Associations of Demographic, Functional, and Behavioral Characteristics with Activity‐Related Fear of Falling Among Older Adults Transitioning to Frailty

Kressig, Reto W.; Wolf, Steven L.; Sattin, Richard W.; O’Grady, Michael J.; Greenspan, Arlene I.; Curns, Aaron T.; Kutner, Michael

doi:10.1046/j.1532-5415.2001.4911237.x

Cited by 243 publications

(189 citation statements)

References 36 publications

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“…Falls are well recognized as precursors to fractures, increased functional disability, and the need for long-term institutional care (5,9,10,13). Falling is a marker of frailty, and fall prevention is a key to reducing poor outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Even in the absence of physical injury, falls can lead to the individual becoming fearful of experiencing subsequent falls (12). In turn, this fear of falling syndrome often causes a voluntary limitation of mobility, a gradual decrease in functional independence, and ultimately an increased need for residential care (13). Therefore, the health implications of falls are enormous, with costs for fall-related fractures alone being estimated at well over US$10 billion (14).…”

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confidence: 99%

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Falls and Fall-Related Injuries in Older Dialysis Patients

Cook

Tomlinson

Donaldson

et al. 2006

Clinical Journal of the American Society of Nephrology

175

174

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Dialysis patients are increasingly older and more disabled. In community-dwelling seniors without kidney disease, falls commonly predict hospitalization, the onset of frailty, and the need for institutional care. Effective fall prevention strategies are available. On the basis of retrospective data, it was hypothesized that the fall rates of older (>65 yr) chronic outpatient hemodialysis (HD) patients would be higher than published rates for community-dwelling seniors (0.6 to 0.8 falls/patientyear). It also was hypothesized that risk factors for falls in dialysis outpatients would include polypharmacy, dialysis-related hypotension, cognitive impairment, and decreased functional status. Using a prospective cohort study design, HD patients who were >65 yr of age at a large academic dialysis unit were recruited. All study participants underwent baseline screening for fall risk factors. Patients were followed prospectively for a minimum of 1 yr. Falls were identified through biweekly patient interviews in the HD unit. A total of 162 patients (mean age 74.7 yr) were recruited; 57% were male. A total of 305 falls occurred in 76 (47%) patients over 190.5 person-years of follow-up (fall-incidence 1.60 falls/person-year). Injuries occurred in 19% of falls; 41 patients had multiple falls. Associated risk factors included age, comorbidity, mean predialysis systolic BP, and a history of falls. In the HD population, the fall risk is higher than in the general community, and fall-related morbidity is high. Better identification of HD patients who are at risk for falls and targeted fall intervention strategies are required.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Falls and Fall-Related Injuries in Older Dialysis Patients

Cook

Tomlinson

Donaldson

et al. 2006

Clinical Journal of the American Society of Nephrology

175

174

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“…46,47 The presence of back, joint, or muscle pain has been found to increase the likelihood of fear of falling reports two to four times, almost double in comparison to the findings from healthy, community-dwelling older adults. 18,45,48 Jamison and colleagues 48 reported that the presence of more intense pain was significantly associated with increased fear of falling in adults with arthritis. The relationship of chronic pain to fall risk is a complex interaction of factors including sleep disturbances, decreased attention, social withdrawal, medication use, functional limitations, gait changes, presence of other chronic conditions, and limitation of activity.…”

Section: Relationship Of Pain and Falls-efficacy To Balance And Walkingmentioning

confidence: 99%

“…First, it is an independent predisposing factor in both reduced physical status (e.g., muscle performance, mobility, balance, and physical activity involvement) [45][46][47] and negative psychosocial effects (e.g., social isolation and depression). 42,44,45 With decreased mobility and increased social isolation, fall-risk factors accumulate. The evidence is clear that increased fear of falling restricts both daily functional activity and recreational activity.…”

Section: Relationship Of Pain and Falls-efficacy To Balance And Walkingmentioning

confidence: 99%

Risk Factors for Falls in Older Adults with Lower Extremity Arthritis: A Conceptual Framework of Current Knowledge and Future Directions

Arnold

Gyurcsik

2012

Physiotherapy Canada

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Purpose: As the numbers of Canadians aged 65 years and over increases over the next 20 years, the prevalence of chronic conditions, including arthritis, will rise as will the number of falls. Although known fall-risk factors are associated with hip and knee osteoarthritis (OA), minimal research has evaluated fall and fracture risk and/or rates in this population. Thus, the purpose was to summarize research on fall and fracture risk in older adults with hip or knee OA and to develop a conceptual framework of fall-risk screening and assessment. Method: The International Classification of Functioning, Disability and Health, clinical practice guidelines for fall-risk screening, and a selected literature review were used. Results: Gaps exist in our knowledge of fall and fracture risk for this population. Muscle performance, balance, and mobility impairments have been identified, but little is known about whether personal and environmental contextual factors impact fall and fracture risk. Physical activity may help to prevent falls, but non-adherence is a problem. Conclusion: A need exists to assess fall risk in older adults with hip and knee OA. Promoting regular physical activity by focusing on disease-and activity-specific personal contextual factors may help direct treatment planning.

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“…17 However, there is growing evidence that fear of falling significantly contributes to activity restriction among older people, which in turn leads to greater disability and loss of independence. 16 Fear of falling has been associated with lower activities of daily living scores, 18 slower gait, 19 use of a walking aid, 19 emotional depression, 18,19 and poor health status. 20 Moreover, fear of falling is greater among those who have experienced a fall 21 and increases with the number of falls experienced.…”

Section: Fear Of Fallingmentioning

confidence: 99%

Maintaining independence after a fall

Spinks

Wasiak

2009

Rev. Clin. Gerontol.

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SummaryFalls have a significant impact upon independent living ability in older people, with fall-related fractures one of the leading predictors of having to move into assisted living facilities. The loss of independence associated with a severe fall is often accompanied by a decline in physical, social, emotional and economic well-being. Rehabilitation programmes to restore functional ability following a fall have a greater chance of success if they adopt a multi-disciplinary approach and, if appropriate, are conducted in the patient's own home. Additional multi-component interventions that improve confidence and reduce the risk of subsequent falls may confer benefits by assisting individuals independently to perform activities of daily living.

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Associations of Demographic, Functional, and Behavioral Characteristics with Activity‐Related Fear of Falling Among Older Adults Transitioning to Frailty

Cited by 243 publications

References 36 publications

Falls and Fall-Related Injuries in Older Dialysis Patients

Falls and Fall-Related Injuries in Older Dialysis Patients

Risk Factors for Falls in Older Adults with Lower Extremity Arthritis: A Conceptual Framework of Current Knowledge and Future Directions

Maintaining independence after a fall

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