Factors Associated with Fear of Falling among Community-Dwelling Older Adults in the Shih-Pai Study in Taiwan

Hsiao-Ting Chang, Hsi-Chung Chen, Pesus Chou, Hsiao-Ting Chang, Hsi-Chung Chen, Pesus Chou

Abstract

Background: Fear of falling is an important risk indicator for adverse health related outcomes in older adults. However, factors associated with fear of falling among community-dwelling older adults are not well-explored.

Objectives: To explore the quality of life and associated factors in fear of falling among older people in the Shih-Pai area in Taiwan.

Methods: This community-based survey recruited three thousand eight hundred and twenty-four older adults aged ≥ 65 years. The measurements included a structured questionnaire, including quality of life by using Short-Form 36, and information of fear of falling, fall history, demographics, medical conditions, insomnia, sleep quality, depression and subjective health through face-to-face interviews.

Results: A total of 53.4% of participants reported a fear of falling. The rate of fear of falling was higher in female subjects. Subjects with fear of falling had lower Short Form-36 scores both for men and women. Falls in the previous year, older age, insomnia, depression and worse subjective health were correlates of fear of falling for both sexes. Male-specific associations with fear of falling were the accessibility of medical help in an emergency, diabetes mellitus and stroke. In parallel, cardiovascular diseases were a female-specific correlate for fear of falling.

Conclusions: Fear of falling is prevalent among community-dwelling older adults. It is seems that there are gender differences in fear of falling with respect to the prevalence and associated factors in older adults. Gender differences should be considered when planning prevention and intervention strategies for fear of falling among older people.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exit.

