Association of Fear of Falling With Cognition and Physical Function in Community-Dwelling Older Adults

Abstract

Background: Fear of falling (FOF) might be associated with physical and cognitive function, but there is a lack of understanding of the specific relationship between the three variables.Objectives: The aim of this study was to accurately investigate the association of FOF with cognitive and physical function in community-dwelling older adults.Methods: Six hundred sixty-nine older adults (>60 years old) participated in this study. A self-report questionnaire collected information about demographic characteristics, lifestyle, and behavioral habits. FOF was evaluated through the Shortened Version of the Falls Efficacy Scale International. Global cognitive function and the subdomains of cognitive function (including memory, visual-spatial, language, attention, and executive function) were assessed using the Montreal Cognitive Assessment scale, the Auditory Verbal Learning Test, the Clock Drawing Test (CDT), the Verbal Fluency Test, and the Trail Making Test. Subjective memory complaints were assessed using the Subjective Memory Complaints Questionnaire. Physical function was evaluated by measuring muscle strength and balance ability, and muscle strength was indicated by hand grip strength. In contrast, balance was assessed using the Timed Up and Go (TUG) Test.Results: After adjustment for potential confounding factors, the linear or ordinal regression analysis showed that the values of hand grip strength, Montreal Cognitive Assessment, Auditory Verbal Learning Test, and CDT were significantly and negatively correlated with the score of FOF. On the other hand, Subjective Memory Complaints Questionnaire and TUG Test values showed significant positive correlations with FOF scores. Moreover, compared with other cognitive or physical measures, the CDT and TUG Test values showed a greater association with the FOF scores.Discussion: Low subjective or objective cognitive ability and low physical function, especially low visuospatial and balance ability, were positively associated with the risk of FOF in a community-dwelling older population.

Effects of Muscle Strength, Agility, and Fear of Falling on Risk of Falling in Older Adults

“…The relationships between cognitive ability, fear of falling, and balance ability in older adults are complex. Age-related cognitive decline can negatively affect balance ability, leading to increased fear of falling [ 36 ]. Additionally, fear of falling can further contribute to decreased balance ability, as individuals may limit their physical activity and become less physically active [ 37 ].…”

A pilot study on fear and risk of fall: The impact of a 8-month multicomponent exercise program in community-dwelling aged adults

“…In older adults, the link between cognitive ability, fear of falling, and balance skill is complex. Age-related cognitive decline can have a negative impact on balance skills, leading to a fear of falling (Wang et al, 2022). Further-more, fear of falling can contribute to impaired balance skills by limiting physical exercise and becoming less physically active (Silva Tavares et al, 2020).…”

“…According to research, old-er persons with greater cognitive capacities have better balance and are less prone to fall (Hadjistavropoulos et al, 2012). Interventions such as cognitive training and physical exercise have also been demonstrated to improve balance ability and reduce fear of falling in older persons (Wang et al, 2022).…”

Influencing factors of fear of falling among glaucoma patients in west China: a cross-sectional study

“…Due to the damage to visual functions, such as visual field impairment, the incidence of falling among glaucoma patients is also higher compared to the general population [3] . Fear of falling reduces confidence and efficacy during everyday activities [4] . In fact, fear of falling has been described as "an exaggerated concern of falling that leads to excess restriction of activities" [5] .…”