Transient versus stable nature of fear of falling over 24 months in community-older persons with falls- data of the EU SCOPE project on Kidney function

Ellen Freiberger, Paolo Fabbietti, Andrea Corsonello, Fabrizia Lattanzio, Rada Artzi-Medvedik, Robert Kob, Itshak Melzer, SCOPE consortium, Sabine Britting, Gerhard Wirnsberger, Regina Roller-Wirnsberger, Francesco Mattace-Raso, Lisanne Tap, Tomasz Kostka, Agnieszka Guligowska, Francesc Formiga, Rafael Moreno-González, Pedro Gil, Sara Laínez Martínez, Andreas Bekmann, Christian Weingart, Cornel Sieber, Johan Ärnlöv, Axel Carlsson, Ellen Freiberger, Paolo Fabbietti, Andrea Corsonello, Fabrizia Lattanzio, Rada Artzi-Medvedik, Robert Kob, Itshak Melzer, SCOPE consortium, Sabine Britting, Gerhard Wirnsberger, Regina Roller-Wirnsberger, Francesco Mattace-Raso, Lisanne Tap, Tomasz Kostka, Agnieszka Guligowska, Francesc Formiga, Rafael Moreno-González, Pedro Gil, Sara Laínez Martínez, Andreas Bekmann, Christian Weingart, Cornel Sieber, Johan Ärnlöv, Axel Carlsson

Abstract

Background: Fear of falling (FoF) is an important risk factor for falls among older people. The objectives of our investigations were: a.) to present characteristics of older community-dwelling (CD) fallers with persistent or transient FoF (P-FoF or T-FoF) over 12 months, and b.) to investigate clinical predictors of P-FoF and T-FoF and c.) to explore differences between P-FoF and T-FoF.

Methods: Our series consisted of 389 older people reporting a fall or injurious fall at baseline and during 24 months follow-up participating in a multicenter prospective study. T-FoF was defined as participants reported "not at all" at baseline and "somewhat/fairly/very concerned" at follow-up, or "not at all" at follow-up, and "somewhat/fairly/very concerned" at baseline, and P-FoF was defined as participants answered "somewhat/fairly/very concerned" in both assessments at baseline and at follow-up. The association between risk factors and T-FoF or P-FoF was investigated by logistic regression analysis.

Results: The mean age of fallers in our sample was 79.0 years (SD 6.0), and 54.2% were females. Out of 389 older adults with a fall history at baseline, 83 participants (21.3%) did not report any FoF over time, P-FoF and T-FoF were observed in 42.7% and 35.9% of participants, respectively. After adjusting for potential confounders (e.g. age, gender), osteoporosis (OR = 2.04, 95%CI = 1.03-4.05) and impaired physical performance (OR = 2.38, 95%CI = 1.12-5.03) were significant predictors of T-FoF vs No-FoF. Osteoporosis (OR = 2.68, 95%CI = 1.31-5.48), depressive symptoms (OR = 3.54, 95%CI = 1.23-10.1) and living alone (OR = 2.44, 95%CI = 1.17-5.06) were significantly associated with P-FoF vs No-FoF. When comparing T-FoF and P-FoF, female gender (OR = 1.95, 95%CI = 1.16-3.27), BMI (OR = 1.08, 95%CI = 1.02-1.14), overall comorbidity (OR = 1.07, 95%CI = 1.02-1.13) and depression (OR = 2.55, 95%CI = 1.33-4.88) were significant predictors of P-FoF.

Conclusions: T-FoF and P-FoF may be predicted by different sets of risk factors among older fallers. Thus, fallers should be screened for FoF especially when carrying specific risk factors, including female gender, osteoporosis, depression, living alone, impaired physical performance, BMI, comorbidity. These findings may be helpful in designing tailored intervention to blunt the risks related to consequence of FoF among older people experiencing falls.

Trial registration: The SCOPE study was registered prospectively at clinicaltrials.gov (NCT02691546; 25/02/2016).

Keywords: Fallers; Falls; Fear of falling; Injurious falls; Older people; Osteoporosis; Physical function.

Conflict of interest statement

EF, IM, RAM, PF, FL, AC, SB and RK declare no conflict of interest. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. EF is an editorial board member of BMC Geriatric.

© 2022. The Author(s).

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