scholarly journals 223SELF-REPORTED UNSTEADINESS PREDICTS FEAR OF FALLING AND ACTIVITY RESTRICTION AT TWO YEARS FOLLOW-UP

2016 ◽  
Vol 45 (suppl 2) ◽  
pp. ii1.40-ii12
Author(s):  
Orna Donoghue ◽  
Annalisa Setti ◽  
Neil O'Leary ◽  
Rose Anne Kenny
Keyword(s):  
Fear Of Falling ◽  
Activity Restriction

scholarly journals Fear of Falling, Recurrence of Falls, and Quality of Life in Patients with a Low Energy Fracture—Part II of an Observational Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 584
Author(s):  
Puck C. R. van der Vet ◽  
Jip Q. Kusen ◽  
Manuela Rohner-Spengler ◽  
Björn-Christian Link ◽  
Roderick M. Houwert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Low Energy ◽  
Activity Levels ◽  
Activity Restriction ◽  
One Year ◽  
Falls In Elderly

Background and objective: Falls in elderly cause injury, mortality, and loss of independence, making Fear of Falling (FoF) a common health problem. FoF relates to activity restriction and increased fall risk. A voluntary intervention including fall risk assessment and prevention strategies was implemented to reduce falls in elderly patients with low energy fractures (LEF). The primary purpose of this study was to evaluate FoF and the number of subsequent falls in trauma patients one year after a LEF. The secondary aim was to examine how FoF affects patients’ lives in terms of Quality of Life (QoL), mobility, and activity levels. Finally, participation in the voluntary fall prevention program (FPP) was evaluated. Materials and Methods: Observational cohort study in one Swiss trauma center. LEF patients, treated between 2012 and 2015, were analyzed one year after injury. Primary outcomes were Falls-Efficacy Score-International (FES-I) and number of subsequent falls. Secondary outcomes were EuroQoL-5-Dimensions-3-Levels (EQ5D-3L), mobility, activity levels, and participation in the FPP. Subgroup analysis was performed for different age categories. Results: 411 patients were included for analysis. Mean age was 72 ± 9.3, mean FES-I was 21.1 ± 7.7. Forty percent experienced FoF. A significant negative correlation between FoF and QoL (R = 0.64; p < 0.001) was found. High FoF correlated with lower activity levels (R= −0.288; p < 0.001). Six percent visited the FPP. Conclusions: At follow-up, 40% suffered from FoF which seems to negatively affect patients’ QoL. Nevertheless, participation in the FPP was low. Simply informing patients about their susceptibility to falls and recommending participation in FPPs seems insufficient to motivate and recruit patients into FPPs. We suggest implementing repeated fall risk- and FoF screenings as standard procedures in the follow-up of LEF, especially in patients aged over 75 years.

scholarly journals Fear of falling and all-cause mortality among young-old community-dwelling adults: a 6-year prospective study

2021 ◽  
Author(s):  
Giulia Belloni ◽  
Christophe Büla ◽  
Brigitte Santos-Eggimann ◽  
Yves Henchoz ◽  
Sarah Fustinoni ◽  
...  
Keyword(s):  
Cox Regression ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Activity Restriction ◽  
Personalized Care ◽  
Hazard Ratios ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Young Old

AbstractThis study investigated whether fear of falling (FOF) measured by two different instruments, the Falls Efficacy Scale-International (FES-I) and the single question on FOF and activity restriction (SQ-FAR), is associated with mortality at 6-year follow-up. Participants (n = 1359, 58.6% women) were community-dwelling persons enrolled in the Lausanne cohort 65 + , aged 66 to 71 years at baseline. Covariables assessed at baseline included demographic, cognitive, affective, functional and health status, while date of death was obtained from the office in charge for population registration. Unadjusted Kaplan Meyer curves were performed to show the survival probability for all-cause mortality according to the degree of FOF reported with FES-I and SQ-FAR, respectively. Bivariable and multivariable Cox regression analyses were performed to assess hazard ratios, using time-in-study as the time scale variable and adjusting for variables significantly associated in bivariable analyses. During the 6-year follow-up, 102 (7.5%) participants died. Reporting the highest level of fear at FES-I (crude HR 3.86, 95% CI 2.37–6.29, P < .001) or “FOF with activity restriction” with SQ-FAR (crude HR 2.42, 95% CI 1.44-4.09, P = .001) were both associated with increased hazard of death but these associations did not remain significant once adjusting for gender, cognitive, affective and functional status. As a conclusion, although high FOF and related activity restriction, assessed with FES-I and SQ-FAR, identifies young-old community-dwelling people at increased risk of 6-year mortality, this association disappears when adjusting for potential confounders. As a marker of negative health outcomes, FOF should be screened for in order to provide personalized care and reduce subsequent risks.

