Associations of Demographic, Functional, and Behavioral Characteristics with Activity‐Related Fear of Falling Among Older Adults Transitioning to Frailty

Abstract

OBJECTIVES: To determine, in a cohort of older individuals transitioning to frailty (defined by Speechley and Tinetti, 1991) who have previously fallen, whether there are significant associations between demographic, functional, and behavioral characteristics and activity‐related fear of falling, using both the Falls Efficacy Scale (FES) and the Activities‐Specific Balance Confidence Scale (ABC). DESIGN: Baseline cross‐sectional analysis in a prospective cohort intervention study. SETTING: Twenty independent senior living facilities in Atlanta. PARTICIPANTS: Seventeen male and 270 female subjects (n = 287), age 70 and older (mean ± standard deviation, 80.9 ± 6.2), with Mini‐Mental State Examination score ≥24, transitioning to frailty, ambulatory (with or without assistive device), medically stable, and having fallen in the past year. MEASUREMENTS: Activity‐related fear of falling was evaluated with the FES and ABC Scale. Because of the comparable data derived from each scale, associations with functional measures‐related analyses were expressed using the latter. Depression was measured by Center for Epidemiological Studies Depression Scale. Functional measurements included timed 360° turn, functional reach test, timed 10‐meter walk test, single limb stands, picking up an object, and three chair stands. RESULTS: No statistically significant association was found between activity‐related fear of falling and age. For the proposed activities, about half (ABC, 48.1%; FES, 50.1%) of the subjects were concerned about falling or showed lack of confidence in controlling their balance. A statistically significant inverse correlation was found between FES and ABC (r = −0.65; P < .001). CONCLUSIONS: Activity‐related fear of falling was present in almost half of this sample of older adults transitioning to frailty. The significant association of activity‐related fear of falling with demographic, functional, and behavioral characteristics emphasizes the need for multidimensional intervention strategies to lessen activity‐related fear of falling in this population.