[Prevalence of fear of falling and related factors in community-dwelling older people]

Nuria Alcolea-Ruiz, Sonia Alcolea-Ruiz, Francisco Esteban-Paredes, Milagros Beamud-Lagos, María Teresa Villar-Espejo, Francisco Javier Pérez-Rivas, Nuria Alcolea-Ruiz, Sonia Alcolea-Ruiz, Francisco Esteban-Paredes, Milagros Beamud-Lagos, María Teresa Villar-Espejo, Francisco Javier Pérez-Rivas

Abstract

Aim: To know, in the population over 70, independent for walking, the prevalence of the concern to fall according to the short version of the Short Falls Efficacy Scale-International (FES-I) questionnaire, in old people living in the community and their associated factors.

Design: Cross-sectional study.

Location: Centro de Salud El Greco, Getafe, Madrid, Spain.

Participants: 189 patients ≥70years with a Barthel ≥60, independent for walking (walk 45minutes without help or with a cane). The study was offered to a total of 328 people, of these accepted 217 and rejected 111.

Main measurements: The dependent variable, fear of falling (FOF), was evaluated by means of the short FES-I questionnaire, considering as a cut-off point for the positive screening of the MC a score ≥11. As independent variables we considered: Barthel index, Downton scale, the Short Physical Performance Battery (SPPB) fragility test, falls in the last year, injuries associated with falls, time since the last fall, sensory deficit, use of gait devices, comorbidity and pharmacological treatment.

Results: The prevalence of FOF was 42.9% (95%CI: 35.5-50.2). The factors associated with FOF in the final multivariate analysis were: female sex, living alone, high risk of falls, presence of frailty (SPPB≤9), use of hypotensive drugs, and injuries associated with previous falls.

Conclusions: The prevalence of FOF in older people is high. Primary Care professionals should systematize the screening of this health problem, prioritizing especially in people who present the following risk factors: being a woman, living alone, having a low score on the SPPB (as an indicator of frailty) or presenting a high risk of falls.

Keywords: Caídas; Elderly; Falls; Fear; Miedo; Persona mayor; Prevalence; Prevalencia.