scholarly journals Fear-of-falling and associated risk factors in persons with rheumatoid arthritis: a 1 year prospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Emma K. Stanmore ◽  
Jackie Oldham ◽  
Dawn A. Skelton ◽  
Terence O’Neill ◽  
Mark Pilling ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Fear Of Falling ◽  
Prevention Measures ◽  
Classification Rate ◽  
Activity Restriction ◽  
Factors Associated ◽  
Risk Of Falls ◽  
Associated Risk Factors

Abstract Background Falls, associated injuries and fear-of-falling are common in adults with RA. Fear-of-falling can be a major consequence of, and as debilitating as falling, resulting in a cycle of activity restriction, reduced quality of life, institutionalisation and potentially increase risk of falls. The objective of this study was to examine the relationship between fear-of-falling and risk factors associated with fear-of-falling in adults with rheumatoid arthritis (RA) over a 1 year period. Methods Five hundred fifty-nine patients with RA were recruited from four outpatient clinics in this prospective cohort study. Baseline assessments included socio-demographic, medical and lifestyle related risk factors. Fall incidence was prospectively obtained monthly using postal cards over a 1 year period. Fear-of-falling was assessed at baseline and 1 year using the Short Falls Efficacy Scale-International (Short FES-I). Logistic regression was used to determine the association between high fear-of-falling (Short FES-I > 11) at baseline (outcome) and a range of putative predictor variables including previous falls, and also baseline factors associated with a high fear-of-falling at follow-up. Results Five hundred thirty-five (ninety-six percent) participants (mean age 62.1 yrs.; 18–88 yrs) completed 1 year follow-up and of these, 254 (47%) completed the Short FES-I questionnaire at 1 year. In a multivariate model, a history of multiple falls (OR = 6.08) higher HAQ score (OR = 4.87) and increased time to complete the Chair Stand Test (OR = 1.11) were found to be independent predictors of high fear-of-falling and had an overall classification rate of 87.7%. There were no significant differences found in fear-of-falling at 1 year follow-up in those who reported falls during the study, participant’s baseline fear appeared to predict future fear, regardless of further falls. Conclusions Fear-of-falling is significantly associated with previous falls and predictive of future falls and fear. RA patients would benefit from fall prevention measures whether or not they have previously fallen.

Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study

2021 ◽  
Author(s):  
K Makino ◽  
S Lee ◽  
S Bae ◽  
I Chiba ◽  
K Harada ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Frailty Status ◽  
Community Dwelling Older Adults ◽  
The Relationship

Abstract Objective The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. Methods A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48±2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to “Are you afraid of falling?”) at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. Results Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (OR: 1.57; 95%CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95%CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95%CI = 1.04-1.68). Conclusions Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. Impact Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high-risk not only for falls but also for FOF.

Gait Disorder among Elderly People, Psychomotor Disadaptation Syndrome: Post-Fall Syndrome, Risk Factors and Follow-Up – A Cohort Study of 70 Patients

Gerontology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Maxence Meyer ◽  
Florentin Constancias ◽  
Thomas Vogel ◽  
Georges Kaltenbach ◽  
Elise Schmitt
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Fear Of Falling ◽  
Functional Mobility ◽  
General Physician ◽  
Major Health ◽  
Mobility Assessment ◽  
Control Study ◽  
Major Health Issue

<b><i>Introduction:</i></b> Falls among older people are a major health issue and the first cause of accidental death after 75 years of age. Post-fall syndrome (PFS) is commonly known and yet poorly studied. <b><i>Objective:</i></b> Identify risk factors for PFS and do a follow-up 1 year later. <b><i>Methods:</i></b> We included all patients over 70 years of age hospitalized after suffering a fall in a case-control study, and then followed them in a cohort study. PFS was retained in case of functional mobility decline (transferring, walking) occurring following a fall in the absence of an acute neurological, orthopedic or rheumatic pathology directly responsible for the decline. The data initially collected were: clinical (anamnestic, emergency and departmental/ward evolution, medical history, lifestyle, treatments, clinical examination items); and imaging if the patient had been subjected to brain imaging in the last 3 years prior to inclusion. Regarding the follow-up at 1 year, we collected from the general physician the occurrence and the characteristics of new falls, functional mobility assessment, hospitalization and death. <b><i>Results:</i></b> Inclusion took place from March 29, 2016 to June 7, 2016 and follow-up until June 30, 2017. We included 70 patients. A total of 29 patients exhibited a PFS (41.4 %). Risk factors for PFS included age, walking disorder prior to the fall, the use of a walking aid prior to the fall, no unaccompanied outdoor walk in the week before the fall, visual impairment making close reading impossible, stiffness in ankle dorsiflexion, grip strength and the fear of falling. Among patients with PFS, 52.9% could still perform a transfer at 1 year and 64.7% could still walk against 80.7% and 85.2%, respectively, for patients without PFS. <b><i>Conclusion:</i></b> The study showed the existence of body functions/structure impairments and activity limitations prior to the fall among patients exhibiting a PFS. This suggests the existence of a pre-fall syndrome, i.e., a psychomotor disadaptation syndrome existing prior to the fall. Among the 8 risk factors, fear of falling, vision impairment and muscle strength could be targeted for improvement. The diagnosis of PFS could be a marker of loss of functional mobility at 1 year.

