Factors Associated With Fear of Falling and Functional Independence in Older Adult Living in an Iranian Nursing Home: A Cross-Sectional Study

Abstract

Background: Fear of falling is common amongst older adults, especially those who live in nursing homes. This study aimed to determinate factors associated with fear of falling and functional independence in older adults living in nursing homes. Methods: This was a cross-sectional study using a convenience sampling method to enroll 200 older adults living in nursing homes from 25 senior centers in Tehran (districts 1 and 2) between September 2015 and November 2015. Main outcome measurement instruments were the 16item falls efficacy scale international (FES-I, Persian version) and 11-item Barthel index (BI) functional independence measure. In this study, variables were analyzed using Student t test and ANOVA. The Pearson coefficient correlation was used to examine the relationship between FES and BBS. A 2-tailed P < 0.05 was considered statistically significant. Results: The participants were mostly female (51.5%) and aged over 70 (mean age 76.89 ± 8.50 y). Of 200 seniors within the study, 60.8% experienced one or more falls during the last year. Statistically significant relationships were found between the fear of falling and functional independence (r =-0.524; P ≤ 0.001). There was a significant relationship between fear of falling and age (P = 0.039), history of falling (P = 0.002), and chronic disease (P = 0.009). In addition, there was a significant relationship between functional independence and some older adults' characteristics, such as gender (P = 0.048), education level (P = 0.028), duration of living in nursing home (P = 0.002), history of falling (P = 0.006), and chronic disease (P = 0.01). Conclusion: According to the findings, there was a high level of fear of falling in the older adults. The fear of falling in the older adults living in nursing homes is associated with age, history of falling, and chronic disease. There was a significant association between functional independence and variables of gender, education level, duration of living in nursing home, history of falling, and chronic disease.

Effects of a Multicomponent Program on Fall Incidence, Fear of Falling, and Quality of Life among Older Adult Nursing Home Residents

“…12) Falling is a serious issue in community-dwelling adults as the resulting psychological consequences may lead to mobility deficits and reduced quality of life. 13) This mental injury results from a fear of falling, which cause social isolation in older adults. 1) Many studies have reported a fear of falling as an essential factor for falls.…”

“…1) Many studies have reported a fear of falling as an essential factor for falls. [12][13][14] Moreover, fear of falling is a crucial factor related to reduced life satisfaction and increased nursing home admission rates. 2,14) Fear of falling or post-fall syndrome is defined as "an ongoing concern about falling and fall-related dangerous complications".…”

“…16) People with a fear of falling have more mobility limitations and a lower quality of life than do others. 12,13,16) As many risk factors for falling are preventable, fall prevention approaches include determining and assessing fall risk factors, removing and reducing fall risk such as modifying the living environment older adults, teaching and changing the lifestyle of older adults with regular exercise programs, following a proper diet and preventing obesity, controlling medications, living in a calm and stress-free environment, and referring to doctors to assess visual status. 17) Coimbra et al 18) conducted a study on interventions for fall prevention in older people, reporting that fall prevention programs should be multicomponent to effectively reduce the fall risk and rate.…”

“… 16 ) People with a fear of falling have more mobility limitations and a lower quality of life than do others. 12 , 13 , 16 )…”

The Effect of Osteoporosis Prevention Empowerment Program on the Self-Efficacy of Iranian Older Adults

“…Low bone mass and loss of bone microarchitecture quality are characteristics of osteoporosis, which leads to higher bone fracture risk. Many people above 65 years are at risk of falling and this rate increases with age (Bastani et al 2016).…”