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.

No abstract

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.

No abstract

A risk model consisting of six variables usually known to the GP from the patient records may be a useful tool in the identification of elderly people living in the community at risk for recurrent falls.

No abstract

Development and evaluation of a homesafety checklist of indoor fall risk for the elderly living in the community. Methods: A checklist of indoor fall risk was developed in a Delphi procedure as part of a baseline assessment of fall risk. Based on the number of falls in the previous year, the 1238 responders to a postal questionnaire on occurrence, risk factors, and consequences of falls in community-living elderly of 70 years or over were divided into three groups: non fallers, one-time fallers and recurrent fallers (22 falls). Out of each group, 130 subjects were randomly selected and stratified on age and gender (n=392), 311 of whom (79%) were available for participation in a prospective study: a baseline assessment including home-safety assessment of indoor fall risk, and a subsequent 36-week follow-up procedure with telephone calls every six weeks. Outcome variables were indoor falls and the number of subjects with indoor falls during follow-up. Prevalences of potential risk factors were determined. In addition, associations between potential risk factors for indoor falls and indoor falls during follow-up were calculated by bivariate analysis. Results: Follow-up was completed by 293 subjects and data from 287 subjects were available for analysis. During follow-up, 198 falls were reported by 96 participants (32%). Two persons had a hip fracture (1%) and four had other fractures (2%). A total of 135 indoor falls were reported by 63 (21%) and 63 outdoor falls by 45 persons (15%). Potential risk factors for indoor falls belong equally to structural (immobile) Paul Stalenhoef, general practitioner. Jos Diederiks, medical sociologist. AndrC Knottnerus, professor of general practice. Harry Crebolder, professor of general practice.

No abstract