References

    1. Howland J, Lachman ME, Peterson EW, Cote J, Kasten L, Jette A. Covariates of fear of falling and associated activity curtailment. Gerontologist. 1998; 38: 549–555.
    1. Friedman SM, Munoz B, West SK, Rubin GS, Fried LP. Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc. 2002; 50: 1329–1335.
    1. Howland J, Peterson EW, Levin WC, Fried L, Pordon D, Bak S. Fear of falling among the community-dwelling elderly. J Aging Health. 1993; 5: 229–243.
    1. Zijlstra GA, van Haastregt JC, van Eijk JT, van Rossum E, Stalenhoef PA, Kempen GI. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age Ageing. 2007; 36: 304–309.
    1. Leung A, Chi I, Lou VW, Chan KS. Psychosocial risk factors associated with falls among Chinese community-dwelling older adults in Hong Kong. Health Soc Care Community. 2010; 18: 272–281. 10.1111/j.1365-2524.2009.00900.x
    1. Mendes da Costa E, Pepersack T, Godin I, Bantuelle M, Petit B, Leveque. Fear of falling and associated activity restriction in older people. results of a cross-sectional study conducted in a Belgian town. Arch Public Health. 2012; 70: 1 10.1186/0778-7367-70-1
    1. Mane AB, Sanjana T, Patil PR, Sriniwas T. Prevalence and correlates of fear of falling among elderly population in urban area of Karnataka, India. J Midlife Health.2014; 5: 150–155. 10.4103/0976-7800.141224
    1. Rossat A, Beauchet O, Nitenberg C, Annweiler C, Fantino B. Risk factors for fear of falling: a cross-sectional population-based study. J Am Geriatr Soc. 2009; 57: 1304–1306. 10.1111/j.1532-5415.2009.02299.x
    1. Arfken CL, Lach HW, Birge SJ, Miller JP. The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health. 1994; 84: 565–570.
    1. Oh E, Hong GS, Lee S, Han S. Fear of falling and its predictors among community-living older adults in Korea. Aging Ment Health. 2015. [In press].
    1. Tomita Y, Arima K, Kanagae M, Okabe T, Mizukami S, Nishimura T,et al. Association of Physical Performance and Pain With Fear of Falling Among Community-Dwelling Japanese Women Aged 65 Years and Older. Medicine (Baltimore). 2015; 94: e1449.
    1. Uemura K, Shimada H, Makizako H, Doi T, Tsutsumimoto K, Yoshida D, et al. Effects of mild and global cognitive impairment on the prevalence of fear of falling in community-dwelling older adults. Maturitas. 2014; 78: 62–66. 10.1016/j.maturitas.2014.02.018
    1. Uemura K, Shimada H, Makizako H, Doi T, Tsutsumimoto K, Lee S, et al. Effects of Mild Cognitive Impairment on the Development of Fear of Falling in Older Adults: A Prospective Cohort Study. J Am Med Dir Assoc. 2015; 16: 1104 e1109–1104 e1113.
    1. Murphy J, Isaacs B. The post-fall syndrome. A study of 36 elderly patients. Gerontology. 1982; 28: 265–270.
    1. Bhala RP, O'Donnell J, Thoppil E. Ptophobia. Phobic fear of falling and its clinical management. Phys Ther. 1982; 62: 187–190.
    1. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988; 319: 1701–1707.
    1. Lawrence RH, Tennstedt SL, Kasten LE, Shih J, Howland J, Jette AM. Intensity and correlates of fear of falling and hurting oneself in the next year: baseline findings from a Roybal Center fear of falling intervention. J Aging Health. 1998; 10: 267–286.
    1. Scheffer AC, Schuurmans MJ, van Dijk N, van der Hooft T, de Rooij SE. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing. 2008; 37: 19–24. 10.1093/ageing/afm169
    1. Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age Ageing. 1997; 26: 189–193.
    1. Martin FC, Hart D, Spector T, Doyle DV, Harari D. Fear of falling limiting activity in young-old women is associated with reduced functional mobility rather than psychological factors. Age Ageing. 2005; 34: 281–287.
    1. Curcio CL, Gomez F, Reyes-Ortiz CA. Activity restriction related to fear of falling among older people in the Colombian Andes mountains: are functional or psychosocial risk factors more important? J Aging Health. 2009; 21: 460–479. 10.1177/0898264308329024
    1. Murphy SL, Dubin JA, Gill TM. The development of fear of falling among community-living older women: predisposing factors and subsequent fall events. J Gerontol A Biol Sci Med Sci. 2003; 58: M943–947.
    1. Oh-Park M, Xue X, Holtzer R, Verghese J. Transient versus persistent fear of falling in community-dwelling older adults: incidence and risk factors. J Am Geriatr Soc. 2011; 59: 1225–1231. 10.1111/j.1532-5415.2011.03475.x
    1. Cumming RG, Salkeld G, Thomas M, Szonyi G. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol A Biol Sci Med Sci. 2000; 55: M299–305.
    1. Clemson L, Kendig H, Mackenzie L, Browning C. Predictors of Injurious Falls and Fear of Falling Differ: An 11-Year Longitudinal Study of Incident Events in Older People. J Aging Health. 2014; 27:239–256. 10.1177/0898264314546716
