Fear of Falling Predicts Incidence of Functional Disability 2 Years Later: A Perspective From an International Cohort Study

Auais, Mohammad; French, Simon; Alvarado, Beatriz; Pirkle, Catherine M; Bélanger, Emmanuelle; Guralnik, Jack M.

doi:10.1093/gerona/glx237

Cited by 53 publications

(44 citation statements)

References 20 publications

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“…With regard to the EQ-VAS, the effect of FoF was partially mediated by disability and completely mediated by function. These findings are not surprising as previous research suggested that FoF is linked to disability and deteriorating function [51,52]. Moreover, the FES-I measures FoF in the context of typical everyday activities.…”

Section: Discussionsupporting

confidence: 65%

Mediating factors on the association between fear of falling and health-related quality of life in community-dwelling German older people: a cross-sectional study

et al. 2020

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Background Previous research has shown that not only falls, but also fear of falling (FoF) influences health-related quality of life (HrQoL) negatively. The EQ-5D (consisting of an index and a visual analogue scale [EQ-VAS]) is a frequently used instrument to determine HrQoL in clinical studies and economic evaluations, but no previous study compared the association between FoF and the EQ-5D index with the association between FoF and the EQ-VAS. Moreover, factors that influence the association between FoF and HrQoL are rarely examined. Thus, this study aimed to examine the association between FoF and HrQoL and to examine factors that mediate the association. Methods FoF (Short Falls Efficacy Scale International) and HrQoL (EQ-5D descriptive system, EQ-5D index, and EQ-VAS) were assessed in a sample of community-dwelling older persons (≥70 years) participating in the baseline assessment of a randomized controlled trial (N = 309). Linear and logistic regression analyses were performed, adjusting for sociodemographic variables, frequency of falls, number of chronic conditions, functional mobility (Timed up-and-go test), and subjective functional capacity (LLFDI function and disability scales). Multiple regression models were used to test the mediating effects. Results Moderate or high FoF was prevalent in 66% of the sample. After adjusting for covariates, FoF was negatively associated with the EQ-5D index, but not with the descriptive system or the EQ-VAS. Subjective functional capacity partly mediated the association between FoF and the EQ-5D index and completely mediated the association between FoF and the EQ-VAS. Conclusion FoF was negatively associated with the EQ-5D index. As subjective functional capacity mediated the association between FoF and HrQoL, future interventions should account for subjective functional capacity in their design.

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Section: Discussionsupporting

confidence: 65%

Mediating factors on the association between fear of falling and health-related quality of life in community-dwelling German older people: a cross-sectional study

et al. 2020

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“…In 2012, 1601 community‐dwelling participants with less than three errors in the orientation section of the LCT scale (aged 64–75 years) from Saint‐Hyacinthe, Canada; Kingston, Canada; Manizales, Colombia; and Natal, Brazil completed the baseline assessment . Participants with poor physical performance at baseline (SPPB score <9) were excluded …”

Section: Methodsmentioning

confidence: 99%

“…The possible total score range is 0–12, with a higher score indicating better function. We operationalized poor physical performance as a score <9 …”

Section: Methodsmentioning

confidence: 99%

Global cognition predicts the incidence of poor physical performance among older adults: A cross‐national study

Dansereau

Hunter

Gómez

et al. 2020

Geriatrics Gerontology Int

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Aim The relationship between physical performance and cognition is well established. However, findings on the relationship between global cognition and the incidence of functional disability has been inconsistent. Using data from the International Mobility in Aging Study, we investigated the relationship between baseline cognitive function and the incidence of poor physical performance 2 years later. Methods A total of 1071 community‐dwelling participants (aged 64–75 years) from four sites in Canada and Latin America, with a Short Physical Performance Battery score ≥9 at baseline (good performance) were included. We carried out two sets of analyses, measuring cognition with either the Leganés Cognitive Test or the Montreal Cognitive Assessment. We used three logistic regression models, controlling for either no confounders, sociodemographic confounders or sociodemographic and health confounders. The full model was also stratified by site. A score <9 on the Short Physical Performance Battery indicated poor physical performance. Results In the fully adjusted model, each 1‐point increase in the baseline Leganés Cognitive Test score (range 0–32) was associated with a 10% decrease in the odds of incidence of poor physical performance at the 2‐year follow‐up (P = 0.019). Likewise, each 1‐point increase in the baseline Montreal Cognitive Assessment score (range 0–30) was associated with a 16% decrease in the odds of developing poor physical performance (P = 0.005). When stratified by site, the results were significant at the Latin American sites (P = 0.02), but not at the Canadian sites (P = 0.08). Conclusions Poor baseline cognition is associated with the incidence of poor physical performance in community‐dwelling older adults. To prevent physical disability, interventions addressing both cognitive and physical performance are required. Geriatr Gerontol Int 2020; ••: ••–••.

