Fear of falling is as important as multiple previous falls in terms of limiting daily activities: a longitudinal study
Open Access
- 7 June 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Geriatrics
- Vol. 21 (1), 1-9
- https://doi.org/10.1186/s12877-021-02305-8
Abstract
Background Fear of falling and previous falls are both risk factors that affect daily activities of older adults. However, it remains unclear whether they independently limit daily activities accounting for each other. Methods We used the data from Round 1 (Year 1) to Round 5 (Year 5) of the National Health and Aging Trends Study. We included a total of 864 community-dwelling participants who provided data on previous falls, fear of falling and limited activities from Year 1 to Year 5 and had no limited daily activities at Year 1 in this study. Previous falls and fear of falling were ascertained by asking participants how many falls they had in the past year and whether they had worried about falling in the last month. Limited daily activities included any difficulties with mobility (e.g., going outside), self-care (e.g., eating), and household activities (e.g., laundering). Generalized estimation equation models were used to examine whether previous falls and fear of falling independently predicted development of limited daily activities adjusting covariates. Results Participants were mainly between 65 and 79 years old (83 %), male (57 %), and non-Hispanic White (79 %). Among participants who had multiple falls in Year 1, 19.1-31 %, 21.4-52.4 %, and 11.9-35.7 % developed limitations in mobility, self-care, and household activities during Year 2 to Year 5, respectively. Among those who had fear of falling in Year 1, 22.5-41.3 %, 30.0-55.0 %, and 18.8-36.3 % developed limitations in mobility, self-care, and household activities during Year 2 to Year 4, respectively. Fear of falling independently predicted limitations in mobility (Incidence rate ratio [IRR]: 1.79, 95 % CI: 1.44, 2.24), self-care (IRR: 1.25, 95 % CI: 1.08, 1.44) and household activities (IRR: 1.39, 95 % CI: 1.08, 1.78) after adjusting for previous falls and covariates. Multiple previous falls independently predicted limitations in mobility (IRR: 1.72, 1.30, 2.27), self-care (IRR: 1.40, 95 % CI: 1.19, 1.66) and household activities (IRR: 1.36, 95 % CI: 1.01, 1.83) after adjusting fear of falling and covariates. Conclusions Fear of falling seems to be as important as multiple previous falls in terms of limiting older adults’ daily activities.Keywords
This publication has 38 references indexed in Scilit:
- Falls and catastrophic thoughts about falls predict mobility restriction in community-dwelling older people: A structural equation modelling approachAging & Mental Health, 2009
- The FLASSH study: protocol for a randomised controlled trial evaluating falls prevention after stroke and two sub-studiesBMC Neurology, 2009
- Activity Restriction Induced by Fear of Falling and Objective and Subjective Measures of Physical Function: A Prospective Cohort StudyJournal of the American Geriatrics Society, 2008
- Fear of falling: measurement strategy, prevalence, risk factors and consequences among older personsAge and Ageing, 2008
- Feasibility of a cognitive behavioural group intervention to reduce fear of falling and associated avoidance of activity in community-living older people: a process evaluationBMC Health Services Research, 2007
- Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older peopleAge and Ageing, 2007
- The risk of being fearful or fearless of falls in older people: An empirical validationDisability and Rehabilitation, 2006
- Incidence and Risk Factors for Developing Fear of Falling in Older AdultsPublic Health Nursing, 2005
- Fear-related avoidance of activities, falls and physical frailty. A prospective community-based cohort studyAge and Ageing, 2004
- Balance, Muscle Strength, and Fear of Falling in Older AdultsExperimental Aging Research, 2003