    1. Murphy SL, Williams CS, Gill TM. Characteristics associated with fear of falling and activity restriction in community-living older persons. J Am Geriatr Soc. 2002; 50: 516–520.
    1. Gagnon N, Flint AJ, Naglie G, Devins GM. Affective correlates of fear of falling in elderly persons. Am J Geriatr Psychiatry. 2005; 13: 7–14.
    1. Austin N, Devine A, Dick I, Prince R, Bruce D. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007; 55: 1598–1603.
    1. Hauer KA, Kempen GI, Schwenk M, Yardley L, Beyer N, Todd C, et al. Validity and sensitivity to change of the falls efficacy scales international to assess fear of falling in older adults with and without cognitive impairment. Gerontology. 2011; 57: 462–472. 10.1159/000320054
    1. Uemura K, Shimada H, Makizako H, Yoshida D, Doi T, Tsutsumimoto K, et al. A lower prevalence of self-reported fear of falling is associated with memory decline among older adults. Gerontology. 2012; 58: 413–418. 10.1159/000336988
    1. Prata MG, Scheicher ME. Effects of strength and balance training on the mobility, fear of falling and grip strength of elderly female fallers. J Bodyw Mov Ther. 2015; 19: 646–650. 10.1016/j.jbmt.2014.11.013
    1. Wetherell JL, Johnson K, Chang D, Ward SR, Bower ES, Merz C, et al. Activity, balance, learning, and exposure (ABLE): a new intervention for fear of falling. Int J Geriatr Psychiatry. 2016. January 4 10.1002/gps.4393
    1. Cruz-Diaz D, Martinez-Amat A, De la Torre-Cruz MJ, Casuso RA, de Guevara NM, Hita-Contreras F. Effects of a six-week Pilates intervention on balance and fear of falling in women aged over 65 with chronic low-back pain: A randomized controlled trial. Maturitas. 2015; 82: 371–376. 10.1016/j.maturitas.2015.07.022
    1. Nick N, Petramfar P, Ghodsbin F, Keshavarzi S, Jahanbin I. The Effect of Yoga on Balance and Fear of Falling in Older Adults. PM R. 2015. July 8 pii: S1934-1482(15)00751-0. 10.1016/j.pmrj.2015.06.442
    1. Dorresteijn TA, Zijlstra GA, Ambergen AW, Delbaere K, Vlaeyen JW, Kempen G I. Effectiveness of a home-based cognitive behavioral program to manage concerns about falls in community-dwelling, frail older people: results of a randomized controlled trial. BMC Geriatr.2016; 16: 2 10.1186/s12877-015-0177-y
    1. Kim BH, Newton RA, Sachs ML, Glutting JJ, Glanz K. Effect of guided relaxation and imagery on falls self-efficacy: a randomized controlled trial. J Am Geriatr Soc. 2012; 60: 1109–1114. 10.1111/j.1532-5415.2012.03959.x
    1. Jung Y, Lee K, Shin S, Lee W. Effects of a multifactorial fall prevention program on balance, gait, and fear of falling in post-stroke inpatients. J Phys Ther Sci. 2015; 27: 1865–1868. 10.1589/jpts.27.1865
    1. Mann R, Birks Y, Hall J, Torgerson D, Watt I. Exploring the relationship between fear of falling and neuroticism: a cross-sectional study in community-dwelling women over 70. Age Ageing. 2006; 35: 143–147.
    1. Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990; 45: P239–243.
    1. Ware JE, Snow KK, Kosinski M. SF-36® Health Survey: Manual and Interpretation Guide. Lincoln, RI: QualityMetric Incorporated, 1993, 2000.
    1. Ware JE & Kosinski M. SF-36® Physical & Mental Health Summary Scales: A Manual for Users of Version 1, Second edition, Lincoln, Rhode Island: QualityMetric Incorporated, 2001.
    1. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28: 193–213.
    1. Lee HB, Chiu HFK, Kwok WY, Leung CM, Kwong PK, Chung DWS. Chinese elderly and the GDS short form: a preliminary study. Clin Gerontol. 1993; 14: 37–42.
    1. Yesavage JA, Sheikh JI. Geriatric Depression Scale (GDS) recent evidence and development of a shorter version. Clin Gerontol. 1986; 5: 165–173.
    1. Bruce D, Hunter M, Peters K, Davis T, Davis W. Fear of falling is common in patients with type 2 diabetes and is associated with increased risk of falls. Age Ageing. 2015. July;44(4):687–90. 10.1093/ageing/afv024
    1. Kim EJ, Kim DY, Kim WH, Lee KL, Yoon YH, Park JM, et al. Fear of falling in subacute hemiplegic stroke patients: associating factors and correlations with quality of life. Ann Rehabil Med. 2012; 36: 797–803. 10.5535/arm.2012.36.6.797
    1. Lane RA, Mazari F, Mockford KA, Vanicek N, Chetter IC, Coughlin PA. Fear of falling in claudicants and its relationship to physical ability, balance, and quality of life. Vasc Endovascular Surg. 2014; 48: 297–304. 10.1177/1538574413519711
    1. Galdas PM, Cheater F, Marshall P. Men and health help-seeking behaviour: literature review. J Adv Nurs. 2005; 49: 616–623.
    1. Manierre MJ. Gaps in knowledge: tracking and explaining gender differences in health information seeking. Soc Sci Med. 2015; 128: 151–158. 10.1016/j.socscimed.2015.01.028

Source: PubMed

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