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“…Excessive fear of falling can have a major impact on physical performance and lead to poor balance [30,31]. In some older adults with impaired mobility, fear of falling may result in ADLs impairments, depression, and disability [14,15,32,33]. On this basis, our research adds to previous research ndings, recognizing that fear of falling may be more important than previous falls in limiting the daily activities of older adults.…”

Section: Discussionmentioning

confidence: 62%

Fear of Falling is More Important Than Previous Falls in Terms of Limiting Activities: A Longitudinal Study

Liu

Hou

et al. 2020

Preprint

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Background: Fear of falling and previous falls are both risk factors that affect daily activities of older adults. However, it remains unclear whether they independently limit daily activities accounting for each other. This study aims to examine whether previous falls and fear of falling independently predict limited daily activities among older adults.Methods: We used the data from Round 1 to Round 5 of the National Health and Aging Trends Study. We included a total of 866 community-dwelling participants who provided data on previous falls, fear of falling and limited activities from Round 1 to Round 5 and had no limited daily activities at Round 1 in this study. Previous falls and fear of falling were ascertained by asking participants whether they had fallen in the past year and whether they had worried about falling in the last month. Limited daily activities included any difficulties with mobility (e.g., going outside), self-care (e.g., eating), and household activities (e.g., laundering). Generalized estimation equation models were used to examine whether previous falls and fear of falling independently predicted development of limited daily activities adjusting covariates.Results: Participants were mainly between 65 and 79 years old (83%), male (57%), and non-Hispanic White (79%). Among participants who fell in Round 1, 13.2%-27.6%, 29.0%-52.0%, and 18.4%-32.9% developed limitations in mobility, self-care, household activities during Round 2 to Round 4, respectively. Among those who had fear of falling in Round 1, 22.5%-41.3%, 30.0%-55.0%, and 18.8%-36.3% developed limitations in mobility, self-care, and household activities during Round 2 to Round 4, respectively. Fear of falling independently predicted limitations in mobility (Incidence rate ratio [IRR]: 1.86, 95% CI: 1.50, 2.31), self-care (IRR: 1.32, 95% CI: 1.11, 1.62) and household activities (IRR: 1.34, 95% CI: 1.11, 1.62) after adjusting for previous falls and covariates. Previous falls only independently predicted limitations in mobility (IRR: 1.30, 1.08, 1.56) and household activities (IRR: 1.27, 95% CI: 1.05, 1.54) after adjusting fear of falling and covariates. Conclusions: While recognizing the risk factor of previous falls, fear of falling can be a more critical factor to intervene to reduce limited daily activities.

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Fear of Falling Predicts Incidence of Functional Disability 2 Years Later: A Perspective From an International Cohort Study

Abstract: FOF is associated with a higher risk of incident mobility disability and poor physical performance in a cohort of older adults. It is increasingly important to study FOF's effect on functional disability and to take necessary measures to prevent the transition to end-stage disability.

Cited by 53 publications

References 20 publications

Mediating factors on the association between fear of falling and health-related quality of life in community-dwelling German older people: a cross-sectional study

Mediating factors on the association between fear of falling and health-related quality of life in community-dwelling German older people: a cross-sectional study

Global cognition predicts the incidence of poor physical performance among older adults: A cross‐national study

Fear of Falling is More Important Than Previous Falls in Terms of Limiting Activities: A Longitudinal Study

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