Associations between health-related quality of life, physical function and fear of falling in older fallers receiving home care

Abstract

BackgroundFalls and injuries in older adults have significant consequences and costs, both personal and to society. Although having a high incidence of falls, high prevalence of fear of falling and a lower quality of life, older adults receiving home care are underrepresented in research on older fallers. The objective of this study is to determine the associations between health-related quality of life (HRQOL), fear of falling and physical function in older fallers receiving home care.MethodsThis study employed cross-sectional data from baseline measurements of a randomised controlled trial. 155 participants, aged 67+, with at least one fall in the previous year, from six Norwegian municipalities were included. Data on HRQOL (SF-36), physical function and fear of falling (FES-I) were collected in addition to demographical and other relevant background information. A multivariate regression model was applied.ResultsA higher score on FES-I, denoting increased fear of falling, was significantly associated with a lower score on almost all subscales of SF-36, denoting reduced HRQOL. Higher age was significantly associated with higher scores on physical function, general health, mental health and the mental component summary. This analysis adjusted for sex, education, living alone, being at risk of or malnourished, physical function like balance and walking speed, cognition and number of falls.ConclusionFear of falling is important for HRQOL in older fallers receiving home care. This association is independent of physical measures. Better physical function is significantly associated with higher physical HRQOL. Future research should address interventions that reduce fear of falling and increase HRQOL in this vulnerable population.Trial registrationClinicalTrials.gov. NCT02374307. First registration, 16 February 2015. First enrolment of participants, February 2016.

Longitudinal Sex‐Specific Physical Function Trends by Age, Race/Ethnicity, and Weight Status

“…1 The increasing older adult population and racial/ethnic diversity within this population 2,3 highlight the need to understand factors associated with healthy aging and functional ability. [4][5][6][7] Physical function, the ability to perform necessary daily activity, is gaining increasing attention due to its association with health-related quality of life among older adults. 4,5 Physical function is predictive of health status among older adults, with low physical function being associated with an increased risk of hospitalization 6,7 and mortality.…”

“…[4][5][6][7] Physical function, the ability to perform necessary daily activity, is gaining increasing attention due to its association with health-related quality of life among older adults. 4,5 Physical function is predictive of health status among older adults, with low physical function being associated with an increased risk of hospitalization 6,7 and mortality. 8,9 Given the importance of physical function, it is crucial to understand trends in physical function in older population, as this will allow health practitioners to better address physical function and related health concerns to promote healthy aging.…”

“…10,11 Although self-reported activity limitations are related to objective measures of physical function, 12 there are compelling reasons to assess physical function using objective measures, particularly the Short Physical Performance Battery (SPPB), 13 due to its relationship with health conditions in older adults, such as healthrelated quality of life, and mortality. [4][5][6][7][8][9] Additionally, there is a need for longitudinal studies assessing physical function as these studies can provide a better understanding of the degree and direction of changes in physical function over time. 14 Few longitudinal studies examining physical function among older adults have utilized objectively measured physical function.…”

Using Health-Related Quality of Life (SF-36v2®) to Predict Falls in Community-Dwelling Older Adults

“…However, it is important to recognize the existence of several other factors previously identified to influence fall risk. These factors, including increasing age, gender, fear of falling, frailty, or fall history, may also influence quality of life [20,21,[36][37][38][39][40] and, thus, may act as confounding variables in the regression analyses. As such, the statistical outcome presented cannot describe the true causal effect; the intricate relationship among these variables is beyond the scope of this paper.…”

A qualitative study exploring physical therapists’ views on the Otago Exercise Programme for fall prevention: a stepping stone to “age in place” and to give faith in the future

“…In order to remain at home, a large percentage of the aged population in Europe, as well as in Norway, need professional home care services, such as practical assistance, home nursing, or a safety alarm (Irwin, Bliss, and Poole, 2018;Mørk et al, 2016). According to Fletcher and Hirdes (2004) and Bjerk, Brovold, Skelton, and Bergland (2018), home care recipients have a higher incidence of falls, lower levels of fall self-efficacy, poorer physical function, and lower levels of healthrelated quality of life (HRQOL) compared to the general population of older adults. This target population is in a transitional period as they are neither independent community-living older adults nor residents of care facilities (Vikman, Nordlund, Näslund, and Nyberg, 2011).…”