scholarly journals Effectiveness of Daily Use of Bilateral Custom-Made Ankle-Foot Orthoses on Balance, Fear of Falling, and Physical Activity in Older Adults: A Randomized Controlled Trial

Gerontology ◽  
2018 ◽  
Vol 65 (3) ◽  
pp. 299-307 ◽  
Author(s):  
Changhong Wang ◽  
Rahul Goel ◽  
Hadi Rahemi ◽  
Qianzi Zhang ◽  
Brian Lepow ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Fear Of Falling ◽  
Controlled Trial ◽  
Foot Orthoses ◽  
Female Age ◽  
Randomized Controlled ◽  
Custom Made ◽  
Ankle Foot Orthoses

Background: Foot problems are prevalent in older adults, which may increase the risk and concern for falls. Ankle-foot orthoses (AFO) have been shown to be effective in the stabilization of lower extremities, but their long-term effectiveness in improving balance and their potential to encourage older adults to become more physically active are still debated. Objective: This randomized controlled trial investigated the effectiveness of daily use of a custom-made AFO on balance, fear of falling, and physical activity in older adults. Study Design: Forty-four older adults with concern about or at risk for falling were randomly allocated to either the control group (CG; 77.3% female, age 75.6 ± 6.5 years, BMI 29.3 ± 6.4) or the intervention group (IG; 63.6% female, age 73.7 ± 6.3 years, BMI = 27.8 ± 4.8). The IG received walking shoes and bilateral custom-made AFO. The CG received only walking shoes. At the baseline and 6-month follow-ups, balance and physical activity were assessed using validated wearable instrumentation and fear of falling was assessed using the Fall Efficacy Scale-International (FES-I). Adherence and acceptability toward wearing the AFO were assessed using self-reported questionnaires at the 6-month follow-up. Results: No significant between-group difference was observed at baseline (p = 0.144–0.882). Compared to baseline and the CG, hip, ankle, and center-of-mass (COM) sways were significantly reduced at the 6-month follow-up in the IG while standing with the feet together during the eyes-open condition (p = 0.005–0.040). Within the IG, the FES-I was reduced significantly (p = 0.036) and there was an increasing trend in the number of walking bouts with a medium effect size (d = 0.52, p = 0.440) compared to baseline. However, there were no significant changes in FES-I and physical activity measures in the CG (p = 0.122–0.894). The reduction in COM sway in the IG was moderately correlated with adherence (r = –0.484, p = 0.047) and strongly correlated with baseline COM sway (r = –0.903, p < 0.001). Conclusion: Results suggest that bilateral custom-made AFO plus walking shoes is effective in improving balance compared to walking shoes alone, and it significantly reduces the fear of falling, with a nonsignificant but noticeable positive trend in physical activity, compared to baseline. The results also suggest that older adults with poor balance at baseline and higher daily adherence to using the AFO will gain more benefit from the AFO intervention.

Participation in Two Evidence-Based Falls Prevention Programs by Adults Aging With a Long-Term Disability: Case-Control Study of Reach and Effectiveness

2018 ◽  
Vol 31 (10_suppl) ◽  
pp. 39S-67S ◽  
Author(s):  
Thomas J. Eagen ◽  
Salom M. Teshale ◽  
Angelica P. Herrera-Venson ◽  
Anne Ordway ◽  
Joe Caldwell
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Prevention Programs ◽  
Preliminary Evidence ◽  
Case Control ◽  
Falls Prevention ◽  
Evidence Based ◽  
Activity Restriction ◽  
Increased Risk

Objective: Adults aging with a long-term disability (LTD) are at an increased risk for falls. The Older Americans Act Title III-D and Prevention and Public Health Fund (PPHF) support several organizations to deliver falls prevention evidence-based programs designed to reduce risk factors; however, little is understood about the reach and effectiveness of these fall prevention programs for those with LTD compared to those without LTD. This study compared the reach and effectiveness of two evidence-based falls prevention programs between older adults with and without LTD. Method: Using a matched case-control design, 105 LTD older adults enrolled in A Matter of Balance (AMOB) or Stepping On were matched to 315 non-LTD older adults on age, sex, race, and education. Results: On average, LTD older adults attended a higher number of class sessions and were significantly more likely to complete the program compared with the matched-sample of non-LTD older adults. LTD older adults were equally likely as non-LTD older adults to report significant reductions in self-reported fear of falling, falls-related activity restriction, and improvement in falls self-efficacy following completion of the programs. Discussion: These findings provide preliminary evidence for the effectiveness of these evidence-based falls prevention programs for LTD older adults; however, more research is needed to extend these findings.

