations
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Journal ArticleDOI
Development and initial validation of the Falls Efficacy Scale-International (FES-I)
Lucy Yardley,Nina Beyer,Klaus Hauer,Gertrudis I. J. M. Kempen,Chantal Piot-Ziegler,Chris Todd +5 more
TL;DR: The modified version of the Falls Efficacy Scale-International has close continuity with the best existing measure of fear of falling, excellent psychometric properties, and assesses concerns relating to basic and more demanding activities, both physical and social.
Journal ArticleDOI
Risk Factors for Falls in Community-dwelling Older People: A Systematic Review and Meta-analysis
Silvia Deandrea,Ersilia Lucenteforte,Francesca Bravi,Roberto Foschi,Carlo La Vecchia,Eva Negri +5 more
TL;DR: This meta-analysis provides comprehensive evidence-based assessment of risk factors for falls in older people, confirming their multifactorial etiology and finding some nonspecific indicators of high baseline risk were also strong predictors of the risk of falling.
Journal ArticleDOI
Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons
TL;DR: There is great variation in the reported prevalence of FOF in older people and that there are multiple associated factors, which may be useful in developing multidimensional strategies to decrease FOF and improve quality of life.
Journal ArticleDOI
Falls and Fear of Falling: Which Comes First? A Longitudinal Prediction Model Suggests Strategies for Primary and Secondary Prevention
TL;DR: The objective was to determine the temporal relationship between falls and fear of falling, and to see whether these two outcomes share predictors.
Journal ArticleDOI
Epidemiology of falls
Tahir Masud,Rob Morris +1 more
TL;DR: This epidemiological review of falls concentrates on four main components, different ways of defining and classifying falls and fallers, and the causes and impact of falls in the older population.
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TL;DR: It is concluded that falls among older persons living in the community are common and that a simple clinical assessment can identify the elderly persons who are at the greatest risk of falling.
Journal ArticleDOI
Falls efficacy as a measure of fear of falling.
TL;DR: The Falls Efficacy Scale (FES) as mentioned in this paper is an instrument to measure fear of falling, based on the operational definition of this fear as "low perceived selfefficacy at avoiding falls during essential, nonhazardous activities of daily living." The reliability and validity of the FES were assessed in two samples of community living elderly persons.
Journal ArticleDOI
Falls, Injuries Due to Falls, and the Risk of Admission to a Nursing Home
TL;DR: Among older people living in the community falls are a strong predictor of placement in a skilled-nursing facility; interventions that prevent falls and their sequelae may therefore delay or reduce the frequency of nursing home admissions.