Background: little is known about the prevalence rates and correlates of fear of falling and avoidance of activity due to fear of falling in the general population of community-living older people. Objective: to assess prevalence rates and study correlates of fear of falling and avoidance of activity due to fear of falling in this population. Study design and setting: cross-sectional study in 4,031 community-living people aged ≥70 years. Results: fear of falling was reported by 54.3% and associated avoidance of activity by 37.9% of our population. Variables independently associated with fear of falling were: higher age (≥80 years: odds ratio (OR) = 1.79; 95% confidence interval (CI) = 1.49-2.16), female gender (OR = 3.23; 95% CI = 2.76-3.79), poor perceived general health (OR = 6.93; 95% CI = 4.70-10.21) and multiple falls (OR = 5.72; 95% CI = 4.40-7.43). Higher age (≥80 years: OR = 1.92; 95% CI = 1.59-2.32), poor perceived general health (OR = 11.91; 95% CI = 8.38-16.95) and multiple falls (OR = 4.64; 95% CI = 3.73-5.76) were also independently associated with avoidance of activity. Conclusions: fear of falling and avoidance of activities due to fear of falling, were highly prevalent in our sample of community-living older people. Particularly, poor perceived general health showed a strong, independent association with both, fear of falling, and related avoidance of activity. Findings of our study may help health care professionals to identify people eligible for interventions aimed at reducing fear of falling and activity restriction.
the Short FES-I is a good and feasible measure to assess fear of falling in older persons. However, if researchers or clinicians are particularly interested in the distributions of specific fear of falling-related activities not included in the Short FES-I, the use of the full FES-I is recommended.
The objective was to assess which interventions effectively reduce fear of falling in community-living older people. An extensive search for relevant literature comprised a database search of PubMed, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials; expert consultation; and manually searching reference lists from potentially relevant papers. Randomized, controlled trials that assessed fear of falling in community-living older people were included. Two independent reviewers extracted data from full papers on study characteristics, methodological quality, outcomes, and process characteristics of the intervention. The search identified 599 abstracts, and 19 papers met the inclusion criteria. Seven of those papers were identified using expert consultation. Fifty-five percent of all validity items and 39% of process characteristic items were fulfilled across the 19 trials. Twelve of the 19 papers were of higher methodological quality. In 11 of these trials, fear of falling was lower in the intervention group than in the control group. Interventions that showed effectiveness were fall-related multifactorial programs (n=5), tai chi interventions (n=3), exercise interventions (n=2), and a hip protector intervention (n=1). Three of these interventions explicitly aimed to reduce fear of falling. Several interventions, including interventions not explicitly aimed at fear of falling, resulted in a reduction of fear of falling in community-living older people. Limited but fairly consistent findings in trials of higher methodological quality showed that home-based exercise and fall-related multifactorial programs and community-based tai chi delivered in group format have been effective in reducing fear of falling in community-living older people.
This multicomponent cognitive behavioral intervention showed positive and durable effects on fear of falling and associated activity avoidance in community-dwelling older adults. Future research should focus on improving intervention uptake and adherence, reaching frailer populations, and determining potential intervention effects on functional outcomes.
Objective To assess the effects of preventive home visits to elderly people living in the community. Design Systematic review. Setting 15 trials retrieved from Medline, Embase, and the Cochrane controlled trial register. Main outcome measures Physical function, psychosocial function, falls, admissions to institutions, and mortality. Results Considerable differences in the methodological quality of the 15 trials were found, but in general the quality was considered adequate.
The FES-I has been shown to have acceptable reliability and construct validity in different samples in different countries and may be used in cross-cultural rehabilitation research and clinical trials.
The multidisciplinary fall-prevention program was not effective in preventing falls and functional decline in this Dutch healthcare setting. Implementing the program in its present form in the Netherlands is not recommended. This trial shows that there can be considerable discrepancy between the "ideal" (experimental) version of a program and the implemented version of the same program. The importance of implementation research in assessing feasibility and effectiveness of such a program in a specific healthcare setting is therefore stressed.
Background: Fear of falling and avoidance of activity are common in old age and are suggested to be (public) health problems of equal importance to falls. Earlier studies of correlates of fear of falling and avoidance of activity did hardly differentiate between severe and mild levels of fear of falling and avoidance of activity which may be relevant from clinical point of view. Furthermore, most studies focused only on socio-demographics and/or health-related variables and hardly incorporated an extensive range of potential correlates of fear of falling including psychosocial variables. This study analyzes the univariate and multivariate associations between five socio-demographic, seven health-related and six psychosocial variables and levels of fear of falling and avoidance of activity in older persons who avoid activity due to fear of falling.
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