scholarly journals 328 An Integrated Approach to Fear of Falling

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Eleanor Murphy ◽  
Petra McLoughlin ◽  
Fiona O'Sullivan ◽  
Ciara Connellan
Keyword(s):  
Older Persons ◽  
Fear Of Falling ◽  
Exercise Program ◽  
Integrated Approach ◽  
Home Exercise ◽  
Activity Restriction ◽  
Home Based ◽  
Increased Risk ◽  
Occupational Therapy Interventions ◽  
The Impact

Abstract Background Fear of falling (FOF) is a known risk factor for falls and subsequent activity restriction which has implications for quality of life and frailty level in older persons.1 The Integrated Care Team for Older Persons in Sligo provides home-based rehabilitation for the acutely frail older adult. We noted that fear of falling was a commonly identified problem in our referral group following comprehensive geriatric assessment (CGA). Our study aims to characterise interventions required. Methods Descriptive study from CGA of acutely frail older adults with a FOF in all referrals to ICTOP from June to December 2018. Results Of the 52 patients studied, 67% reported a FOF with a higher incidence in females (81% vs 45%). Increasing age was associated with a greater likelihood of FOF with 0% reported at 70-74years (n=4) and 86% at 90-95 years (n=7). There was a 1.6 times increased risk of FOF associated with cerebral vascular disease and 1.26 with mental health issues. The median Rockwood Clinical Frailty score was 6 with a median TUG of 28 seconds. Of those with a FOF, 100% received falls education, a home exercise program and advice on acquiring a pendant alarm. A mobility aid was provided in 63% and additional functional aids in 71%. Major housing adaption advice was given in 50% and additional equipment signposting and purchasing advice in 66%. Transport advice was provided in 49% of cases and onward referrals to ophthalmology and orthotics were provided in 9% and 11% respectively. There were only 2 readmissions with a fall within 30 days. Conclusion A significant cohort of ICTOP referrals report a fear of falling. Specific physiotherapy and occupational therapy interventions aim to reduce the impact of this and our low rate of readmissions due to falls indicates the success of this program.

Self-Reported Unsteadiness Predicts Fear of Falling, Activity Restriction, Falls, and Disability

2017 ◽  
Vol 18 (7) ◽  
pp. 597-602 ◽  
Author(s):  
Orna A. Donoghue ◽  
Annalisa Setti ◽  
Neil O'Leary ◽  
Rose Anne Kenny
Keyword(s):  
Fear Of Falling ◽  
Activity Restriction

scholarly journals A Regression Tree for Identifying Risk Factors for Fear of Falling: The International Mobility in Aging Study (IMIAS)

2019 ◽  
Vol 75 (1) ◽  
pp. 181-188 ◽  
Author(s):  
Carmen-Lucia Curcio ◽  
Yan Yan Wu ◽  
Afshin Vafaei ◽  
Juliana Fernandez de Souza Barbosa ◽  
Ricardo Guerra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Functional Impairment ◽  
Fear Of Falling ◽  
Classification Tree ◽  
Regression Tree ◽  
International Mobility ◽  
Mobility Disability ◽  
Self Rated Health ◽  
Aging Study

Abstract Background We determine the best combination of factors for predicting the risk of developing fear of falling (FOF) in older people via Classification Regression Tree (CaRT) analysis. Methods Community-dwelling older adults living in Canada, Albania, Brazil, and Colombia were from International Mobility in Aging Study (IMIAS). In 2014, 1,725 participants (aged 65–74) were assessed. With a retention rate of 81%, in 2016, 1,409 individuals were reassessed. Risk factors for FOF were entered into the CaRT: age, sex, education, self-rated health, comorbidity, medication, visual impairment, frailty, cognitive deficit, depression, fall history, Short Physical Performance Battery (SPPB), walking aid use, and mobility disability measured by the Nagi questionnaire. Results The classification tree included 12 end groups representing differential risks of FOF with a minimum of two and a maximum of five predictors. The first split in the tree involved impaired physical function (SPPB scores). Respondents with less than 8 in SPPB score and mobility disability had 82% risk of developing FOF at the end of 2-year follow-up. Between 23.2% and 82.3% of the risk of developing FOF in 2 years of follow-up were explained by only five variables: age, sex, self-rated health, functional impairment measured by SPPB, and mobility disability. In those with no functional impairment or mobility disability, levels of education, sex, and self-rated health were important predictors of FOF in the future. Conclusion This classification tree included different groups based on specific combinations of a maximum of five easily measurable predictors with emphasis on impaired physical functioning risk factors for developing FOF.

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