Copyright © 2020 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

References

    1. Tinetti M., Richman D., Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990;45:239–243. doi: 10.1093/geronj/45.6.p239.
    1. Lavedán Santamaría A., Jürschik Giménez P., Botigué Satorra T., Nuin Orrio C., Viladrosa Montoy M. Prevalencia y factores asociados a caídas en adultos mayores que viven en la comunidad. Aten Primaria. 2015;47:367–375. doi: 10.1016/j.aprim.2014.07.012.
    1. Vitorino L.M., Teixeira C.A.B., Vilas Boas E.L., Pereira R.L., Santos N.O., Rozendo C.A. Fear of falling in older adults living at home: Associated factors. Rev Esc Enferm USP. 2017;51:e03215. doi: 10.1590/s1980-220x2016223703215.
    1. Pena S.B., Guimarães H.C., Lopes J.L., Guandalini L.S., Taminato M., Barbosa D.A. Fear of falling and risk of falling: A systematic review and meta-analysis. Acta Paul Enferm. 2019;32:456–463. doi: 10.1590/1982-0194201900062.
    1. Makino K., Makizako H., Takehiko D., Tsutsumimoto K., Hotta R., Nakakubo S. Impact of fear of falling and fall history on disability incidence among older adults: Prospective cohort study. Int Geriatr Psychiatry. 2018;33:658–662. doi: 10.1002/gps.4837.
    1. Lee S., Oh E., Son Hong G.R. Comparison of factors associated with fear of falling between older adults with and without a fall history. Int J Environ Res Public Health. 2018;15:1–12. doi: 10.3390/ijerph15050982.
    1. Lavedán A., Viladrosa M., Jürschik P., Botigue T., Nuín C., Masot O. Fear of falling in community-dwelling older adults: A cause of falls, a consequence, ¿or both? PLoS One. 2018;13:e0194967. doi: 10.1371/journal.pone.0194967.
    1. Tomita Y., Arima K., Tsujimoto R., Kawashiri S., Nishimura T., Mizukami S. Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults. Medicine. 2018;97:e9721. doi: 10.1097/MD.0000000000009721.
    1. Liu T.W., YFNG G., Chung R.C.K., Samsay N.G. Cognitive behavioural therapy for fear of falling and balance among older people: A systematic review and meta-analysis. Age Ageing. 2018;47:520–527. doi: 10.1093/ageing/afy010.
    1. Lach H.W., Parsons J.L. Impact of fear of falling in long term care: An integrative review. J Am Med Dir Assoc. 2013;14:573–577. doi: 10.1016/j.jamda.2013.02.019.
    1. Schoene D., Heller C., Aung Y.N., Sieber C.C., Kemmler W., Freiberger E. A systematic review in the influence of fear of falling on quality of life in older people: Is there a role for falls? Cli Int Age. 2019;14:701–719. doi: 10.2147/CIA.S197857.
    1. Kim J.H., Bae S.M. Association between Fear of Falling (FOF) and all-cause mortality. Arch Gerontol Geriatr. 2020;88:104017. doi: 10.1016/j.archger.2020.104017.
    1. Alarcón T., González-Montalvo J.I., Otero Puime A. Evaluación de los pacientes con miedo a caídas. ¿El método empleado modifica los resultados? Una revisión sistemática. Aten Primaria. 2009;41:262–268. doi: 10.1016/j.aprim.2008.09.019.
    1. Yardley L. Development and initial validation of the FES-I. Age Ageing. 2005;34:614–619. doi: 10.1093/ageing/afi196.
    1. Kempen G.I., Yardley L., van Haastregt J.C., Zijlstra G.A., Beyer N., Hauer K. The Short FES-I: A shortened version of the falls efficacy scale-international to asses fear of falling. Age Ageing. 2008;37:45–50. doi: 10.1093/ageing/afm157.
    1. Araya A., Valenzuela E., Padilla O., Iriarte E., Caro C. Preocupación a caer: validación de un instrumento de medición en personas mayores chilenas que viven en la comunidad. Rev Esp Geriatr Gerontol. 2017;52:188–192. doi: 10.1016/j.regg.2016.12.003.
    1. Parraga-Martinez I., Navarro-Bravo B., Andrés-Pretel F., Denia-Muñoz J.N., Elicegui-Molina R.P., Lopez-Torres-Hidalgo J. Miedo a las caídas en personas mayores no institucionalizadas. Gac Sanit. 2010;24:453–459. .
    1. Moles-Julio P., Lavedán-Santamaría A., Maciá-Soler L. Prevalencia y factores del miedo a caer asociados en adultos mayores de Castellón de la Plana. Gerokomos. 2017;28:178–183. .
    1. Lee J., Choi M., Kim C.O. Falls, a fear of falling and related factors in older adults with complex chronic disease. J Clin Nurs. 2017;26:4964–4972. doi: 10.1111/jocn.13995.
    1. Liu J.Y. Fear of falling in robust community-dwelling older people: results of a cross-sectional study. J Clin Nurs. 2015;24:393–405. doi: 10.1111/jocn.12613.
    1. Chang H., Chen H., Chou P. Factors associated with fear of falling among community-dwelling older adults in the Shih-Pai Study in Taiwan. PLoS One. 2016;11:1–12. doi: 10.1371/journal.pone.0150612.
    1. Simsek H., Erkoyun E., Akoz A., Ergor A., Ucku R. Falls fear of falling and related factors in community-dwelling individuals aged 80 and over in Turkey. Australas J Ageing. 2020;39:e16–e23. doi: 10.1111/ajag.12673.
    1. Kulkarni S., Gadkari R., Nagarkar A. Risk factors for fear of falling in older adults in India. J Public Health. 2020;28:123–129. doi: 10.1007/s10389-019-01061-9.
    1. Delbaere K., Close J.C.T., Mikolaizak A.S., Sachdev P.S., Brodaty L., Lord S.R. The falls efficacy scale international (FES-I). A comprehensive longitudinal validation study. Age Ageing. 2010;39:210–216. doi: 10.1093/ageing/afp225.
    1. Cabrero-García J., Muñoz-Mendoza C.L., Cabañero-Martínez M.J., González-Llopís L., Ramos-Pichardo J.D., Reig-Ferrer A. Valores de referencia de la Short Physical Performance Battery para pacientes de 70 y más años en atención primaria de salud. Aten Primaria. 2012;44:540–548. doi: 10.1016/j.aprim.2012.02.007.
    1. Rivasi G., Kenny R.A., Ungar A. Predictors of incident Fear of Falling in Community-Dwelling Older Adults. J Am Med Dir Assoc. 2020;21:615–620. doi: 10.1016/j.jamda.2019.08.020.
    1. Vitorino L.M., Marques-Vieira C., Low G., Sousa L. Fear of falling among Brazilian and Portuguese older adults. Int Older People Nurs. 2019;14:e12230. doi: 10.1111/opn.12230.
    1. Berlowitz D.R., Foy C., Conroy M., Evans G.W., Olney C.M., Pisoni R. Impact of intensive blood pressure therapy on concern about falling: Longitudinal Results from the Systolic Blood Pressure Intervention Trial (SPRINT) J Am Geriatr Soc. 2020;68:614–618. doi: 10.1111/jgs.16264.
    1. Auais M., French S., Alvarado B., Pirkle C., Belanguer E., Guralnik J. Fear of falling predicts indicende of functional disability 2 years later: A perspective from an international cohort study. J Gerontol A Biol Med Sci. 2018;73:1212–1215. doi: 10.1093/gerona/glx237.
    1. Jang S., Cho S., Oh S., Lee E., Baik H. Time since falling and fear of falling among community-dwelling elderly. Int Psychogeriatr. 2007;19:1072–1083. doi: 10.1017/S1041610206004807.

Source: PubMed

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